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Zhang Y, Li X, Wang J, Ma W, Wang H, Wang J, Xu J. Exploring Salivary Iodine Concentration as a Biomarker for Iodine Status and Thyroid Nodules in Females From Different Water Iodine Areas: a Cross-sectional Study. Am J Clin Nutr 2024; 120:162-169. [PMID: 38677523 DOI: 10.1016/j.ajcnut.2024.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 03/24/2024] [Accepted: 04/23/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND It is unclear whether salivary iodine concentration (SIC) can assess iodine status in females from different water iodine regions. OBJECTIVES Through a cross-sectional study, we explored the feasibility of SIC as a biomarker to assess iodine status in females and develop optimal cutoff values. METHODS A total of 1991 females were analyzed in this cross-sectional study from the coastal iodine-deficient areas (CIDAs), inland iodine-deficient areas (IIDAs), iodine-adequate areas (IAAs), iodine-excess areas (IEAs), and iodine extra-high areas (IEHAs). SIC, spot urine iodine concentration (SUIC), and daily total iodine intake (TII) were assessed, and ultrasonography was performed in all subjects. RESULTS There was a positive correlation between SIC and SUIC (r = 0.67; 95% CI: 0.64, 0.69; P < 0.001), and TII (r = 0.47; 95% CI: 0.43, 0.50; P < 0.001). The prevalence of thyroid nodules (TN) showed an upward trend with SIC increasing (Z = -2.83; P-trend = 0.005). The area under the receiver-operating characteristic (ROC) curve for SIC to assess iodine deficiency was 0.62 (95% CI: 0.60, 0.65; P < 0.001) and 0.75 (95% CI: 0.73, 0.77; P < 0.001) for iodine excess. The cutoff values were as follows: SIC < 93.32 μg/L, iodine deficiency; 93.32-224.60 μg/L, iodine adequacy; and >224.60 μg/L, iodine excess. When SIC > 224.60 μg/L, the odds ratio (OR) for UIC > 300 μg/L, excessive TII, and the prevalence of TN were 6.44, 3.68, and 1.27 (95% CI: 4.98, 8.31; 2.83, 4.79; and 1.02, 1.56, respectively; P < 0.05); when SIC < 93.32 μg/L, the OR for UIC < 100 μg/L and insufficient TII were 2.34 and 1.94 (95% CI: 1.73, 3.14 and 1.33, 2.83, respectively; P < 0.05). CONCLUSIONS Using SIC as a biomarker, females in CIDA exhibited mild iodine deficiency, those in IIDA and IAA demonstrated moderate iodine deficiency, and those in IEA and IEHA exhibited an excess of iodine, consistent with SUIC to assess iodine status. SIC can be used as a good biomarker to evaluate the iodine status in population.
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Affiliation(s)
- Ying Zhang
- Key Laboratory of Public Nutrition and Health, National Health Commission of the Peoples' Republic of China, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiuwei Li
- Key Laboratory of Public Nutrition and Health, National Health Commission of the Peoples' Republic of China, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jianqiang Wang
- Key Laboratory of Public Nutrition and Health, National Health Commission of the Peoples' Republic of China, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wei Ma
- Key Laboratory of Public Nutrition and Health, National Health Commission of the Peoples' Republic of China, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Haiyan Wang
- Key Laboratory of Public Nutrition and Health, National Health Commission of the Peoples' Republic of China, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jinpeng Wang
- Key Laboratory of Public Nutrition and Health, National Health Commission of the Peoples' Republic of China, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jing Xu
- Key Laboratory of Public Nutrition and Health, National Health Commission of the Peoples' Republic of China, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China.
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Li S, Guo W, Jin Q, Meng Q, Yang R, Zhang H, Fu M, Wang T, Liu D, Meng X, Zhang W. Salivary iodine concentration in pregnant women and its association with iodine status and thyroid function. Eur J Nutr 2024; 63:1139-1149. [PMID: 38355932 DOI: 10.1007/s00394-024-03332-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 01/25/2024] [Indexed: 02/16/2024]
Abstract
PURPOSE There have been no reports on the application of salivary iodine concentration (SIC) in evaluating iodine nutrition in pregnant women. This study aimed to clarify the relationship between SIC and indicators of iodine nutritional status and thyroid function during pregnancy, to investigate whether salivary iodine can be applied to the evaluation of iodine nutritional status in pregnant women, and to provide a reference basis for establishing a normal range of salivary iodine values during pregnancy. METHODS Pregnant women were enrolled in the Department of Obstetrics, the people's hospital of Yuncheng Country, Shandong Province, from July 2021 to December 2022, using random cluster sampling. Saliva, urine, and blood samples were collected from pregnant women to assess iodine nutritional status, and venous blood was collected to determine thyroid function. RESULTS A total of 609 pregnant women were included in this study. The median spot urinary iodine concentration (SUIC) was 261 μg/L. The median SIC was 297 μg/L. SIC was positively correlated with SUIC (r = 0.46, P < 0.0001), 24-h UIC (r = 0.30, P < 0.0001), 24-h urinary iodine excretion (24-h UIE) (r = 0.41, P < 0.0001), and estimated iodine intake (EII) (r = 0.52, P < 0.0001). After adjusting for confounders, there was a weak correlation between SIC and serum total iodine and serum non-protein-bound iodine (P = 0.02, P = 0.04, respectively). Pregnant women with a SIC < 176 μg/L had a higher risk of insufficient iodine status (OR = 2.07, 95% CI 1.35-3.19) and thyroid dysfunction (OR = 2.71, 95% CI 1.18-6.21) compared to those with higher SIC. Those having SIC > 529 μg/L were more likely to have excessive iodine status (OR = 2.82, 95% CI 1.81-4.38) and thyroid dysfunction (OR = 3.04, 95% CI 1.36-6.78) than those with lower SIC values. CONCLUSION SIC is associated with urinary iodine concentration and thyroid function in pregnant women. SIC < 176 μg/L was associated with an increased risk for iodine deficiency and hypothyroxinemia, while SIC > 529 μg/L was related to excess and thyrotoxicosis. SIC can be used as a reference indicator for evaluating the iodine nutrition status of pregnant women, but it needs further investigation and verification. TRIAL REGISTRATION NCT04492657(Aug 9, 2022).
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Affiliation(s)
- Shaohan Li
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Wenxing Guo
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Qi Jin
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Qi Meng
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Rui Yang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Hexi Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Min Fu
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Ting Wang
- Department of Obstetrics, Yuncheng County People's Hospital, Yuncheng, 274700, China
| | - Denghai Liu
- Department of Clinical Laboratory, Yuncheng County People's Hospital, Yuncheng, 274700, China
| | - Xianglu Meng
- Department of Clinical Laboratory, Yuncheng County People's Hospital, Yuncheng, 274700, China
| | - Wanqi Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, 300070, China.
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, 300052, China.
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, 300070, China.
- Tianjin Key Laboratory of Hormones and Development (Ministry of Health), Tianjin, 300384, China.
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Alsaeedi EE, Rose P, Welham SJM. Salivary iodide status as a measure of whole body iodine homoeostasis? Br J Nutr 2024; 131:1740-1753. [PMID: 38287697 PMCID: PMC11063662 DOI: 10.1017/s000711452400031x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 01/09/2024] [Accepted: 01/23/2024] [Indexed: 01/31/2024]
Abstract
Iodine is a trace element required to produce the thyroid hormones, which are critical for development, growth and metabolism. To ensure appropriate population iodine nutrition, convenient and accurate methods of monitoring are necessary. Current methods for determining iodine status either involve a significant participant burden or are subject to considerable intra-individual variation. The continuous secretion of iodide in saliva potentially permits its use as a convenient, non-invasive assessment of status in populations. To assess its likely effectiveness, we reviewed studies analysing the association between salivary iodide concentration (SIC) and dietary iodine intake, urinary iodide concentration (UIC) and/or 24-h urinary iodide excretion (UIE). Eight studies conducted in different countries met the inclusion criteria, including data for 921 subjects: 702 healthy participants and 219 with health conditions. SIC correlated positively with UIC and/or UIE in four studies, with the strength of relationship ranging from r = 0·19 to r = 0·90 depending on sampling protocol, age, and if salivary values were corrected for protein concentration. Additionally, SIC positively correlated with dietary intake, being strongest when saliva was collected after dinner. SIC varied with external factors, including thyroid function, use of some medications, smoking and overall health status. Evidence provided here supports the use of SIC as a viable, low-burden method for determining iodine status in populations. However, small sample sizes and high variability indicates the need for more extensive analyses across age groups, ethnicities, disease states and dietary groups to clarify the relative accuracy and reliability in each case and standardise procedure.
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Affiliation(s)
- Eatedal Eenizan Alsaeedi
- University of Nottingham, School of Biosciences, Division of Food, Nutrition & Dietetics, Loughborough, LeicestershireLE12 5RD, UK
- University of Hafr Al Batin, College of Applied Medical Sciences, Division of Clinical Nutrition, Hafr Al Batin, Saudi Arabia
| | - Peter Rose
- University of Nottingham, School of Biosciences, Division of Food, Nutrition & Dietetics, Loughborough, LeicestershireLE12 5RD, UK
| | - Simon J. M. Welham
- University of Nottingham, School of Biosciences, Division of Food, Nutrition & Dietetics, Loughborough, LeicestershireLE12 5RD, UK
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Mortazavi H, Yousefi-Koma AA, Yousefi-Koma H. Extensive comparison of salivary collection, transportation, preparation, and storage methods: a systematic review. BMC Oral Health 2024; 24:168. [PMID: 38308289 PMCID: PMC10837873 DOI: 10.1186/s12903-024-03902-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 01/16/2024] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND Human saliva as a bodily fluid-similar to blood-is utilized for diagnostic purposes. Unlike blood sampling, collecting saliva is non-invasive, inexpensive, and readily accessible. There are no previously published systematic reviews regarding different collection, transportation, preparation, and storage methods for human saliva. DESIGN This study has been prepared and organized according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) 2020 guidelines. This systematic review has been registered at PROSPERO (Registration ID: CRD42023415384). The study question according to the PICO format was as followed: Comparison of the performance (C) of different saliva sampling, handling, transportation, and storage techniques and methods (I) assessed for analyzing stimulated or unstimulated human saliva (P and O). An electronic search was executed in Scopus, Google Scholar, and PubMed. RESULTS Twenty-three descriptive human clinical studies published between 1995 and 2022 were included. Eight categories of salivary features and biomarkers were investigated (i.e., salivary flow rate, total saliva quantity, total protein, cortisol, testosterone, DNA quality and quantity, pH and buffering pH). Twenty-two saliva sampling methods/devices were utilized. Passive drooling, Salivette®, and spitting were the most utilized methods. Sampling times with optimum capabilities for cortisol, iodine, and oral cancer metabolites are suggested to be 7:30 AM to 9:00 AM, 10:30 AM to 11:00 AM, and 14:00 PM to 20:00 PM, respectively. There were 6 storage methods. Centrifuging samples and storing them at -70 °C to -80 °C was the most utilized storage method. For DNA quantity and quality, analyzing samples immediately after collection without centrifuging or storage, outperformed centrifuging samples and storing them at -70 °C to -80 °C. Non-coated Salivette® was the most successful method/device for analyzing salivary flow rate. CONCLUSION It is highly suggested that scientists take aid from the reported categorized outcomes, and design their study questions based on the current voids for each method/device.
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Affiliation(s)
- Hamed Mortazavi
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Daneshjoo Blvd, Evin, Shahid Chamran Highway, Tehran, 1983963113, Iran
| | - Amir-Ali Yousefi-Koma
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Daneshjoo Blvd, Evin, Shahid Chamran Highway, Tehran, 1983963113, Iran.
- Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Savinov SS, Drobyshev AI. Determination of Trace Elements in Biological Fluids by Arc Atomic Emission Spectrometry. JOURNAL OF ANALYTICAL CHEMISTRY 2022. [DOI: 10.1134/s1061934822010129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Dekker BL, Touw DJ, van der Horst-Schrivers ANA, Vos MJ, Links TP, Dijck-Brouwer DAJ, Kobold ACM. Use of Salivary Iodine Concentrations to Estimate the Iodine Status of Adults in Clinical Practice. J Nutr 2021; 151:3671-3677. [PMID: 34587258 PMCID: PMC8643657 DOI: 10.1093/jn/nxab303] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 07/22/2021] [Accepted: 08/12/2021] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Measurement of the 24-h urinary iodine concentration or urinary iodine excretion (UIE) is the gold standard to determine iodine status; however, this method is inconvenient. The use of salivary iodine could be a possible alternative since salivary glands express the sodium-iodine symporter. OBJECTIVES We aimed to establish the correlation between the salivary iodine secretion and UIE, to evaluate the clinical applicability of the iodine saliva measurement. METHODS We collected 24-h urine and saliva samples from 40 participants ≥18 y: 20 healthy volunteers with no specific diet (group 1), 10 patients with differentiated thyroid cancer with a low dietary intake (<50 μg/d, group 2), and 10 patients with a high iodine status as the result of the use of amiodarone (group 3). Urinary and salivary iodine were measured using a validated inductively coupled plasma MS method. To correct for differences in water content, the salivary iodine concentration (SIC) was corrected for salivary protein and urea concentrations (SI/SP and SI/SU, respectively). The intra- and inter-individual CVs were calculated, and the Kruskal-Wallis test and Spearman's correlation were used. RESULTS The intra-individual CVs for SIC, SI/SP, and SI/SU were 63.8%, 37.7%, and 26.9%, respectively. The inter-individual CVs for SIC, SI/SP, and SI/SU were 77.5%, 41.6% and 47.0%, respectively. We found significant differences (P < 0.01) in urinary and salivary iodine concentrations between all groups [the 24-h UIE values were 176 μg/d (IQR, 96.1-213 μg/d), 26.0 μg/d (IQR, 22.0-37.0 μg/d), and 10.0*103 μg/d (IQR, 7.57*103-11.4*103 μg/d) in groups 1-3, respectively; the SIC values were 136 μg/L (IQR, 86.3-308 μg/L), 71.5 μg/L (IQR, 29.5-94.5 μg/L), and 14.3*103 μg/L (IQR, 10.6*103-25.6*103 μg/L) in groups 1-3, respectively]. Correlations between the 24-h UIE and SIC, SI/SP, and SI/SU values were strong (ρ = 0.80, ρ = 0.90, and ρ = 0.86, respectively; P < 0.01). CONCLUSIONS Strong correlations were found between salivary and urinary iodine in adults with different daily iodine intakes. A salivary iodine measurement can be performed to assess the total iodine body pool, with the recommendation to correct for salivary protein or urea.
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Affiliation(s)
- Bernadette L Dekker
- Internal Medicine, Department of Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Daan J Touw
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Anouk N A van der Horst-Schrivers
- Internal Medicine, Department of Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Internal Medicine, Division of Endocrinology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Michel J Vos
- Department of Laboratory Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Thera P Links
- Internal Medicine, Department of Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - D A Janneke Dijck-Brouwer
- Department of Laboratory Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Anneke C Muller Kobold
- Department of Laboratory Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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