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Sohn SY, Inoue K, Rhee CM, Leung AM. Risks of Iodine Excess. Endocr Rev 2024:bnae019. [PMID: 38870258 DOI: 10.1210/endrev/bnae019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 06/04/2024] [Accepted: 06/12/2024] [Indexed: 06/15/2024]
Abstract
Iodine is a micronutrient that is required for thyroid hormone synthesis. The iodide cycle in thyroid hormone synthesis consists of a series of transport, oxidation, organification, and binding/coupling steps in thyroid follicular cells. Common sources of iodine include the consumption of an iodine-rich diet or iodine fortified foods, the administration of amiodarone, iodine-containing supplements, or iodinated contrast media, and other miscellaneous sources. Methods to assess population iodine status include the measurement of urinary iodine concentrations, blood thyroglobulin levels, prevalence of elevated neonatal TSH levels, and thyroid volume. Although excessive iodine intake or exposure is generally well tolerated, an acute iodine load may result in thyroid dysfunction (hypothyroidism or hyperthyroidism) in certain susceptible individuals due to the failure to escape from the Wolff-Chaikoff effect and to the Jod-Basedow phenomenon, respectively. In this review, we discuss the associations between excessive iodine intake or exposure, with particular focus on iodinated contrast media as a common source of excess iodine in healthcare settings, and risks of incident thyroid dysfunction. We also summarize the risks of iodine excess in vulnerable populations and review current guidelines regarding the screening and monitoring of iodinated contrast-induced thyroid dysfunction. Finally, we discuss the long-term potential nonthyroidal health risks associated with iodine excess and suggest the need for more data to define safe upper limits for iodine intake, particularly in high-risk populations.
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Affiliation(s)
- Seo Young Sohn
- Division of Endocrinology, Department of Internal Medicine, Myongji Hospital, Hanyang University College of Medicine, Goyang, South Korea
| | - Kosuke Inoue
- Department of Social Epidemiology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Hakubi Center, Kyoto University, Kyoto, Japan
| | - Connie M Rhee
- Division of Nephrology, Department of Medicine, Department of Medicine, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USA
- Division of Nephrology, Department of Medicine, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, USA
| | - Angela M Leung
- Division of Endocrinology, Diabetes, and Metabolism; Department of Medicine, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USA
- Division of Endocrinology, Diabetes, and Metabolism; Department of Medicine, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, USA
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Doh H, Lee MH. Total Iodine Quantification and In Vitro Bioavailability Study in Abalone ( Haliotis discus hannai) Using Inductively Coupled Plasma Mass Spectrometry. Foods 2024; 13:1400. [PMID: 38731770 PMCID: PMC11083789 DOI: 10.3390/foods13091400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 04/24/2024] [Accepted: 04/26/2024] [Indexed: 05/13/2024] Open
Abstract
The aim of this study is to determine the total iodine content in Korean abalone (Haliotis discus hannai) and to investigate the bioavailability of iodine using an in vitro method. This research paper focuses on total iodine quantification in abalone (Haliotis discus hannai) and its components (viscera and muscle) using inductively coupled plasma mass spectrometry (ICP-MS). Additionally, an in vitro bioavailability study explored iodine absorption potential. Abalone pretreatment involved both the European standard method (ES) and microwave-assisted extraction method (MAE). The limits of detection (LOD) were 0.11 ng/g for both ES and MAE, with a limit of quantification (LOQ) of 5.4 ng/g for MAE. Accuracy, assessed using a reference material (fish muscle, ERM-BB422), showed values of 1.5 ± 0.010 mg/kg for ES and 1.6 ± 0.066 mg/kg for MAE, within an acceptable range of 1.4 ± 0.42 mg/kg. Precision, evaluated using the Horwitz ratio (HorRat) with a reference material, was determined to be 0.45 for ES and 0.27 for MAE. Therefore, total iodine contents were estimated as 74 ± 2.2 µg/g for abalone viscera and 17 ± 0.77 µg/g for abalone muscle with ES, and 76 ± 1.0 µg/g for abalone viscera and 17 ± 0.51 µg/g for abalone muscle with MAE. Recovery tests demonstrated an acceptable range of 90-110%. In the in vitro bioavailability assessment, digestion efficiency yielded ranges of 42-50.2% for viscera and 67-115% for muscle. Absorption efficiency variations were determined as 37-43% for viscera and 48-75% for muscle.
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Affiliation(s)
- Hansol Doh
- Department of Food Science and Biotechnology, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Republic of Korea;
| | - Min Hyeock Lee
- Department of Biotechnology, College of Life Sciences and Biotechnology, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul 02841, Republic of Korea
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Guzman DC, Brizuela NO, Peraza AV, Herrera MO, Mejia GB, Juarez Olguin H. Post COVID-19 Vertigo in a Patient with Hypothyroidism: A Case Report. Diabetes Metab Syndr Obes 2024; 17:1845-1851. [PMID: 38706809 PMCID: PMC11069111 DOI: 10.2147/dmso.s459711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 04/12/2024] [Indexed: 05/07/2024] Open
Abstract
Case Summary Female nurse, 44-years-old with a weight of 127 pounds. She attended our emergency clinic for an urgent care due to post COVID-19 vertigo and anxiety. Her problem began with severe, short-lived attacks of objective-circular type vertigo, accompanied by nausea and vomiting. The symptoms occurred when she assumed a lying position, turn right and sat or stood upright. Interventions The patient received medical prescription for hypothyroidism, vertigo and anxiety symptoms. Oral route feeding was started and was well tolerated. Outcomes The patient showed good evolution with the treatment. Currently, she is at home with daily intake of levothyroxine and losartan without complications. Conclusion The clinical case suggests that in patients with hypothyroidism, COVID-19 infection may trigger and exacerbate vertigo and anxiety.
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Affiliation(s)
- David Calderon Guzman
- Laboratory of Neurosciences. Instituto Nacional de Pediatria (INP), Mexico City, Mexico
| | - Norma Osnaya Brizuela
- Laboratory of Neurosciences. Instituto Nacional de Pediatria (INP), Mexico City, Mexico
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Abstract
Background: Previous observational epidemiological studies such as case-control studies and cohort studies have reported inconsistent results regarding the associations between seafood intake and the risk of thyroid cancer. Materials and methods: We searched PubMed and EMBASE in August 2021 using keywords related to seafood intake and thyroid cancer. A pooled odds ratio (OR) or relative risk (RR) with its 95% confidence interval (CI) was calculated. Results: We included 17 observational studies with 13 case-control studies and 4 cohort studies, which included 4,309 thyroid cancer patients among 599,161 participants. In the random effects model meta-analysis of all 17 studies, we found that there was no significant association between seafood intake (highest vs. lowest intake) and the risk of thyroid cancer (OR or RR, 1.01; 95% CI: 0.86 to 1.19; I2=51.4%). Although the associations were not statistically significant, subgroup meta-analyses by study design showed opposite findings: seafood intake decreased the risk of thyroid cancer in case-control studies (OR or RR, 0.94; 95% CI: 0.74 to 1.19; I2=60.6%; n=13) but increased in cohort studies (OR or RR, 1.14; 95% CI: 0.97 to 1.35; I2=0.0%; n=4). Conclusion: The current meta-analysis of observational epidemiological studies found that that overall, there was no significant association between seafood intake and the risk of thyroid cancer. However, given that cohort studies give us a higher level of evidence than case-control studies, further prospective cohort studies are warranted to confirm the association between them.
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Affiliation(s)
- Seung-Hee Hong
- Food and Nutrition Major, Division of Food Science and Culinary Arts, Shinhan University, Uijeongbu, Republic of Korea
| | - Seung-Kwon Myung
- Department of Cancer AI & Digital Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Republic of Korea
- Cancer Epidemiology Branch, Division of Cancer Data Science, National Cancer Center Research Institute, Goyang, Republic of Korea
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Gao R, Lyu X, Yang Y, Fu J, Zhao C, Guan H, Ma X. Evaluating the progression to abnormal thyrotropin in euthyroid preconception women: a population-based study. Thyroid Res 2024; 17:5. [PMID: 38462616 PMCID: PMC10926655 DOI: 10.1186/s13044-024-00192-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 01/22/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND Abnormal preconception thyrotropin levels were associated with fecundability and adverse fetomaternal outcomes, however, little is known regarding the natural change of serum thyrotropin in euthyroid preconception women. Thus, we performed a population-based study to evaluate the progression to abnormal thyrotropin in euthyroid preconception women. METHODS This retrospective cohort study used data from the National Free Prepregnancy Checkups Project (NFPCP) collected between 2010 and 2020. Female Han Chinese participants aged 20-49 years who had two repeated NFPCP participations with a time interval of 1.5-3.0 years, confirmed non-pregnant status within this duration, and normal thyrotropin levels during their first participation were included for the analysis of thyrotropin abnormalities during the second NFPCP examination. Data were analyzed between June 1 and October 1, 2023. RESULTS This study included 186,095 euthyroid women of reproductive age (mean ± SD, 26.72 ± 4.70 years) whose preconception thyrotropin levels were between 0.37 and 4.87 mIU/L. The median follow-up time was 2.13 (IQR, 1.85-2.54) years. A total of 8,497 (4.57%) women developed abnormal thyrotropin, including 4,118 (2.21%) subnormal thyrotropin and 4,379 (2.35%) supranormal thyrotropin. Compared with the reference group (thyrotropin 1.01-2.00 mIU/L), the lower baseline thyrotropin group had greater risk of developing subnormal thyrotropin, and the higher baseline thyrotropin group had greater risk of developing supranormal thyrotropin. Moreover, the restricted cubic spline analysis revealed a U-shaped dose-response association of baseline thyrotropin levels or thyrotropin multiples of the median (MOM) levels against risk of subnormal thyrotropin in the follow-up, and a J-shaped dose-response association against risk of supranormal thyrotropin levels in the follow-up. We further found that baseline thyrotropin outside of 1.43-1.93 mIU/L or baseline thyrotropin MOM outside 0.59-1.36 would hava a higher risk of developing of abnormal thyrotropin. CONCLUSIONS Both low and high baseline thyrotropin were associated with a significantly increased risk of developing abnormal thyrotropin outcomes. The optimal preconception baseline thyrotropin levels may be between 1.43 mIU/L and 1.93 mIU/L or baseline thyrotropin MoM between 0.59 and 1.36 to minimize progression toward abnormal thyrotropin after 1.5-3.0 years. These findings may help with counseling of preconception thyroid function monitoring.
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Affiliation(s)
- Rili Gao
- Department of Endocrinology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Xinyi Lyu
- National Research Institute for Family Planning, Beijing, China
- National Human Genetic Resources Center, Beijing, China
- Graduate School of Peking Union Medical College, Beijing, China
| | - Ying Yang
- National Research Institute for Family Planning, Beijing, China
- National Human Genetic Resources Center, Beijing, China
- Graduate School of Peking Union Medical College, Beijing, China
| | - Jinrong Fu
- Department of Endocrinology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Chuanyu Zhao
- National Research Institute for Family Planning, Beijing, China
- National Human Genetic Resources Center, Beijing, China
- Graduate School of Peking Union Medical College, Beijing, China
| | - Haixia Guan
- Department of Endocrinology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
| | - Xu Ma
- National Research Institute for Family Planning, Beijing, China.
- National Human Genetic Resources Center, Beijing, China.
- Graduate School of Peking Union Medical College, Beijing, China.
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Lin Z, Lu C, Teng D, Sun Y, Liu T, Li Y, Shan Z, Teng W. Influencing Factors and New Reference Intervals of Adult Thyroid Volume in Iodine-Sufficient Areas of China. Biol Trace Elem Res 2023; 201:5652-5661. [PMID: 37121984 PMCID: PMC10620313 DOI: 10.1007/s12011-023-03635-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 03/15/2023] [Indexed: 05/02/2023]
Abstract
The diagnosis of goiter is based on the thyroid volume measured by ultrasound in which iodine plays an important role. The purpose of this study was to evaluate the factors that affect thyroid volume and update the reference range of thyroid volume to provide a new basis for the diagnosis and treatment of goiter. A study population from mainland China was evaluated in the Thyroid disorders, Iodine status and Diabetes Epidemiological (TIDE) study. Thyroid size was measured by ultrasound, and thyroid volume was calculated. A quantile regression model was used to analyze the influence of related factors on the thyroid volume at each percentile. The median urinary iodine concentration (UIC) was 185.54 μg/l. The quantile regression model suggested that body surface area (BSA) and thyroid-stimulating hormone (TSH) were positive and negative factors for thyroid volume, respectively (p < 0.01). Excess iodine reduces the median and lower limits of thyroid volume. In iodine-sufficient areas, smoking is no longer a risk factor. The reference value range of thyroid volume stratified by sex was 3.92-19.06 ml for males and 3.1-16.17 ml for females. The maximum reference ranges for stratification by sex and BSA were 4.25-20.98 ml for men and 3.44-18.31 ml for women. The iodine nutrition level of the population in mainland China is sufficient. Iodine has the potential to alter the effect of certain factors on thyroid volume and effect is not regional. The new reference interval of adult thyroid volume based on sex and BSA has been updated, which can be used as a reliable reference for updating the diagnostic criteria of endemic goiter.
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Affiliation(s)
- Zheyu Lin
- Department of Endocrinology and Metabolism and the Institute of Endocrinology, The NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China, 110001
- Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, 110001, People's Republic of China
| | - Cihang Lu
- Department of Endocrinology and Metabolism and the Institute of Endocrinology, The NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China, 110001
- Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, 110001, People's Republic of China
| | - Di Teng
- Department of Endocrinology and Metabolism and the Institute of Endocrinology, The NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China, 110001.
- Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, 110001, People's Republic of China.
| | - Ying Sun
- Department of Endocrinology and Metabolism and the Institute of Endocrinology, The NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China, 110001
- Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, 110001, People's Republic of China
| | - Tingting Liu
- Department of Endocrinology and Metabolism and the Institute of Endocrinology, The NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China, 110001
- Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, 110001, People's Republic of China
| | - Yongze Li
- Department of Endocrinology and Metabolism and the Institute of Endocrinology, The NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China, 110001
- Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, 110001, People's Republic of China
| | - Zhongyan Shan
- Department of Endocrinology and Metabolism and the Institute of Endocrinology, The NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China, 110001
- Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, 110001, People's Republic of China
| | - Weiping Teng
- Department of Endocrinology and Metabolism and the Institute of Endocrinology, The NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China, 110001
- Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, 110001, People's Republic of China
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Chelyadina NS, Kapranov SV, Popov MA, Smirnova LL, Bobko NI. The mussel Mytilus galloprovincialis (Crimea, Black Sea) as a source of essential trace elements in human nutrition. Biol Trace Elem Res 2023; 201:5415-5430. [PMID: 36881258 DOI: 10.1007/s12011-023-03607-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 02/23/2023] [Indexed: 03/08/2023]
Abstract
Micronutrients, or essential trace elements, are important components in various metabolic processes inherent to the normal functioning of organism. To date, a substantial part of the world population suffers from a lack of micronutrients in the diet. Mussels are an important and cheap source of nutrients, which can be utilized to mitigate the micronutrient deficiency in the world. In the present work, using inductively coupled plasma mass spectrometry, the contents of the micronutrients Cr, Fe, Cu, Zn, Se, I, and Mo were studied for the first time in soft tissues, shell liquor, and byssus of females and males of the mussel Mytilus galloprovincialis as the promising sources of essential elements in the human diet. Fe, Zn, and I were the most abundant micronutrients in the three body parts. Significant sex-related differences in the body parts were detected only for Fe, which was more abundant in byssus of males, and Zn, which exhibited higher levels in shell liquor of females. Significant tissue-related differences were registered in the contents of all the elements under study. M. galloprovincialis meat was characterized as the optimal source of I and Se for covering the daily human needs. Regardless of sex, byssus turned out to be richer in Fe, I, Cu, Cr, and Mo in comparison with soft tissues, which fact allows recommending this body part for the preparation of dietary supplements to compensate for the deficiency of these micronutrients in the human body.
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Affiliation(s)
- Natalya S Chelyadina
- A.O. Kovalevsky Institute of Biology of the Southern Seas of RAS, 2 Nakhimov ave., 299011, Sevastopol, Russian Federation.
| | - Sergey V Kapranov
- A.O. Kovalevsky Institute of Biology of the Southern Seas of RAS, 2 Nakhimov ave., 299011, Sevastopol, Russian Federation
| | - Mark A Popov
- A.O. Kovalevsky Institute of Biology of the Southern Seas of RAS, 2 Nakhimov ave., 299011, Sevastopol, Russian Federation
| | - Lyudmila L Smirnova
- Institute of Natural and Technical Systems of RAS, Lenin str. 28, Sevastopol, Russian Federation, 299011
| | - Nikolay I Bobko
- A.O. Kovalevsky Institute of Biology of the Southern Seas of RAS, 2 Nakhimov ave., 299011, Sevastopol, Russian Federation
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Gong B, Wang X, Wang C, Yang W, Shan Z, Lai Y. Iodine-induced thyroid dysfunction: a scientometric study and visualization analysis. Front Endocrinol (Lausanne) 2023; 14:1239038. [PMID: 37800143 PMCID: PMC10548383 DOI: 10.3389/fendo.2023.1239038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 09/05/2023] [Indexed: 10/07/2023] Open
Abstract
Objective Iodine is essential in thyroid hormone production. Iodine deficiency is associated with serious complications (i.e miscarriage and stillbirth), whereas excess can cause thyroid dysfunction (i.e hyperthyroidism, hypothyroidism, thyroid autoimmunity). We conducted this scientometric study to visualize hot spots and trends in iodine-induced thyroid dysfunction over past two decades. The aim of this paper was to help scholars quickly understand the development and potential trend in this field, and guide future research directions. Methods Articles on iodine-induced thyroid dysfunction from 2000 to 2022 were retrieved from the Web of Science Core Collection (WoSCC) using the following search terms: (((((TS=(hypothyroid*)) OR TS=(hyperthyroid*)) OR TS= ("TSH deficiency")) OR TS= ("thyroid stimulating hormone deficiency")) AND TS=(Iodine)) NOT TS=(radioiodine). Only publications in English were selected. CiteSpace, VOSviewer, Tableau, Carrot2, and R software were used to analyze the contribution and co-occurrence relationships of different countries, institutes, keywords, references, and journals. Results A total of 2986 publications from 115 countries and 3412 research institutions were included. From 2000 to 2022, research on iodine-induced thyroid dysfunction progressed over a three-stage development period: initial development (2000-2009), stable development (2010-2016), and rapid development (2016-2022) period. The Journal of Clinical Endocrinology and Metabolism had the most co-citations followed and China Medical University (n=76) had the most publications. The top three clusters of co-citation references were isolated maternal hypothyroxinemia, subclinical hyperthyroidism, and brain development. Various scientific methods were applied to reveal acknowledge structure, development trend and research hotspots in iodine-induced thyroid dysfunction. Conclusion Our scientometric analysis shows that investigations related to pregnant women, epidemiology surveys, and iodine deficiency are promising topics for future iodine-induced thyroid dysfunction research and highlights the important role of iodine on thyroid function.
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Affiliation(s)
| | | | | | | | - Zhongyan Shan
- Department of Endocrinology and Metabolism, Institute of Endocrinology, National Health Council (NHC) Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yaxin Lai
- Department of Endocrinology and Metabolism, Institute of Endocrinology, National Health Council (NHC) Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
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Manso J, Piva I, Censi S, Clausi C, Bardi M, Schiavon B, Merante Boschin I, Tona F, Mian C. Safety and efficacy of prophylactic treatment for hyperthyroidism induced by iodinated contrast media in a high-risk population. Front Endocrinol (Lausanne) 2023; 14:1154251. [PMID: 37255974 PMCID: PMC10225693 DOI: 10.3389/fendo.2023.1154251] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 04/27/2023] [Indexed: 06/01/2023] Open
Abstract
Introduction The use of iodinated contrast media (ICM) can lead to thyrotoxicosis, especially in patients with risk factors, such as Graves' disease, multinodular goiter, older age, and iodine deficiency. Although hyperthyroidism may have clinically relevant effects, whether high-risk patients should receive prophylactic treatment before they are administered ICM is still debated. Aim of the study We aimed to demonstrate the safety and efficacy of prophylactic treatment with sodium perchlorate and/or methimazole to prevent ICM-induced hyperthyroidism (ICMIH) in a population of high-risk cardiac patients. We ran a cost analysis to ascertain the most cost-effective prophylactic treatment protocol. We also aimed to identify possible risk factors for the onset of ICMIH. Materials and methods We performed a longitudinal retrospective study on 61 patients admitted to a tertiary-level cardiology unit for diagnostic and/or therapeutic ICM-procedures. We included patients with available records of thyroid function tests performed before and after ICM were administered, who were at high risk of developing ICMIH. Patients were given one of two different prophylactic treatments (methimazole alone or both methimazole and sodium perchlorate) or no prophylactic treatment. The difference between their thyroid function at the baseline and 11-30 days after the ICM-related procedure was considered the principal endpoint. Results Twenty-three (38%) of the 61 patients were given a prophylactic treatment. Thyroid function deteriorated after the administration of ICM in 9/61 patients (15%). These cases were associated with higher plasma creatinine levels at admission, higher baseline TSH levels, lower baseline FT4 levels, and no use of prophylactic treatment. The type of prophylaxis provided did not influence any onset of ICMIH. A cost-benefit analysis showed that prophylactic treatment with methimazole alone was less costly per person than the combination protocol. On multivariate analysis, only the use of a prophylactic treatment was independently associated with a reduction in the risk of ICMIH. Patients not given any prophylactic treatment had a nearly five-fold higher relative risk of developing ICMIH. Conclusion Prophylactic treatment can prevent the onset of ICMIH in high-risk populations administered ICM. Prophylaxis is safe and effective in this setting, especially in cardiopathic patients. Prophylaxis with methimazole alone seems to be the most cost-effective option.
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Affiliation(s)
- Jacopo Manso
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
- Pediatric Endocrinology Unit, Department of Women’s and Children’s Health, Padua University Hospital, Padova, Italy
| | - Ilaria Piva
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Simona Censi
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Cristina Clausi
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Maria Bardi
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Benedetta Schiavon
- Cardiology Unit, Department of Cardiac, Thoracic and Vascular Sciences, Padua University Hospital, Padua, Italy
| | - Isabella Merante Boschin
- Department of Surgical, Oncological, and Gastroenterological Sciences, University of Padova, Padova, Italy
| | - Francesco Tona
- Cardiology Unit, Department of Cardiac, Thoracic and Vascular Sciences, Padua University Hospital, Padua, Italy
| | - Caterina Mian
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
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Mathews DM, Peart JM, Sim RG, Johnson NP, O'Sullivan S, Derraik JGB, Hofman PL. The SELFI Study: Iodine Excess and Thyroid Dysfunction in Women Undergoing Oil-Soluble Contrast Hysterosalpingography. J Clin Endocrinol Metab 2022; 107:3252-3260. [PMID: 36124847 PMCID: PMC9693785 DOI: 10.1210/clinem/dgac546] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Indexed: 11/19/2022]
Abstract
CONTEXT Hysterosalpingography (HSG) with oil-soluble contrast medium (OSCM) improves pregnancy rates. However, OSCM has high iodine content and long half-life, leading to potential iodine excess. OBJECTIVE This work aimed to determine the pattern of iodine excess after OSCM HSG and the effect on thyroid function. METHODS A prospective cohort study was conducted of 196 consecutive consenting eligible women without overt hypothyroidism or hyperthyroidism. All completed the study with compliance greater than 95%. Participants underwent OSCM HSG (Auckland, 2019-2021) with serial monitoring of thyrotropin (TSH), free thyroxine (FT4), and urine iodine concentration (UIC) for 24 weeks. The main outcome measure was the development of subclinical hypothyroidism (SCH), defined as a nonpregnant TSH greater than 4 mIU/L with normal FT4 (11-22 pmol/L) in those with normal baseline thyroid function. RESULTS Iodine excess (UIC ≥ 300 μg/L) was almost universal (98%) with UIC peaking usually by 4 weeks. There was marked iodine excess, with 90% and 17% of participants having UIC greater than or equal to 1000 μg/L and greater than 10 000 μg/L, respectively. Iodine excess was prolonged with 67% having a UIC greater than or equal to 1000 μg/L for at least 3 months. SCH developed in 38%; the majority (96%) were mild (TSH 4-10 mIU/L) and most developed SCH by week 4 (75%). Three participants met the current treatment guidelines (TSH > 10 mIU/L). Thyroxine treatment of mild SCH tended to improve pregnancy success (P = .063). Hyperthyroidism (TSH < 0.3 mIU/L) occurred in 9 participants (5%). CONCLUSION OSCM HSG resulted in marked and prolonged iodine excess. SCH occurred frequently with late-onset hyperthyroidism occasionally. Regular thyroid function tests are required for 6 months following this procedure.
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Affiliation(s)
- Divya M Mathews
- Liggins Institute, University of Auckland, Auckland 1142, New Zealand
| | - Jane M Peart
- Department of Radiology, Auckland Radiology Group, Auckland 1050, New Zealand
| | - Robert G Sim
- Department of Radiology, Auckland Radiology Group, Auckland 1050, New Zealand
| | - Neil P Johnson
- Department of Obstetrics and Gynecology, Robinson Research Institute, University of Adelaide, Adelaide, South Australia 5006, Australia
- Department of Reproductive Endocrinology and Fertility, Repromed Auckland and Auckland Gynecology Group, Auckland 1050, New Zealand
| | - Susannah O'Sullivan
- Department of Endocrinology, Greenlane Clinical Centre, Auckland District Health Board, Auckland 1051, New Zealand
| | - José G B Derraik
- Liggins Institute, University of Auckland, Auckland 1142, New Zealand
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland 1023, New Zealand
| | - Paul L Hofman
- Liggins Institute, University of Auckland, Auckland 1142, New Zealand
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Giri B, Pandey S, Shakya S, Neupane BB, Kandel KP, Yadav CK, Yadav RP, Neupane BP, Gc RB, Saud PS, Yonjan M. Excessive iodine in iodized household salt in Nepal. Ann N Y Acad Sci 2022; 1514:166-173. [PMID: 35611772 DOI: 10.1111/nyas.14793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Iodine is an essential trace element required for the regulation of physiological processes involving the thyroid gland. However, inadequate and excessive intake of iodine are responsible for health problems, such as iodine deficiency disorders, hypothyroidism, hyperthyroidism, thyroiditis, thyroid papillary cancer, and thyrotoxicosis. The Universal Salt Iodization (USI) program has become successful in providing supplemental iodine at the population level globally. Packaging quality, fortification level, and transportation and storage conditions of iodized salt determine the availability of iodine. Previous studies have reported severe health issues caused by excessive iodine intake after the implementation of the USI program. To understand the levels of iodine, we collected 2117 household salt samples from seven districts of Nepal and tested them for iodine content; among them, 98.1% were iodized. Overall median concentration of iodine was 53.9 ppm (range: 43.5-61.4 ppm). The majority (67.2%) of samples had iodine in the range of 45-75 ppm. Approximately 0.9% of samples had inadequate, 13.3% contained adequate, and 83.9% had excessive iodine than the World Health Organization-recommended value. Iodine content varied among the sampling districts and seasons, to some extent. Our study confirmed that iodized salt is widely used in Nepal and is excessively iodized. Excessive intake of iodine through iodized salt requires further attention by policy makers. The iodine level may need adjustment to address the health impact.
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Affiliation(s)
- Basant Giri
- Center for Analytical Sciences, Kathmandu Institute of Applied Sciences, Kathmandu, Nepal
| | - Shishir Pandey
- Center for Analytical Sciences, Kathmandu Institute of Applied Sciences, Kathmandu, Nepal
| | - Sadiksha Shakya
- Center for Analytical Sciences, Kathmandu Institute of Applied Sciences, Kathmandu, Nepal
| | - Bhanu Bhakta Neupane
- Center for Analytical Sciences, Kathmandu Institute of Applied Sciences, Kathmandu, Nepal.,Central Department of Chemistry, Tribhuvan University, Kathmandu, Nepal
| | | | | | | | - Bishnu Prasad Neupane
- Faculty of Health Sciences, School of Health and Allied Sciences, Pokhara University, Kaski, Nepal
| | | | - Prem Singh Saud
- Kailali Multiple Campus, Far-western University, Kailali, Nepal
| | - Meghraj Yonjan
- Amrit Science Campus, Tribhuvan University, Kathmandu, Nepal
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13
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So S, Hashimoto K, Mori M, Endo S, Yamaguchi W, Miyano N, Murabayashi N, Tawara F. Serum thyroid-stimulating hormone receptor antibody levels and thyroid dysfunction after hysterosalpingography: a case-control study. Gynecol Endocrinol 2021; 37:898-901. [PMID: 34355625 DOI: 10.1080/09513590.2021.1963430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE Hysterosalpingography (HSG) performed with an iodine contrast media can cause thyroid dysfunction, including thyrotoxicosis and hypothyroidism. We investigated the association between the serum levels of thyroid-stimulating hormone receptor antibody (TRAb), an indicator of Graves' disease, and abnormal thyroid function after performing HSG. METHODS The screening of TRAb was conducted in 362 patients who first visited the Tawara IVF Clinic between April and September 2018. The association between TRAb levels and the effects of HSG examinations on thyroid function were evaluated. RESULTS Of the 362 patients, 2 (0.55%) had high levels (>2.0 IU/L) of TRAb, whereas 18 (5.0%) had intermediate TRAb levels, ranging from 0.3 to 1.9 IU/L. Of the 98 women (including 7 of the 18 women with TRAb level 0.3-1.9 IU/L, and 91 of the 342 women with TRAb level <0.3 IU/L) who had undergone HSG, two women developed overt thyrotoxicosis after HSG, and the frequency was significantly higher (p = .0044) in the group with intermediate levels of TRAb (28.6%, 2 of 7) than that in the group with low TRAb levels (<0.3 IU/L; 0.0%, 0 of 91). CONCLUSIONS These findings indicate that increased serum levels of TRAb are significantly associated with the development of thyrotoxicosis after HSG.
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Affiliation(s)
- Shuhei So
- Department of Reproductive and Perinatal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
- Tawara IVF Clinic, Suruga-ku Shizuok, Japan
| | - Koshi Hashimoto
- Department of Diabetes, Endocrinology and Hematology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan
| | - Masatomo Mori
- Metabolic and Obesity Research Institute, Midori-shi, Japan
| | | | | | | | - Nao Murabayashi
- Department of Reproductive and Perinatal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
- Tawara IVF Clinic, Suruga-ku Shizuok, Japan
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Liu Q, Zhang Y, Zhao H, Yao X. Increased Epoxyeicosatrienoic Acids and Hydroxyeicosatetraenoic Acids After Treatment of Iodide Intake Adjustment and 1,25-Dihydroxy-Vitamin D 3 Supplementation in High Iodide Intake-Induced Hypothyroid Offspring Rats. Front Physiol 2021; 12:669652. [PMID: 34381374 PMCID: PMC8352438 DOI: 10.3389/fphys.2021.669652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 06/22/2021] [Indexed: 11/25/2022] Open
Abstract
Aim: This study aimed to investigate the potential role of fatty acids in high iodide intake-induced hypothyroidism and its complications and also in the intervention of iodide intake adjustment and 1,25-dihydroxy-vitamin D3 [1,25(OH)2D3] supplementation. Methods: Pregnant rats were allocated to two groups, namely, normal iodide (NI, 7.5 μg/day) intake and 100 times higher-than-normal iodide (100 HI, 750 μg/day) intake. The offspring were continuously administered potassium iodide from weaning [i.e., postnatal day 21 (PN21)] to PN90. After PN90, the offspring were either administered iodide intake adjustment (7.5 μg/day) or 1,25(OH)2D3 supplementation (5 μg·kg-1·day-1), or both, for 4 weeks. Thyroid function tests (free triiodothyronine, free thyroxine, thyrotropin, thyroid peroxidase antibody, and thyroglobulin antibody), blood lipids (triglyceride, total cholesterol, free fatty acid, and low-density lipoprotein cholesterol), and vitamin D3 (VD3) levels were detected by ELISA. Cardiac function was measured by echocardiography. Blood pressure was measured using a non-invasive tail-cuff system. The serum fatty acids profile was analyzed by liquid chromatography-mass spectrometry. Results: In the offspring rats with continued 100 HI administration, the levels of 8,9-dihydroxyeicosatrienoic acid (8,9-DHET) and thromboxane B2 (TXB2) were decreased, while those of prostaglandin J2 (PGJ2), prostaglandin B2 (PGB2), 4-hydroxydocosahexaenoic acid (4-HDoHE), 7-HDoHE, 8-HDoHE, and 20-HDoHE were increased. Significant correlations were found between PGB2, 8,9-DHET, 7-HDoHE levels and thyroid dysfunction, between PGJ2, 20-HDoHE, PGB2, 8,9-DHET levels and cardiac dysfunction, between PGJ2, 20-HDoHE levels and hypertension, between 4-HDoHE, 8-HDoHE, TXB2 levels and dyslipidemia, and between PGB2 and decreased VD3 level. After the treatment of iodide intake adjustment and 1,25(OH)2D3 supplementation, the levels of 16-hydroxyeicosatetraenoic acids (16-HETE), 18-HETE, 5,6-epoxyeicosatrienoic acid (5,6-EET), 8,9-EET, 11,12-EET, 14,15-EET, PGE2, 5-oxo-ETE, and 15-oxo-ETE were increased. The significant associations between PGE2, 16-HETE, 18-HETE and improved thyroid function and also between 5,6-EET, 11,12-EET, 14,15-EET, 16-HETE, 15-oxo-ETE and attenuated dyslipidemia were detected. Conclusion: Increased levels of prostaglandins (PGs) and HDoHEs and decreased levels of 8,9-DHET and TXB2 might occur in the progression of cardiac dysfunction, hypertension, and dyslipidemia in high iodide intake-induced hypothyroidism. The increased levels of EETs and HETEs might help to ameliorate these complications after iodide intake adjustment and 1,25(OH)2D3 supplementation.
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Affiliation(s)
- Qing Liu
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Yue Zhang
- Tianjin Key Laboratory of Ionic-Molecular of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, the Second Hospital of Tianjin Medical University, Tianjin, China
| | - Hailing Zhao
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Xiaomei Yao
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
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15
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Bervini S, Trelle S, Kopp P, Stettler C, Trepp R. Prevalence of Iodine-Induced Hyperthyroidism After Administration of Iodinated Contrast During Radiographic Procedures: A Systematic Review and Meta-Analysis of the Literature. Thyroid 2021; 31:1020-1029. [PMID: 33327840 DOI: 10.1089/thy.2020.0459] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Background: Iodine-induced hyperthyroidism (IIH) was a common issue in the early twentieth century after introduction of iodine supplementation in dietary salt. Currently, IIH is mostly encountered in Western countries as a consequence of radiographic procedures involving the administration of iodinated contrast media (ICM). However, little is known about the magnitude and clinical relevance of this issue. To assess the incidence of hyperthyroidism after ICM exposure, we performed a systematic review and meta-analysis of the literature. Methods: MEDLINE, Embase, and the Cochrane Library were systematically searched for studies published between 1946 and May 2018. Studies were considered eligible if they investigated the association between hyperthyroidism and iodinated contrast. Data on study design, baseline characteristics, and outcomes were extracted independently by two reviewers. Results: Thirty out of 1493 retrieved studies were included in the analysis. The time endpoint to assess thyroid hormone levels after ICM exposure varied between 1 and 541 days among studies, with most studies having a time endpoint between 7 and 56 days. The overall estimated prevalence of overt hyperthyroidism after ICM exposure was extremely low (0.1% [confidence interval, CI 0-0.6%]), and did not change after adjustments for baseline thyroid function status (0.3% in euthyroid patients at baseline [CI 0-1.7%]). There were no cases with overt hyperthyroidism at 7 days after ICM exposure, and the incidence was very low at 30 days (0.2% [CI 0-0.8%]). Conclusion: The incidence of IIH after ICM administration during radiographic procedures is extremely low.
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Affiliation(s)
- Sandrina Bervini
- Department of Internal Medicine, Hospital Center, Biel, Switzerland
| | - Sven Trelle
- Clinical Trial Unit (CTU), University of Bern, Bern, Switzerland
| | - Peter Kopp
- Division of Endocrinology, Diabetology and Metabolism, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - Christoph Stettler
- Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism (UDEM), Inselspital, Bern University Hospital, Bern, Switzerland
| | - Roman Trepp
- Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism (UDEM), Inselspital, Bern University Hospital, Bern, Switzerland
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16
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Pelewicz K, Wolny R, Bednarczuk T, Miśkiewicz P. Prevention of Iodinated Contrast Media-Induced Hyperthyroidism in Patients with Euthyroid Goiter. Eur Thyroid J 2021; 10:306-313. [PMID: 34395302 PMCID: PMC8314765 DOI: 10.1159/000515126] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 02/07/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Iodinated contrast media (ICM)-induced hyperthyroidism is an underestimated, potentially severe condition; however, its prevention has not been sufficiently investigated. The aim of this study was to evaluate the influence of ICM on thyroid status, the advantages of prophylactic therapy for iodine-induced hyperthyroidism (IIH) in patients with euthyroid goiter and cardiovascular comorbidities, and the association between the incidence of IIH and thyroid volume. METHODS Thirty-six euthyroid patients undergoing procedures involving ICM administration were divided into 2 groups: the first group (n = 13) received prophylactic treatment with thiamazole or thiamazole combined with sodium perchlorate during ICM exposure; the second group (n = 23) did not receive prophylaxis. Thyroid-stimulating hormone levels were evaluated before and after ICM, and thyroid hormone levels were assessed after ICM at different points in time. The morphology of the thyroid was evaluated by ultrasonography. RESULTS Twenty-one patients (58%) developed hyperthyroidism after ICM. Hyperthyroidism was observed more frequently in the group without prophylactic treatment than in the group with prophylaxis (65 vs. 15%, respectively; p = 0.006). No cases of overt hyperthyroidism were observed in the group receiving thiamazole with sodium perchlorate. IIH persisted for a median time of 52.5 days. Larger thyroid volume was associated with a significantly higher occurrence of ICM-induced hyperthyroidism (p = 0.04). CONCLUSIONS Patients with euthyroid goiter receiving ICM are at risk of developing hyperthyroidism. The occurrence of hyperthyroidism after ICM in euthyroid patients with goiter is higher in those with larger thyroid volume. The frequency of ICM-induced hyperthyroidism in euthyroid patients with goiter is lower in those receiving prophylactic therapy with thiamazole in monotherapy or in combination with sodium perchlorate than in those not receiving prophylactic treatment.
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Affiliation(s)
- Katarzyna Pelewicz
- Department of Internal Medicine and Endocrinology, Medical University of Warsaw, Warsaw, Poland
| | - Rafał Wolny
- Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warsaw, Poland
| | - Tomasz Bednarczuk
- Department of Internal Medicine and Endocrinology, Medical University of Warsaw, Warsaw, Poland
| | - Piotr Miśkiewicz
- Department of Internal Medicine and Endocrinology, Medical University of Warsaw, Warsaw, Poland
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Vassiliadi DA, Ilias I, Pratikaki M, Jahaj E, Vassiliou AG, Detsika M, Ampelakiotou K, Koulenti M, Manolopoulos KN, Tsipilis S, Gavrielatou E, Diamantopoulos A, Zacharis A, Athanasiou N, Orfanos S, Kotanidou A, Tsagarakis S, Dimopoulou I. Thyroid hormone alterations in critically and non-critically ill patients with SARS-CoV-2 infection. Endocr Connect 2021; 10:646-655. [PMID: 34010152 PMCID: PMC8240704 DOI: 10.1530/ec-21-0029] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 05/19/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Following the evolution of COVID-19 pandemic, reports pointed on a high prevalence of thyroiditis-related thyrotoxicosis. Interpretation of thyroid tests during illness, however, is hampered by changes occurring in the context of non-thyroidal illness syndrome (NTIS). In order to elucidate these findings, we studied thyroid function in carefully selected cohorts of COVID-19 positive and negative patients. DESIGN Cohort observational study. METHODS We measured TSH, FT4, T3 within 24 h of admission in 196 patients without thyroid disease and/or confounding medications. In this study, 102 patients were SARS-CoV-2 positive; 41 admitted in the ICU, 46 in the ward and 15 outpatients. Controls consisted of 94 SARS-CoV-2 negative patients; 39 in the ICU and 55 in the ward. We designated the thyroid hormone patterns as consistent with NTIS, thyrotoxicosis and hypothyroidism. RESULTS A NTIS pattern was encountered in 60% of ICU and 36% of ward patients, with similar frequencies between SARS-CoV-2 positive and negative patients (46.0% vs 46.8%, P = NS). A thyrotoxicosis pattern was observed in 14.6% SARS-CoV-2 ICU patients vs 7.7% in ICU negative (P = NS) and, overall in 8.8% of SARS-CoV-2 positive vs 7.4% of negative patients. In these patients, thyroglobulin levels were similar to those with normal thyroid function or NTIS. The hypothyroidism pattern was rare. CONCLUSIONS NTIS pattern is common and relates to the severity of disease rather than SARS-CoV-2 infection. A thyrotoxicosis pattern is less frequently observed with similar frequency between patients with and without COVID-19. It is suggested that thyroid hormone monitoring in COVID-19 should not differ from other critically ill patients.
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Affiliation(s)
- Dimitra Argyro Vassiliadi
- Department of Endocrinology Diabetes and Metabolism, National Expertise Center for Rare Endocrine Diseases, Evangelismos Hospital, Athens, Greece
- Correspondence should be addressed to D A Vassiliadi:
| | - Ioannis Ilias
- Department of Endocrinology Diabetes and Metabolism, Elena Venizelou Hospital, Elena Venizelou Square, Athens, Greece
| | - Maria Pratikaki
- 1st Department of Critical Care & Pulmonary Services, Medical School National & Kapodistrian, Evangelismos Hospital, University of Athens, Athens, Greece
| | - Edison Jahaj
- 1st Department of Critical Care & Pulmonary Services, Medical School National & Kapodistrian, Evangelismos Hospital, University of Athens, Athens, Greece
| | - Alice G Vassiliou
- 1st Department of Critical Care, GP Livanos & M Simou Laboratories, Medical School National & Kapodistrian, Evangelismos Hospital, University of Athens, Athens, Greece
| | - Maria Detsika
- 1st Department of Critical Care, GP Livanos & M Simou Laboratories, Medical School National & Kapodistrian, Evangelismos Hospital, University of Athens, Athens, Greece
| | - Kleio Ampelakiotou
- Department of Immunology and Histocompatibility Evangelismos Hospital, Athens, Greece
| | - Marina Koulenti
- Department of Endocrinology Diabetes and Metabolism, National Expertise Center for Rare Endocrine Diseases, Evangelismos Hospital, Athens, Greece
| | - Konstantinos N Manolopoulos
- Department of Endocrinology Diabetes and Metabolism, National Expertise Center for Rare Endocrine Diseases, Evangelismos Hospital, Athens, Greece
| | - Stamatis Tsipilis
- 1st Department of Critical Care & Pulmonary Services, Medical School National & Kapodistrian, Evangelismos Hospital, University of Athens, Athens, Greece
| | - Evdokia Gavrielatou
- 1st Department of Critical Care & Pulmonary Services, Medical School National & Kapodistrian, Evangelismos Hospital, University of Athens, Athens, Greece
| | - Aristidis Diamantopoulos
- Department of Endocrinology Diabetes and Metabolism, National Expertise Center for Rare Endocrine Diseases, Evangelismos Hospital, Athens, Greece
| | - Alexandros Zacharis
- 1st Department of Critical Care & Pulmonary Services, Medical School National & Kapodistrian, Evangelismos Hospital, University of Athens, Athens, Greece
| | - Nicolaos Athanasiou
- 1st Department of Critical Care & Pulmonary Services, Medical School National & Kapodistrian, Evangelismos Hospital, University of Athens, Athens, Greece
| | - Stylianos Orfanos
- 2nd Department of Critical Care Medical School National & Kapodistrian University of Athens Attikon University Hospital, Athens-Haidari, Greece
| | - Anastasia Kotanidou
- 1st Department of Critical Care & Pulmonary Services, Medical School National & Kapodistrian, Evangelismos Hospital, University of Athens, Athens, Greece
| | - Stylianos Tsagarakis
- Department of Endocrinology Diabetes and Metabolism, National Expertise Center for Rare Endocrine Diseases, Evangelismos Hospital, Athens, Greece
| | - Ioanna Dimopoulou
- 1st Department of Critical Care & Pulmonary Services, Medical School National & Kapodistrian, Evangelismos Hospital, University of Athens, Athens, Greece
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Abstract
Objective Painless thyroiditis (PT) is characterized by transient hyperthyroidism with a low 99mTc uptake. We herein describe 11 cases of PT that occurred during treatment with potassium iodide (KI) for Graves' disease (GD). Methods From August 2016 to December 2018, 11 women with GD who developed PT during treatment with KI were enrolled. Of these patients, 10 discontinued antithyroid drug (ATD) because of side effects and began KI, and 1 patient switched from thiamazole to KI because she was planning a pregnancy. The mean patient age was 40.1 years old. Thyroid function tests, thyroid autoantibodies including anti thyroglobulin antibody (TgAb), anti-thyroperoxidase antibody (TPOAb), and M22-TRAb, and the 99mTc uptake were evaluated at the time of PT. Results All 11 women patients presented with transient thyrotoxicosis in which 99mTc scans revealed a low uptake of 0.34±0.15% (normal 0.70-1.02%). M22-TRAb was absent in all cases except for one (2.4 IU/L), whereas TgAb and TPOAb were present in 10 and 6 cases, respectively. Ten patients returned to a euthyroid status without passing through the post-hypothyroid phase, and one patient underwent total thyroidectomy during the euthyroid phase of PT. Only four patients require beta-blocker therapy. All patients with KI-induced PT except 1 displayed GD remission during a mean observation period of 23.3 months, and 1 patient had recurrence of GD after PT. Conclusion We encountered 11 GD patients who developed PT during treatment with KI, which was initiated after ATD had been discontinued due to side effects.
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Affiliation(s)
- Keiichi Kamijo
- Department of Internal Medicine, Kamijo Thyroid Clinic, Japan
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19
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Xu T, Ren Z, Li S, Tan L, Zhang W. The relationship of different levels of high iodine and goiter in school children: a meta-analysis. Nutr Metab (Lond) 2021; 18:46. [PMID: 33941207 PMCID: PMC8094504 DOI: 10.1186/s12986-021-00563-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 03/12/2021] [Indexed: 11/11/2022] Open
Abstract
Background Over the past decade, the phenomenon of high urine iodine (HUI) and high water iodine (HWI) has become more common. But the risk of goiter caused by different levels of HUI and HWI remains unclear. Objectives To explore the risk of goiter development caused by HUI and HWI, and compare the risk of goiter development from different levels of high iodine. Methods The Medline, Cochrane library, Embase, China National Knowledge Infrastructure and Wan fang databases were searched for relevant population-based studies investigating the link between high iodine levels and goiter development in mainland China. Three reviewers extracted data from the included studies independently, assessing the prevalence of goiter development due to high iodine. Results Taking 100 μg/L ≤ UIC < 300 μg/L (UIC = urinary iodine concentration) as the reference group, the odds ratio (OR) regarding high iodine levels and goiter formation was 1.74 (95% CI 1.50, 2.01, P < 0.001), if the water iodine concentration (WIC) was greater than 100 μg/L, the OR between goiter development and WIC was 4.74 (95% CI 1.15, 19.46, P = 0.001). The Linear trend analysis of HUI and goiter showed that the prevalence of goiter increased with the increase of UIC (χ2 = 734.605, P < 0.001). Conclusions When the UIC ≥ 300 μg/L or the WIC ≥ 100 μg/L, the risk of goiter will increase. The higher the UIC, the greater the risk of goiter development. In order to improve the public thyroid health, we should adhere to the monitoring of urinary iodine and water iodine, and keep them at an appropriate level. Trial registration PROSPEROCR, CRD42020197620. Registered 8 August 2020, https://www.crd.york.ac.uk/PROSPERO/.
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Affiliation(s)
- Tingting Xu
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Heping District, No. 22, Qixiangtai Road, Tianjin, China
| | - Zhiyuan Ren
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Heping District, No. 22, Qixiangtai Road, Tianjin, China
| | - Shaohan Li
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Heping District, No. 22, Qixiangtai Road, Tianjin, China
| | - Long Tan
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Heping District, No. 22, Qixiangtai Road, Tianjin, China.
| | - Wanqi Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Heping District, No. 22, Qixiangtai Road, Tianjin, China
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Wang C, Li Y, Teng D, Shi X, Ba J, Chen B, Du J, He L, Lai X, Li Y, Chi H, Liao E, Liu C, Liu L, Qin G, Qin Y, Quan H, Shi B, Sun H, Tang X, Tong N, Wang G, Zhang JA, Wang Y, Xue Y, Yan L, Yang J, Yang L, Yao Y, Ye Z, Zhang Q, Zhang L, Zhu J, Zhu M, Shan Z, Teng W. Hyperthyroidism Prevalence in China After Universal Salt Iodization. Front Endocrinol (Lausanne) 2021; 12:651534. [PMID: 34122333 PMCID: PMC8194401 DOI: 10.3389/fendo.2021.651534] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 04/20/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Universal salt iodization (USI) was implemented in mainland China in 1996. The prevalence of hyperthyroidism and its risk factors now require examination. METHODS Data were acquired from a nationwide Thyroid, Iodine, and Diabetes Epidemiological survey (TIDE 2015-2017) of 78,470 subjects from 31 provinces. Iodine status, and thyroid hormones and antibodies were measured. RESULTS After two decades of USI, the prevalence of overt hyperthyroidism (OH), Graves' disease (GD), severe subclinical hyperthyroidism (severe SCH), and mild subclinical hyperthyroidism (mild SCH) in mainland China was 0.78%, 0.53%, 0.22%, and 0.22%, respectively. OH and GD prevalence were higher in women than in men (OH: 1.16% vs. 0.64%, P<0.001; GD: 0.65% vs. 0.37%, P<0.001).Prevalence was significantly decreased after 60 years-of-age compared with 30-39 years-of-age (OH:0.61% vs. 0.81%, P<0.001; GD: 0.38% vs. 0.57%, P<0.001).Excessive iodine(EI) and deficient iodine(DI) were both related to increased prevalence of OH (odds ratio [OR] 2.09, 95% confidence interval [CI] 1.68-2.59; OR1.35, 95%CI 1.07-1.72, respectively); however, only deficient iodine was associated with increased prevalence of GD (OR1.67, 95%CI 1.30-2.15). Increased thyroid peroxidase antibody and thyroglobulin antibody levels were significantly associated with prevalence of OH and GD, but not severe SCH and mild SCH. Although hyperthyroidism was more prevalent in women, the association disappeared after adjusting for other factors such as antibody levels. CONCLUSION OH and GD prevalences in mainland China are stable after two decades of USI. Iodine deficiency, elevated thyroid antibody levels, and middle age are the main risk factors for OH and GD. The severe SCH population, rather than the mild SCH population, shows similar characteristics to the OH population.
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Affiliation(s)
- Chuyuan Wang
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yongze Li
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Di Teng
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Xiaoguang Shi
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Jianming Ba
- Department of Endocrinology, Chinese People’s Liberation Army (PLA) General Hospital, Beijing, China
| | - Bing Chen
- Department of Endocrinology, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Jianling Du
- Department of Endocrinology, First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Lanjie He
- Department of Endocrinology, Cardiovascular and Cerebrovascular Disease Hospital, General Hospital of Ningxia Medical University, Jinfeng, China
| | - Xiaoyang Lai
- Department of Endocrinology and Metabolism, Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yanbo Li
- Department of Endocrinology, First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Haiyi Chi
- Department of Endocrinology, Hohhot First Hospital, Hohhot, China
| | - Eryuan Liao
- Department of Endocrinology and Metabolism, Second Xiangya Hospital, Central South University, Changsha, China
| | - Chao Liu
- Research Center of Endocrine and Metabolic Diseases, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Libin Liu
- Fujian Institute of Hematology, Union Hospital, Fujian Medical University, Fuzhou, China
| | - Guijun Qin
- International Medical Center, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China
| | - Yingfen Qin
- Department of Endocrinology, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Huibiao Quan
- Department of Endocrinology, Hainan General Hospital, Haikou, China
| | - Bingyin Shi
- Department of Endocrinology, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Hui Sun
- Department of Endocrinology, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xulei Tang
- Department of Endocrinology, First Hospital of Lanzhou University, Lanzhou, China
| | - Nanwei Tong
- State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Guixia Wang
- Department of Endocrinology and Metabolism, First Affiliated Hospital of Jilin University, Changchun, China
| | - Jin-an Zhang
- Department of Endocrinology, Zhoupu Hospital, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Youmin Wang
- Department of Endocrinology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yuanming Xue
- Department of Endocrinology, The First People’s Hospital of Yunnan Province, Kunming, China
| | - Li Yan
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jing Yang
- Department of Endocrinology, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Lihui Yang
- Department of Endocrinology and Metabolism, People’s Hospital of Tibet Autonomous Region, Lhasa, China
| | - Yongli Yao
- Department of Endocrinology, Qinghai Provincial People’s Hospital, Xining, China
| | - Zhen Ye
- Zhejiang Center for Disease Control and Prevention (Zhejiang CDC), Hangzhou, China
| | - Qiao Zhang
- Department of Endocrinology and Metabolism, Affiliated Hospital of Guiyang Medical University, Guiyang, China
| | - Lihui Zhang
- Department of Endocrinology, Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Jun Zhu
- Department of Endocrinology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Mei Zhu
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
| | - Zhongyan Shan
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of China Medical University, Shenyang, China
- *Correspondence: Zhongyan Shan, ; Weiping Teng,
| | - Weiping Teng
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of China Medical University, Shenyang, China
- *Correspondence: Zhongyan Shan, ; Weiping Teng,
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Keestra S, Högqvist Tabor V, Alvergne A. Reinterpreting patterns of variation in human thyroid function: An evolutionary ecology perspective. Evol Med Public Health 2020; 9:93-112. [PMID: 34557302 PMCID: PMC8454515 DOI: 10.1093/emph/eoaa043] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 11/02/2020] [Indexed: 12/21/2022] Open
Abstract
Two hundred million people worldwide experience some form of thyroid disorder, with women being especially at risk. However, why human thyroid function varies between populations, individuals, and across the lifespan has attracted little research to date. This limits our ability to evaluate the conditions under which patterns of variation in thyroid function are best understood as 'normal' or 'pathological'. In this review, we aim to spark interest in research aimed at understanding the causes of variation in thyroid phenotypes. We start by assessing the biomedical literature on thyroid imbalance to discuss the validity of existing reference intervals for diagnosis and treatment across individuals and populations. We then propose an evolutionary ecological framework for understanding the phylogenetic, genetic, ecological, developmental, and physiological causes of normal variation in thyroid function. We build on this approach to suggest testable predictions for how environmental challenges interact with individual circumstances to influence the onset of thyroid disorders. We propose that dietary changes, ecological disruptions of co-evolutionary processes during pregnancy and with pathogens, emerging infections, and exacerbated stress responses can contribute to explaining the onset of thyroid diseases. For patients to receive the best personalized care, research into the causes of thyroid variation at multiple levels is needed.
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Affiliation(s)
- Sarai Keestra
- School of Anthropology & Museum Ethnography,
University of Oxford, Oxford, UK
- Amsterdam UMC, University of
Amsterdam, Amsterdam, The
Netherlands
| | | | - Alexandra Alvergne
- School of Anthropology & Museum Ethnography,
University of Oxford, Oxford, UK
- ISEM, Université de Montpellier, CNRS, IRD,
EPHE, Montpellier, France
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22
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Mikosch P, Trifina-Mikosch E, Saidler K, Kellner J, Suhrau S. [Iodine-rich thermal water in cure and rehabilitation from the perspective of the thyroid gland]. Wien Med Wochenschr 2020; 170:392-402. [PMID: 33026541 PMCID: PMC7593323 DOI: 10.1007/s10354-020-00782-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 08/19/2020] [Indexed: 11/05/2022]
Abstract
Bei einzelnen Schilddrüsenerkrankungen (Immunthyreopathie Morbus Basedow, Immunthyreopathie Hashimoto, Struma mit Autonomie) sollte eine übermäßige Jodzufuhr vermieden werden. Betreffend alimentärer Jodzufuhr gibt es dazu reichliches Informationsmaterial. Kuranwendungen werden zu einem breiten Indikationsspektrum eingesetzt und tragen einen wichtigen Teil zur Therapie gerade chronisch degenerativen Erkrankungen, zur Rehabilitation nach Traumen oder Tumorerkrankungen bei. Eine Jodzufuhr ist auch bei Kuranwendungen mit jodhaltigem Thermalwasser möglich, das Ausmaß der Jodzufuhr ist dabei abhängig von der Applikationsform und der Expositionsdauer. Informationsmaterial dazu ist nur spärlich in der Literatur zu finden. Der Artikel betrachtet jodhaltige Kuranwendungen aus thyreologischer Sicht im Spannungsfeld von positiven und möglichen negativen Auswirkungen einer jodhaltigen Kuranwendung. Neben einem Einblick in die Physiologie und Pathophysiologie des Jodstoffwechsels und Auswirkungen auf einzelne Schilddrüsenerkrankungen wird die Intensität einer Jodaufnahme bei unterschiedlichen Kuranwendungen dargestellt. Eine Übersicht von Kurorten/Thermen mit jodhaltigem Wasser in Österreich und seinen Nachbarstaaten ergänzt von einem Algorithmus zur Selektion von Patienten für eine Kur in Kurorten mit jodhaltigem Wasser wird präsentiert, um mögliche negative jodinduzierte Schilddrüsenfehlfunktionen schon vor Kurantritt zu vermeiden. Dem klinisch tätigen Arzt wird damit eine Unterstützung in der Entscheidungsfindung bei der Auswahl bzw. Ablehnung einer jodhaltigen Kuranwendung für seine Patienten zur Verfügung gestellt.
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Affiliation(s)
- Peter Mikosch
- 2. Medizinische Abteilung, Landesklinikum Mistelbach, Mistelbach, Österreich. .,Medizinische Universität Wien, Externe Lehre, Wien, Österreich.
| | | | - Katharina Saidler
- 2. Medizinische Abteilung, Landesklinikum Mistelbach, Mistelbach, Österreich.,Medizinische Universität Wien, Externe Lehre, Wien, Österreich
| | - Jennifer Kellner
- 2. Medizinische Abteilung, Landesklinikum Mistelbach, Mistelbach, Österreich
| | - Susanne Suhrau
- 2. Medizinische Abteilung, Landesklinikum Mistelbach, Mistelbach, Österreich
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Hernández AF, Requena M, López A, Parrón T, Navarro Á, Alarcón R. Reply to Swaen's letter regarding 'Environmental exposure to pesticides and risk of thyroid diseases'. Toxicol Lett 2020; 331:254-256. [PMID: 32497563 DOI: 10.1016/j.toxlet.2020.05.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 05/29/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Antonio F Hernández
- Dept. Legal Medicine and Toxicology, University of Granada School of Medicine, Granada, Spain.
| | - Mar Requena
- University of Almería School of Health Sciences, Almería, Spain
| | | | - Tesifón Parrón
- University of Almería School of Health Sciences, Almería, Spain
| | | | - Raquel Alarcón
- University of Almería School of Health Sciences, Almería, Spain
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24
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Leandro A, Pacheco D, Cotas J, Marques JC, Pereira L, Gonçalves AMM. Seaweed's Bioactive Candidate Compounds to Food Industry and Global Food Security. Life (Basel) 2020; 10:E140. [PMID: 32781632 PMCID: PMC7459772 DOI: 10.3390/life10080140] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/29/2020] [Accepted: 07/29/2020] [Indexed: 12/19/2022] Open
Abstract
The world population is continuously growing, so it is important to keep producing food in a sustainable way, especially in a way that is nutritious and in a sufficient quantity to overcome global needs. Seaweed grows, and can be cultivated, in seawater and generally does not compete for arable land and freshwater. Thus, the coastal areas of the planet are the most suitable for seaweed production, which can be an alternative to traditional agriculture and can thus contribute to a reduced carbon footprint. There are evolving studies that characterize seaweed's nutritional value and policies that recognize them as food, and identify the potential benefits and negative factors that may be produced or accumulated by seaweed, which are, or can be, dangerous for human health. Seaweeds have a high nutritional value along with a low caloric input and with the presence of fibers, proteins, omega 3 and 6 unsaturated fatty acids, vitamins, and minerals. Moreover, several seaweed sub-products have interesting features to the food industry. Therefore, the focus of this review is in the performance of seaweed as a potential alternative and as a safe food source. Here described is the nutritional value and concerns relating to seaweed consumption, and also how seaweed-derived compounds are already commercially explored and available in the food industry and the usage restrictions to safeguard them as safe food additives for human consumption.
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Affiliation(s)
- Adriana Leandro
- Department of Life Sciences, Marine and Environmental Sciences Centre (MARE), University of Coimbra, 3000-456 Coimbra, Portugal; (A.L.); (D.P.); (J.C.); (J.C.M.); (L.P.)
| | - Diana Pacheco
- Department of Life Sciences, Marine and Environmental Sciences Centre (MARE), University of Coimbra, 3000-456 Coimbra, Portugal; (A.L.); (D.P.); (J.C.); (J.C.M.); (L.P.)
| | - João Cotas
- Department of Life Sciences, Marine and Environmental Sciences Centre (MARE), University of Coimbra, 3000-456 Coimbra, Portugal; (A.L.); (D.P.); (J.C.); (J.C.M.); (L.P.)
| | - João C. Marques
- Department of Life Sciences, Marine and Environmental Sciences Centre (MARE), University of Coimbra, 3000-456 Coimbra, Portugal; (A.L.); (D.P.); (J.C.); (J.C.M.); (L.P.)
| | - Leonel Pereira
- Department of Life Sciences, Marine and Environmental Sciences Centre (MARE), University of Coimbra, 3000-456 Coimbra, Portugal; (A.L.); (D.P.); (J.C.); (J.C.M.); (L.P.)
| | - Ana M. M. Gonçalves
- Department of Life Sciences, Marine and Environmental Sciences Centre (MARE), University of Coimbra, 3000-456 Coimbra, Portugal; (A.L.); (D.P.); (J.C.); (J.C.M.); (L.P.)
- Department of Biology and CESAM, University of Aveiro, 3810-193 Aveiro, Portugal
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25
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26
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Wan S, Jin B, Ren B, Qu M, Wu H, Liu L, Boah M, Shen H. The Relationship between High Iodine Consumption and Levels of Autoimmune Thyroiditis-Related Biomarkers in a Chinese Population: a Meta-Analysis. Biol Trace Elem Res 2020; 196:410-418. [PMID: 31713113 DOI: 10.1007/s12011-019-01951-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 10/23/2019] [Indexed: 01/30/2023]
Abstract
To comprehensively evaluate the relationship between high iodine concentration and biomarker abnormalities related to autoimmune thyroiditis in a Chinese population. Medline, PubMed, and Embase electronic databases were searched for articles published domestically and internationally on the relationship between high iodine concentrations and thyroid hormone antibodies and thyroid-stimulating hormone in China before March 2019. Articles published in Chinese were searched in the China Biology Medicine (CBM) disc, Wanfang Database, and China National Knowledge Infrastructure (CNKI). A total of 16 cross-sectional articles were included in this study, including 9061 participants. A meta-analysis was conducted in Stata 14.0. The binary categorical and continuous variables used odds ratios (ORs) and standardized mean differences (SMDs) with the corresponding 95% confidence intervals (CIs) as the effect statistics, respectively. The results showed that high iodine concentrations had a minimal association with the abnormal rates of thyroid peroxidase antibody (TPOAb) (OR = 1.274, 95% CI (0.957, 1.695), P > 0.05) and thyroglobulin antibody (TGAb) (OR = 1.217, 95% CI (0.911, 1.626), P > 0.05) in the entire population. The thyroid-stimulating hormone (TSH) level in the high iodine group was greater than that in the adaptive iodine group (SMD = 0.202, 95% CI (0.096, 0.309), P < 0.05). The results of the subgroup analysis showed that the abnormal TPOAb rate in pregnant women (OR = 1.519, 95% CI (1.007, 2.291), P < 0.05) and children (OR = 3.365, 95% CI (1.966, 5.672), P < 0.05) in the high iodine group was greater than that in the adaptive iodine group, and the abnormal TGAb rate of children in the high iodine group was greater than that in the adaptive iodine group. The TSH levels of lactating women (SMD = 0.24, 95% CI (0.053, 0.427), P < 0.05), pregnant women (SMD = 0.301, 95% CI (0.176, 0.426), P < 0.05), and children (SMD = 0.25, 95% CI(0.096, 0.309), P < 0.05) in the high iodine group were higher than those in the adaptive iodine group. Egger's and Begg's tests showed no significant (P > 0.1) publication bias. High iodine can increase the risk of abnormal levels of TPOAb, TGAb, and TSH related to autoimmune thyroiditis in pregnant women, lactating women, and children in China.
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Affiliation(s)
- Siyuan Wan
- Department of Preventive Medicine, Qiqihar Medical University, Qiqihar, Heilongjiang, China
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
| | - Baiming Jin
- Department of Preventive Medicine, Qiqihar Medical University, Qiqihar, Heilongjiang, China
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
| | - Bingxuan Ren
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
| | - Mengying Qu
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
| | - Huaiyong Wu
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
| | - Lixiang Liu
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
| | - Michael Boah
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
| | - Hongmei Shen
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China.
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Chaudhary M, Verma M, Jena KC, Singh N. Histidine‐Naphthalimide based Organic‐Inorganic Nanohybrid for Electrochemical Detection of Cyanide and Iodide ions. ChemistrySelect 2020. [DOI: 10.1002/slct.202001968] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Monika Chaudhary
- Center for Biomedical Engineering Indian institute of Technology Ropar, Roopnagar Punjab 140001 India
| | - Meenakshi Verma
- Department of UCRD Chandigarh University, Ghraun Mohali, 140413 India
| | - Kailash C. Jena
- Center for Biomedical Engineering Indian institute of Technology Ropar, Roopnagar Punjab 140001 India
- Department of Physics Indian institute of Technology Ropar Roopnagar, Punjab 140001 India
| | - Narinder Singh
- Center for Biomedical Engineering Indian institute of Technology Ropar, Roopnagar Punjab 140001 India
- Department of Chemistry Indian institute of Technology Ropar Roopnagar, Punjab 140001 India
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28
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The significance of serum thyroglobulin measurement before and after the treatment of toxic nodular goiter with 131I. Nucl Med Commun 2020; 41:344-349. [DOI: 10.1097/mnm.0000000000001153] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Affiliation(s)
- Soumya Thumma
- Department of Medicine, St. Vincent's Medical Center, Bridgeport, CT
| | - Venkata Manchala
- Department of Medicine, St. Vincent's Medical Center, Bridgeport, CT.,Frank H. Netter MD School of Medicine, Quinnipiac University, North Haven, CT
| | - Joseph Mattana
- Department of Medicine, St. Vincent's Medical Center, Bridgeport, CT.,Frank H. Netter MD School of Medicine, Quinnipiac University, North Haven, CT
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Wang Y, Cui Y, Chen C, Duan Y, Wu Y, Li W, Zhang D, Li F, Hou C. Stopping the supply of iodized salt alone is not enough to make iodine nutrition suitable for children in higher water iodine areas: A cross-sectional study in northern China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2020; 188:109930. [PMID: 31727496 DOI: 10.1016/j.ecoenv.2019.109930] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 11/04/2019] [Accepted: 11/05/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND For the sake of children's health, iodized salt supply has been stopped in many areas with excessive iodine in the drinking water, but children's iodine nutrition status and thyroid function after terminating the iodized salt supply is unknown. Objective We assessed the iodine nutrition, thyroid function and influencing factors for thyroid abnormalities in children from areas with different concentrations of water iodine; the supply of iodized salt has been stopped in high water iodine areas. This study aimed to evaluate whether the strategy of stopping the supplies of iodized salt alone is enough to avoid thyroid dysfunction in all areas with excess water iodine while still meeting the iodine nutrition needs of children. METHODS A cross-sectional study was conducted in children from four areas with different drinking water iodine concentrations in Tianjin, China. The drinking water samplings and spot urine samples were collected to estimate the external and internal iodine exposure levels. The thyroid volume was measured, and blood samples were collected to assess thyroid function. Logistic regression analysis was used to analyze risk factors for thyroid abnormalities. A dietary survey was conducted to determine the sources of iodine nutrition among the areas with different iodine concentrations in the drinking water. RESULTS In the area with a drinking water iodine concentration ≥300 μg/L, the median urinary iodine concentration (UIC) in children was 476.30 (332.20-639.30) μg/L, which was higher than that in other groups (all P < 0.05), and the prevalence of thyroid nodules and the thyroid goiter rate were higher than those in the <100 μg/L, 100-150 μg/L and 150-300 μg/L areas (all P < 0.01). Binary logistic regression analysis indicated that the risk of thyroid abnormalities was significantly increased in the UIC 200-299 μg/L group (OR: 4.534; 95% CI: 1.565, 13.135; bootstrapped 95% CI: 1.689, 21.206, P = 0.004) and in the UIC ≥ 300 μg/L group (OR: 6.962; 95% CI: 2.490, 19.460; bootstrapped 95% CI: 2.838, 32.570, P = 0.001) compared to the 100-199 μg/L group. The iodine contribution rates from water in areas with water iodine concentrations ≥300 μg/L are up to 63.04%. CONCLUSIONS After termination of the iodized salt supply, the level of iodine nutrition of children in the area with drinking water iodine concentrations ≥300 μg/L is still excessive. The water source needs to be replaced in this area. In the area with a water iodine concentration of 150-300 μg/L, it is proposed that stopping the supply of iodized salt is sufficient to achieve the proper iodine nutrition status in children.
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Affiliation(s)
- Yang Wang
- Tianjin Centers for Disease Control and Prevention, 6 Huayue Road, Hedong District, Tianjin, 300011, PR China
| | - Yushan Cui
- Tianjin Centers for Disease Control and Prevention, 6 Huayue Road, Hedong District, Tianjin, 300011, PR China
| | - Chen Chen
- Tianjin Health Education Center, 6 Huayue Road, Hedong District, Tianjin, 300011, PR China
| | - Yani Duan
- Tianjin Centers for Disease Control and Prevention, 6 Huayue Road, Hedong District, Tianjin, 300011, PR China
| | - Yinghong Wu
- Tianjin Centers for Disease Control and Prevention, 6 Huayue Road, Hedong District, Tianjin, 300011, PR China
| | - Wenfeng Li
- Tianjin Centers for Disease Control and Prevention, 6 Huayue Road, Hedong District, Tianjin, 300011, PR China
| | - DanDan Zhang
- Tianjin Centers for Disease Control and Prevention, 6 Huayue Road, Hedong District, Tianjin, 300011, PR China
| | - Fang Li
- Tianjin Centers for Disease Control and Prevention, 6 Huayue Road, Hedong District, Tianjin, 300011, PR China
| | - Changchun Hou
- Tianjin Centers for Disease Control and Prevention, 6 Huayue Road, Hedong District, Tianjin, 300011, PR China.
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Dynamics of the body weight changes induced by iodine of organic and inorganic chemical nature in the conditions of subclinical hyperthyroidism. ACTA MEDICA LEOPOLIENSIA 2020. [DOI: 10.25040/aml2020.01.062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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32
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Wang Y, Liu Q, Dong H, Feng Y, Raguthu C, Liang X, Liu C, Zhang Z, Yao X. The protective effect of iodide intake adjustment and 1,25(OH) 2D 3 supplementation in rat offspring following excess iodide intake. Ther Adv Endocrinol Metab 2020; 11:2042018820958295. [PMID: 35154633 PMCID: PMC8832296 DOI: 10.1177/2042018820958295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 08/20/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND In this study, we aimed to investigate the effect of iodide intake adjustment, 1,25(OH)2D3 supplementation, or both, on the thyroid gland of rat offspring. METHODS The offspring of female rats administered 100 times the normal dose of iodide (100 HI; 750 μg/d) during pregnancy and lactation were divided into four different treatment groups. They were either having their iodide intake adjusted from 100 HI to normal iodide intake (7.5 μg/day) or supplemented with 25-hydroxy vitamin D3 [1,25(OH)2D3; 5 μg·kg-1·day-1], or both, for 4 weeks. Thyroid sodium pertechnetate (Na99mTcO4) uptake percentages were measured using single-photon emission computed tomography, while serum levels of free triiodothyronine (FT3), free thyroxine (FT4), thyroglobulin antibody (TgAb), thyroid peroxidase antibody (TPOAb), and vitamin D3 (VD3) were monitored using enzyme-linked immunosorbent assay. The messenger ribonucleic acid expression of interleukin (IL)-17A, interferon gamma (IFN-γ), and IL-10 in the thyroid gland was measured using quantitative real-time polymerase chain reaction, while the protein expression of thyroid-hormone-receptor α1 (TRα1) and thyroid-hormone-receptor β1 (TRβ1) in the thyroid gland was detected using Western blotting. Haematoxylin and eosin (H & E) and immunofluorescence staining were also used to assess thyroid follicular structure and lymphocytic infiltration in the thyroid glands. RESULTS The immunofluorescence staining showed CD4+ co-localized with TRβ1 or the vitamin D receptor in thyroid gland cells of rats that were continuously treated with 100 HI. Following iodide adjustment, 1,25(OH)2D3 supplementation, or both, an increase in serum levels of FT3, free thyroxine, and VD3, protein expression of TRα1 and TRβ1 in the thyroid gland cells, and Na99mTcO4 thyroid uptake percentages was observed. The mRNA expression levels of IL-17A and IFN-γ, decreased, while the mRNA expression levels of IL-10 increased in the thyroid cells of each treatment group, except the group with continuous 100 HI intake. CONCLUSION Iodide adjustment, 1,25(OH)2D3 supplementation, or both may increase the serum levels of FT3, FT4, and VD3, as well as the protein expression levels of TRα1 and TRβ1, in thyroid cells. In addition, iodide adjustment, 1,25(OH)2D3 supplementation, or both, may potentially reverse the imbalance in pro-inflammatory and anti-inflammatory cytokines (IL-17A, IFN-γ, and IL-10) caused by 100 HI, which may be beneficial in improving Na99mTcO4 thyroid uptake percentages.
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Affiliation(s)
| | | | | | - Yanni Feng
- Department of Physiology and Pathophysiology,
Tianjin Medical University, Tianjin, China
| | - Ciri Raguthu
- Department of Physiology and Pathophysiology,
Tianjin Medical University, Tianjin, China
| | - Xue Liang
- Department of Physiology and Pathophysiology,
Tianjin Medical University, Tianjin, China
| | - Chen Liu
- Department of Nuclear Medicine, The Second
Hospital of Tianjin Medical University, Tianjin, China
| | - Zuncheng Zhang
- Department of Nuclear Medicine, The Second
Hospital of Tianjin Medical University, Tianjin 300211, China
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Antonelli A, Ferrari SM, Ragusa F, Elia G, Paparo SR, Ruffilli I, Patrizio A, Giusti C, Gonnella D, Cristaudo A, Foddis R, Shoenfeld Y, Fallahi P. Graves' disease: Epidemiology, genetic and environmental risk factors and viruses. Best Pract Res Clin Endocrinol Metab 2020; 34:101387. [PMID: 32107168 DOI: 10.1016/j.beem.2020.101387] [Citation(s) in RCA: 103] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Graves' disease (GD) is the most common cause of hyperthyroidism in developed Countries. It is more common between 30 and 60 years; 5-10 times more frequent in women. The genetic predisposition accounts for 79% of the risk for GD, while environmental factors for 21%. About 70% of genes associated with autoimmune thyroid disorders (AITD) are implicated in T-cell function. Among GD endogenous factors, estrogens, X-inactivation and microchimerism are important. Among environmental risk factors, smoking, iodine excess, selenium and vitamin D deficiency, and the occupational exposure to Agent Orange have been associated with GD. Many studies showed that HCV is associated with thyroid autoimmunity and hypothyroidism, in patients with chronic HCV hepatitis (CHC); a significant link has been shown also between HCV-related mixed cryoglobulinemia and risk for GD. Moreover, IFN-α-treated CHC patients develop GD more frequently. Novel studies are needed about possible risk factors to reduce the occurence of GD in West Countries.
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Affiliation(s)
- Alessandro Antonelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
| | | | - Francesca Ragusa
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
| | - Giusy Elia
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
| | | | - Ilaria Ruffilli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
| | - Armando Patrizio
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
| | - Claudia Giusti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
| | - Debora Gonnella
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
| | - Alfonso Cristaudo
- Department of Translational Research of New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
| | - Rudy Foddis
- Department of Translational Research of New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
| | - Yehuda Shoenfeld
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Russia.
| | - Poupak Fallahi
- Department of Translational Research of New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
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Kim S, Kwon YS, Kim JY, Hong KH, Park YK. Association between Iodine Nutrition Status and Thyroid Disease-Related Hormone in Korean Adults: Korean National Health and Nutrition Examination Survey VI (2013-2015). Nutrients 2019; 11:E2757. [PMID: 31766270 PMCID: PMC6893705 DOI: 10.3390/nu11112757] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 11/06/2019] [Accepted: 11/11/2019] [Indexed: 01/21/2023] Open
Abstract
This study aimed to observe the relationship between iodine nutrition status (dietary iodine intake and estimated iodine intake based on urinary iodine concentration (UIC)) and thyroid disease-related hormones. This study involved 6090 subjects >19 years old with valid UIC, assessed between 2013 and 2015 by the Korean National Health and Nutrition Examination Survey, using a stratified, multistage, clustered probability-sampling design. The estimated iodine intake in participants was measured using UIC and urine creatinine. To examine the effect of iodine intake on thyroid disease, the iodine intake was divided into Korean Dietary Reference Intakes groups, and logistic regression analysis was performed via the surveylogistic procedure to obtain odds ratios (ORs) and 95% confidence intervals (CIs). The estimated iodine intake showed a significant positive correlation with dietary iodine intake (r = 0.021, p < 0.001), UIC (r = 0.918, p < 0.001), and thyroid-stimulating hormone (TSH) (r = 0.043, p < 0.001), but a significant negative correlation with free thyroxine (FT4) (r = -0.037, p < 0.001). Additionally, as the estimated iodine intake increased, age, TSH, and UIC increased, but FT4 decreased (p for trend < 0.0001). The risk of thyroid disease was higher in the "≥tolerable upper intake level (UL ≥ 2400 µg/day)" group than in the "
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Affiliation(s)
- Sohye Kim
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Korea;
- Nutrition Care Services, Seoul National University of Bundang Hospital, Seongnam 13620, Korea
| | | | - Ju Young Kim
- Department of Family Medicine, Seoul National University of Bundang Hospital, Seongnam 13620, Korea;
| | - Kyung Hee Hong
- Department of Food Science and Nutrition, Dongseo University, Pusan 47011, Korea;
| | - Yoo Kyoung Park
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Korea;
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Torres Acosta ND, Loku Galappaththy S, Barthel B. Iodide-induced Hyperthyroidism Within Four Hours of Iodide Load: A Case Report and Review. Cureus 2019; 11:e5960. [PMID: 31803549 PMCID: PMC6874283 DOI: 10.7759/cureus.5960] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The recommended amount of iodide consumption for the majority of adults is approximately 150 mcg per day. During a computed tomography scan, patients can receive 14 to 35 million mcg of iodinated contrast. A 46-year-old African female with no known prior thyroid disease presented with dyspnea and tachycardia. She underwent computed tomography angiogram of the chest to rule out pulmonary embolism. She had evidence of hyperthyroidism four hours after receiving iodinated contrast. We presumed that her hyperthyroidism was a consequence of the Jod-Basedow phenomenon due to an underlying multinodular goiter that was later discovered.
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Affiliation(s)
- Noel D Torres Acosta
- Internal Medicine, University of Missouri-Kansas City School of Medicine, Truman Medical Center, Kansas City, USA
| | | | - Brandon Barthel
- Endocrinology, University of Missouri-Kansas City School of Medicine, Kansas City, USA
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Bel Lassen P, Kyrilli A, Lytrivi M, Corvilain B. Graves' disease, multinodular goiter and subclinical hyperthyroidism. ANNALES D'ENDOCRINOLOGIE 2019; 80:240-249. [PMID: 31427038 DOI: 10.1016/j.ando.2018.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 06/27/2018] [Accepted: 09/04/2018] [Indexed: 12/17/2022]
Abstract
Subclinical hyperthyroidism is a common clinical entity, defined by serum TSH below the reference range, with normal FT4 and FT3 levels in an asymptomatic patient. Whether or not subclinical hyperthyroidism should be treated remains a matter of debate. Cross-sectional and longitudinal population-based studies demonstrate association of subclinical hyperthyroidism with risk of atrial fibrillation and osteoporosis, and with cardiovascular and all-cause mortality. However, there are no randomized clinical trials addressing whether long-term health outcomes are improved by treating subclinical hyperthyroidism; in the absence of evidence one way or the other, it seems appropriate to use decision trees taking account of TSH concentration and presence of risk factors (age>65 years or post-menopause, osteoporosis and cardiac disease).
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Affiliation(s)
- Pierre Bel Lassen
- Department of endocrinology, université Libre de Bruxelles, Erasme University Hospital, route de Lennik 808, 1070 Brussels, Belgium; UMRS 1166 (Inserm), 91, boulevard de l'Hôpital, 75013 Paris, France.
| | - Aglaia Kyrilli
- Department of endocrinology, université Libre de Bruxelles, Erasme University Hospital, route de Lennik 808, 1070 Brussels, Belgium
| | - Maria Lytrivi
- Department of endocrinology, université Libre de Bruxelles, Erasme University Hospital, route de Lennik 808, 1070 Brussels, Belgium
| | - Bernard Corvilain
- Department of endocrinology, université Libre de Bruxelles, Erasme University Hospital, route de Lennik 808, 1070 Brussels, Belgium
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Leidig-Bruckner G. Jodhaltige Kontrastmittel bei Patienten mit Schilddrüsenerkrankungen. Radiologe 2019; 59:413-424. [DOI: 10.1007/s00117-019-0520-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Farebrother J, Zimmermann MB, Andersson M. Excess iodine intake: sources, assessment, and effects on thyroid function. Ann N Y Acad Sci 2019; 1446:44-65. [PMID: 30891786 DOI: 10.1111/nyas.14041] [Citation(s) in RCA: 101] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 01/30/2019] [Accepted: 02/02/2019] [Indexed: 12/15/2022]
Abstract
Iodine is essential for thyroid hormone synthesis. High iodine intakes are well tolerated by most healthy individuals, but in some people, excess iodine intakes may precipitate hyperthyroidism, hypothyroidism, goiter, and/or thyroid autoimmunity. Individuals with preexisting thyroid disease or those previously exposed to iodine deficiency may be more susceptible to thyroid disorders due to an increase in iodine intake, in some cases at intakes only slightly above physiological needs. Thyroid dysfunction due to excess iodine intake is usually mild and transient, but iodine-induced hyperthyroidism can be life-threatening in some individuals. At the population level, excess iodine intakes may arise from consumption of overiodized salt, drinking water, animal milk rich in iodine, certain seaweeds, iodine-containing dietary supplements, and from a combination of these sources. The median urinary iodine concentration (UIC) of a population reflects the total iodine intake from all sources and can accurately identify populations with excessive iodine intakes. Our review describes the association between excess iodine intake and thyroid function. We outline potential sources of excess iodine intake and the physiological responses and consequences of excess iodine intakes. We provide guidance on choice of biomarkers to assess iodine intake, with an emphasis on the UIC and thyroglobulin.
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Affiliation(s)
- Jessica Farebrother
- Human Nutrition Laboratory, Institute of Food, Nutrition, and Health, ETH Zurich, Zurich, Switzerland.,Department of Women and Children's Health, King's College London, London, UK
| | - Michael B Zimmermann
- Human Nutrition Laboratory, Institute of Food, Nutrition, and Health, ETH Zurich, Zurich, Switzerland.,Iodine Global Network, Ottawa, Ontario, Canada
| | - Maria Andersson
- Human Nutrition Laboratory, Institute of Food, Nutrition, and Health, ETH Zurich, Zurich, Switzerland.,Iodine Global Network, Ottawa, Ontario, Canada.,Division of Gastroenterology and Nutrition, University Children's Hospital Zurich, Zurich, Switzerland
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Santos JAR, Christoforou A, Trieu K, McKenzie BL, Downs S, Billot L, Webster J, Li M. Iodine fortification of foods and condiments, other than salt, for preventing iodine deficiency disorders. Cochrane Database Syst Rev 2019; 2:CD010734. [PMID: 30746700 PMCID: PMC6370918 DOI: 10.1002/14651858.cd010734.pub2] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Iodine deficiency disorders (IDD) affect close to 1.9 billion people worldwide, and are a major public health concern in many countries. Among children, iodine deficiency is the main cause of potentially preventable deficits of central nervous system development and impairment of cognitive function, as well as goitre and hypothyroidism in people of all ages. Salt iodisation is the preferred strategy for IDD prevention and control, however, in some instances where salt is not the major condiment, alternate vehicles for iodine fortification have been considered. OBJECTIVES To assess the effects of fortifying foods, beverages, condiments, or seasonings other than salt with iodine alone or in conjunction with other micronutrients, on iodine status and health-related outcomes in all populations. SEARCH METHODS Studies were identified through systematic searches of the following databases from their start date to January 2018: Cochrane Public Health Group Specialised Register; CENTRAL; MEDLINE; MEDLINE in Process; Embase; Web of Science; CINAHL; POPLINE; AGRICOLA; BIOSIS; Food Science and Technology Abstracts; OpenGrey; Bibliomap and TRoPHI; AGRIS; IBECS; Scielo; Global Index Medicus-AFRO and EMRO; LILACS; PAHO; WHOLIS; WPRO; IMSEAR; IndMED; and Native Health Research Database. We also searched reference list of relevant articles, conference proceedings, and databases of ongoing trials, and contacted experts and relevant organisations to identify any unpublished work. We applied no language or date restrictions. SELECTION CRITERIA Studies were eligible if they were randomised or quasi-randomised controlled trials (RCT) with randomisation at either the individual or cluster level (including cross-over trials), non-randomised RCTs, or prospective observational studies with a control group, such as cohort studies, controlled before-and-after studies, and interrupted time series. We included studies that examined the effects of fortification of food, beverage, condiment, or seasoning with iodine alone, or in combination with other micronutrients versus the same unfortified food, or no intervention. We considered the following measures: death (all-cause), goitre, physical development, mental development, cognitive function and motor skill development, cretinism, hypothyroidism, adverse effects (any reported by trialists), urinary iodine concentration, thyroid-stimulating hormone (TSH) concentration, and serum thyroglobulin concentration. We included all populations, including pregnant women, from any country. DATA COLLECTION AND ANALYSIS Two review authors independently assessed study eligibility, extracted data, and assessed risk of bias of included studies.We used random-effects meta-analyses to combine data and generate an overall estimate of treatment effect, when more than one study examined the same outcome measure. The overall effect estimate was calculated as the mean difference (MD) or standardised mean difference (SMD) between the intervention group and the comparison group for continuous outcomes, and as odds ratio (OR) for dichotomous outcomes. We assessed the level of heterogeneity through the I² statistic. We conducted post-hoc subgroup analyses to explore possible sources of heterogeneity, and sensitivity analyses to check the robustness of the findings from the primary analyses. We assessed the quality of the evidence for each outcome using the GRADE framework.Where it was not possible to pool the results in a meta-analysis, we provided a narrative summary of the outcomes. MAIN RESULTS Eleven studies met the criteria, providing 14 comparisons, and capturing data on 4317 participants. Seven studies were RCTs, three were cluster non-RCTs, and one was a randomised cross-over design. Seven studies were carried out among school children (N = 3636), three among women of reproductive age (N = 648), and one among infants (N = 33). The studies used diverse types of food as vehicle for iodine delivery: biscuits, milk, fish sauce, drinking water, yoghourt, fruit beverage, seasoning powder, and infant formula milk. Daily amounts of iodine provided ranged from 35 µg/day to 220 µg/day; trial duration ranged from 11 days to 48 weeks. Five studies examined the effect of iodine fortification alone, two against the same unfortified food, and three against no intervention. Six studies evaluated the effect of cofortification of iodine with other micronutrients versus the same food without iodine but with different levels of other micronutrients. We assessed one study to be at low risk of bias for all bias domains, three at low risk of bias for all domains apart from selective reporting, and seven at an overall rating of high risk of bias.No study assessed the primary outcomes of death, mental development, cognitive function, cretinism, or hypothyroidism, or secondary outcomes of TSH or serum thyroglobulin concentration. Two studies reported the effects on goitre, one on physical development measures, and one on adverse effects. All studies assessed urinary iodine concentration.The effects of iodine fortification compared to control on goitre prevalence (OR 1.60, 95% CI 0.60 to 4.31; 1 non-RCT, 83 participants; very low-quality evidence), and five physical development measures were uncertain (1 non-RCT, 83 participants; very low-quality evidence): weight (MD 0.23 kg, 95% CI -6.30 to 6.77); height (MD -0.66 cm, 95% CI -4.64 to 3.33); weight-for-age (MD 0.05, 95% CI -0.59 to 0.69); height-for-age (MD -0.30, 95% CI -0.75 to 0.15); and weight-for-height (MD -0.21, 95% CI -0.51 to 0.10). One study reported that there were no adverse events observed during the cross-over trial (low-quality evidence).Pooled results from RCTs showed that urinary iodine concentration significantly increased following iodine fortification (SMD 0.59, 95% CI 0.37 to 0.81; 6 RCTs, 2032 participants; moderate-quality evidence). This is equivalent to an increase of 38.32 µg/L (95% CI 24.03 to 52.61 µg/L). This effect was not observed in the meta-analysis of non-RCTs (SMD 0.25, 95% CI -0.16 to 0.66; 3 non-RCTs, 262 participants; very low-quality evidence). Sensitivity analyses did not change the effect observed in the primary analyses. AUTHORS' CONCLUSIONS The evidence on the effect of iodine fortification of foods, beverages, condiments, or seasonings other than salt on reducing goitre, improving physical development measures, and any adverse effects is uncertain. However, our findings suggest that the intervention likely increases urinary iodine concentration. Additional, adequately powered, high-quality studies on the effects of iodine fortification of foods on these, and other important outcomes, as well as its efficacy and safety, are required.
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Affiliation(s)
- Joseph Alvin R Santos
- The George Institute for Global Health, University of New South WalesOffice of the Chief ScientistSydneyAustralia
| | | | - Kathy Trieu
- The George Institute for Global Health, University of New South WalesOffice of the Chief ScientistSydneyAustralia
| | - Briar L McKenzie
- The George Institute for Global Health, University of New South WalesOffice of the Chief ScientistSydneyAustralia
| | - Shauna Downs
- Rutgers School of Public HealthDepartment of Health Systems and PolicyNew BrunswickNJUSA
| | - Laurent Billot
- The George Institute for Global Health, University of New South WalesOffice of the Chief ScientistSydneyAustralia
| | - Jacqui Webster
- The George Institute for Global Health, University of New South WalesOffice of the Chief ScientistSydneyAustralia
| | - Mu Li
- The University of SydneySydney School of Public HealthLevel 10, King George V Building RPA. 83‐117 Missenden RoadCamperdownNSWAustralia2050
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Is iodine nutrition in the Spanish pediatric population adequate? Historical review and current situation. ACTA ACUST UNITED AC 2018; 65:458-467. [PMID: 30030155 DOI: 10.1016/j.endinu.2018.05.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 05/16/2018] [Accepted: 05/16/2018] [Indexed: 11/21/2022]
Abstract
Iodine is an essential component of thyroid hormones, and iodine deficit is the leading cause of preventable mental retardation worldwide. Spain was considered iodine-deficient until 2003. Although iodine urinary levels have been in the optimal range in Spain since 2004, the WHO recognizes that our country does not meet the necessary requirements to ensure that the whole population is not at risk of an iodine deficiency disorder. The aim of this article is to review the current iodine status in Spain. Data from several studies emphasize the low consumption of iodized salt at home. Despite the progress made in recent decades, Spanish children are not exempt from suffering an iodine deficiency disorder. Policies that allow for controlling iodine nutrition and promote universal consumption of iodized salt should therefore be implemented.
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Kang MJ, Hwang IT, Chung HR. Excessive Iodine Intake and Subclinical Hypothyroidism in Children and Adolescents Aged 6-19 Years: Results of the Sixth Korean National Health and Nutrition Examination Survey, 2013-2015. Thyroid 2018; 28:773-779. [PMID: 29737233 DOI: 10.1089/thy.2017.0507] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Iodine is an important element for the synthesis of thyroid hormone, and its deficiency or excessive intake is associated with various thyroid diseases. Little is known about the association between iodine status and thyroid function among children and adolescents living in iodine-rich areas. Therefore, this study analyzed this association using data from a nationwide survey. METHODS From the Korea National Health and Nutrition Examination Surveys VI (2013-2015) data, 1288 subjects (711 male) aged 6-19 years who underwent a urinary iodine concentration (UIC) test and 1000 subjects (564 male) aged 10-19 years who underwent a thyroid function test were included in this study. Serum levels of thyrotropin (TSH), free thyroxine (fT4), and thyroperoxidase antibodies (TPOAb) were analyzed. Subclinical hypothyroidism (SCH) was defined as TSH >5.5 μIU/mL with a normal fT4 level. Median daily iodine intake was calculated from the UIC. Daily sodium intake was derived from the nutritional survey data of 1181 subjects. RESULTS The median UIC was 449 μg/L (range 15-21,905 μg/L), and the prevalence rates of UIC ≥300 μg/L and ≥1000 μg/L were 64.9% and 25.0%, respectively. The prevalence rates of a sodium intake >2000 mg/day and iodine intake >2400 μg/day were 75.0% (885/1181) and 12.7% (164/1288), respectively. The prevalence rates of SCH and TPOAb >34 IU/mL were 7.2% (72/1000) and 2.3% (23/1000), respectively. The prevalence of SCH was significantly higher in the iodine deficient and iodine excess groups compared to those in the UIC 100-299.9 μg/L group (p = 0.038). Therefore, there was a U-shaped and inverted U-shaped correlation between serum levels of TSH and fT4 with UIC, respectively. These correlations were especially prominent when UIC was >1000 μg/L. There was no definite correlation between TPOAb and UIC. CONCLUSIONS Excess iodine was prevalent in Korean children and adolescents, and it may be associated with SCH. Therefore, monitoring the iodine status and education on adequate intake are needed in iodine-rich areas.
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Affiliation(s)
- Min Jae Kang
- 1 Department of Pediatrics, Hallym University Sacred Heart Hospital , Anyang, Korea
| | - Il Tae Hwang
- 2 Department of Pediatrics, Kangdong Sacred Heart Hospital , Seoul, Korea
| | - Hye Rim Chung
- 3 Department of Pediatrics, Seoul National University Bundang Hospital , Seongnam, Korea
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Li S, Nie Y, Zhan J, Wang Y, Huang W, Wang Y, He J, Liu Y. The analysis of correlation between frailty index and postoperative complications of aged patients with nodular goiter. Aging Med (Milton) 2018; 1:18-22. [PMID: 31942475 PMCID: PMC6880665 DOI: 10.1002/agm2.12016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 04/02/2018] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE To explore the correlation between frailty index (FI) and postoperative complications of aged patients with nodular goiter (NG). METHODS A total of 120 aged patients with NG undergoing operative treatment from May 2013 to October 2015 in our hospital were selected. All of them were divided into 3 groups according to the FI as follows: nonfrail group (FI < 0.2), intermediately frail group (0.2 ≤ FI < 0.4), and frail group (FI ≥ 0.4). Clinical data of patients about general data, body mass index, American Society of Anesthesiology (ASA) classification, hospital stays, and postoperative complications were examined. Then, the correlations between the indexes above and FI were examined. RESULTS Frailty index and the ASA classification have some relevance (r = .265, P = .007). The postoperative complication rates of total nonfrail group, intermediately frail group, and frail group were, respectively, 4 cases (11.4%), 11 cases (31.4%), and 24 cases (48.0%). With the increase in FI, the incidence of postoperative complications and hospital stays had also significantly increased. The area under receiver operating characteristic curve examining frailty's ability to forecast postoperative complications was 0. 815 (95% CI: 0.675-0.954, P = .000). CONCLUSION The level of frailty index is a risk factor for postoperative complications of aged patients with NG. The preoperative frailty index evaluation can provide reference evidence for the treatment of aged NG patients undergoing surgery.
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Affiliation(s)
- Shuang Li
- Department of Geriatricsthe Second Xiangya HospitalCentral South UniversityChangshaChina
| | - Yue Nie
- Department of Geriatricsthe Third Hospital of ChangshaChangshaChina
| | - Junkun Zhan
- Department of Geriatricsthe Second Xiangya HospitalCentral South UniversityChangshaChina
| | - Yanjiao Wang
- Department of Geriatricsthe Second Xiangya HospitalCentral South UniversityChangshaChina
| | - Wu Huang
- Department of Geriatricsthe Second Xiangya HospitalCentral South UniversityChangshaChina
| | - Yi Wang
- Department of Geriatricsthe Second Xiangya HospitalCentral South UniversityChangshaChina
| | - Jieyu He
- Department of Geriatricsthe Second Xiangya HospitalCentral South UniversityChangshaChina
| | - Youshuo Liu
- Department of Geriatricsthe Second Xiangya HospitalCentral South UniversityChangshaChina
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Wainwright P, Cook P. The assessment of iodine status - populations, individuals and limitations. Ann Clin Biochem 2018; 56:7-14. [PMID: 29703103 DOI: 10.1177/0004563218774816] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Iodine deficiency is a significant global health concern, and the single greatest cause of preventable cognitive impairment. It is also a growing public health concern in the UK particularly among pregnant women. Biomarkers such as urinary iodine concentration have clear utility in epidemiological studies to investigate population-level iodine status, but determination of iodine status in individuals is much more problematic with current assays. This article reviews the available biomarkers of iodine status and their relative utility at the level of both populations and individuals for the investigation of iodine deficiency and iodine excess.
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Affiliation(s)
- Patrick Wainwright
- 1 Chemical Pathology and Metabolic Medicine, Department of Laboratory Medicine, University Hospital Southampton, Southampton, UK.,2 Current affiliation: Department of Blood Sciences, Glan Clwyd Hospital, Bodelwyddan, UK
| | - Paul Cook
- 1 Chemical Pathology and Metabolic Medicine, Department of Laboratory Medicine, University Hospital Southampton, Southampton, UK
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Doh HS, Park HJ. Speciation of Bio-Available Iodine in Abalone (Haliotis discus hannai) by High-Performance Liquid Chromatography Hyphenated with Inductively Coupled Plasma-Mass Spectrometry Using an In Vitro Method. J Food Sci 2018; 83:1579-1587. [PMID: 29786855 DOI: 10.1111/1750-3841.14173] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 04/02/2018] [Accepted: 04/04/2018] [Indexed: 11/26/2022]
Abstract
Abalone is one of the most valuable marine products found in East Asia because it is rich in nutritious substances including iodine. In this study, the in vitro dialyzability approach was used to assess the bio-available iodine species in abalone. Iodide, iodate, 3-iodo-L-tyrosine (MIT), and 3,5-diiodo-L-tyrosine (DIT) were separated by high-performance liquid chromatography hyphenated with inductively coupled plasma-mass spectrometry (HPLC-ICP-MS). To assure the consistency, reliability, and accuracy of the data, the method was validated. Comparison of the total iodine in abalone muscle and viscera indicated that abalone muscle showed greater digestion/absorption efficiency than abalone viscera (digestion efficiency: 68.13 ± 2.59% and 47.88 ± 5.76% and absorption efficiency: 59.78 ± 2.93% and 35.12 ± 1.43% for abalone viscera and muscle, respectively). However, evaluation of the sum of the analyzed iodine species targeted in this study by HPLC-ICP-MS indicated that abalone muscle showed lower digestion efficiency and similar absorption efficiency compared to that of abalone viscera (digestion efficiency: 35.52 ± 5.41% and 28.84 ± 1.83%; absorption efficiency: 23.56 ± 4.38% and 27.56 ± 1.51% for abalone viscera and muscle, respectively). The main forms of iodine detected in abalone muscle were iodide and MIT, whereas iodide was the major form in abalone viscera. PRACTICAL APPLICATION The bio-available iodine in abalone was quantified via an in vitro method employing HPLC-ICP-MS. The results of this study indicated that abalone is feasible as a new iodine source and may prospectively find application in iodine-fortified foods.
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Affiliation(s)
- Han Sol Doh
- Dept. of Biotechnology, College of Life Science and Biotechnology, Korea Univ., Anam-dong, Seongbuk-gu, Seoul, 02841, Republic of Korea
| | - Hyun Jin Park
- Dept. of Biotechnology, College of Life Science and Biotechnology, Korea Univ., Anam-dong, Seongbuk-gu, Seoul, 02841, Republic of Korea
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Taylor PN, Albrecht D, Scholz A, Gutierrez-Buey G, Lazarus JH, Dayan CM, Okosieme OE. Global epidemiology of hyperthyroidism and hypothyroidism. Nat Rev Endocrinol 2018; 14:301-316. [PMID: 29569622 DOI: 10.1038/nrendo.2018.18] [Citation(s) in RCA: 644] [Impact Index Per Article: 107.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Thyroid hormones are essential for growth, neuronal development, reproduction and regulation of energy metabolism. Hypothyroidism and hyperthyroidism are common conditions with potentially devastating health consequences that affect all populations worldwide. Iodine nutrition is a key determinant of thyroid disease risk; however, other factors, such as ageing, smoking status, genetic susceptibility, ethnicity, endocrine disruptors and the advent of novel therapeutics, including immune checkpoint inhibitors, also influence thyroid disease epidemiology. In the developed world, the prevalence of undiagnosed thyroid disease is likely falling owing to widespread thyroid function testing and relatively low thresholds for treatment initiation. However, continued vigilance against iodine deficiency remains essential in developed countries, particularly in Europe. In this report, we review the global incidence and prevalence of hyperthyroidism and hypothyroidism, highlighting geographical differences and the effect of environmental factors, such as iodine supplementation, on these data. We also highlight the pressing need for detailed epidemiological surveys of thyroid dysfunction and iodine status in developing countries.
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Affiliation(s)
- Peter N Taylor
- Thyroid Research Group, Systems Immunity Research Institute, Cardiff University School of Medicine, Cardiff, UK
| | - Diana Albrecht
- University Medicine Greifswald, Institute for Community Medicine, Greifswald, Germany
| | - Anna Scholz
- Thyroid Research Group, Systems Immunity Research Institute, Cardiff University School of Medicine, Cardiff, UK
| | - Gala Gutierrez-Buey
- Clinica Universidad de Navarra, Department of Endocrinology and Nutrition, Pamplona, Spain
| | - John H Lazarus
- Thyroid Research Group, Systems Immunity Research Institute, Cardiff University School of Medicine, Cardiff, UK
| | - Colin M Dayan
- Thyroid Research Group, Systems Immunity Research Institute, Cardiff University School of Medicine, Cardiff, UK
| | - Onyebuchi E Okosieme
- Thyroid Research Group, Systems Immunity Research Institute, Cardiff University School of Medicine, Cardiff, UK
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Henry RK, Chaudhari M. In iodine-induced thyrotoxicosis, steroid therapy today could keep the surgical knife at bay. J Pediatr Endocrinol Metab 2018; 31:585-588. [PMID: 29466241 DOI: 10.1515/jpem-2017-0485] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 01/29/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND Amiodarone-induced thyrotoxicosis (AIT) type 2, characterized as a destructive thyroiditis, is well described in the medical literature; however, iodine-induced thyrotoxicosis (IIT) is not, though the latter has similar features and can be managed similarly. CASE PRESENTATION We present a 17-year-old female who presented with a history of an intermittent goiter with thyroid function tests (TFTs): thyroid-stimulating hormone (TSH)<0.015 (0.4-4 μU/mL), free thyroxine (T4)≥6 (0.7-2.1 ng/dL) and total triiodothyronine (T3) 651 (50-200 mg/dL). Thyroid antibodies were all negative. Despite methimazole therapy for 6 weeks, hyperthyroidism proved refractory to medical management. 123I scan uptake was suppressed. With hyperthyroidism being recalcitrant to therapy, a nutritional history revealed consumption of an iodine supplement containing at least 7 times the recommended daily allowance (RDA) for 5 years, contributing to the Jod-Basedow phenomenon. Urinary spot and 24-hour urinary iodine were both elevated. Though a surgical consult was obtained, surgery was cancelled once TFTs improved and then normalized with steroid therapy. The TFTs and urinary iodine levels remained normal post steroid therapy. CONCLUSIONS We suggest that in addition to the need for a thorough nutritional history, a trial of corticosteroids should be utilized in the management of IIT which can present with findings similar to AIT type 2 which is recalcitrant to thionamide therapy. If successful, corticosteroids may delay or prevent surgical management thus avoiding possible complications with the latter approach.
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Affiliation(s)
- Rohan K Henry
- Division of Endocrinology, Department of Pediatrics, Nationwide Children's Hospital/The Ohio State University College of Medicine, Columbus, OH, USA
| | - Monika Chaudhari
- Division of Endocrinology, Department of Pediatrics, Nationwide Children's Hospital/The Ohio State University College of Medicine, Columbus, OH, USA
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Qin F, Pan X, Yang J, Li S, Shao L, Zhang X, Liu B, Li J. Dietary Iodine Affected the GSH-Px to Regulate the Thyroid Hormones in Thyroid Gland of Rex Rabbits. Biol Trace Elem Res 2018; 181:251-257. [PMID: 28577235 DOI: 10.1007/s12011-017-1064-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 05/23/2017] [Indexed: 12/17/2022]
Abstract
Iodine (I) is an essential trace element that can influence animal health and productivity. In this study, we investigated the effects of dietary iodine on the antioxidant indices of organ (liver and thyroid gland) and messenger RNA (mRNA) expression of glutathione peroxidase (GSH-Px) in Rex rabbits. A total of 120 4-month-old Rex rabbits (2235.4 ± 13.04 g BW) were divided into four equal groups, and their diets were supplemented with iodine (0, 0.2, 2, or 4 mg/kg dry matter (DM)). The iodine concentration in basal diet (control group) was 0.36 mg/kg DM. In most of measured parameters, supplemental iodine exerted no significant effect. Growth and slaughter performance and organ weight were not influenced significantly by iodine supplementation. Serum T3 was significantly lower in 2-mg I group than in 0.2 and 4-mg I groups (P < 0.05). Superoxide dismutase (SOD), GSH-Px, methane dicarboxylic aldehyde (MDA), and thyroperoxidase (TPO) in the serum and liver were not influenced (P > 0.05). Conversely, serum catalase (CAT) was significantly reduced (P < 0.05). In the thyroid, GSH-Px was higher in the 2-mg I group than in the 0.2- and 4-mg I groups (P < 0.05). RT-PCR results showed that the mRNA expression level of GSH-Px in the liver was not significantly influenced (P > 0.05). In the thyroid gland, the mRNA expression level of GSH-Px was higher in the 2-mg I group than in the 4-mg I group (P < 0.05), which agreed with the activity of GSH-Px. In conclusion, iodine supplementation exerted no effect on the performance and antioxidant capacity of the body, but dietary iodine influenced serum T3 or GSH-Px in the thyroid gland. Thus, on the basis of serum T3 and GSH-Px levels in the thyroid gland, we hypothesized that GSH-Px secretion was increased by adding dietary iodine in the thyroid, which may inhibit the H2O2 generation and further influence the thyroid hormone synthesis.
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Affiliation(s)
- Feng Qin
- Institute of Animal Science, Jiangsu Academy of Agricultural Sciences, Nanjing, 210014, People's Republic of China
| | - Xiaoqing Pan
- Institute of Animal Science, Jiangsu Academy of Agricultural Sciences, Nanjing, 210014, People's Republic of China
| | - Jie Yang
- Institute of Animal Science, Jiangsu Academy of Agricultural Sciences, Nanjing, 210014, People's Republic of China.
| | - Sheng Li
- Institute of Animal Science, Jiangsu Academy of Agricultural Sciences, Nanjing, 210014, People's Republic of China
| | - Le Shao
- Institute of Animal Science, Jiangsu Academy of Agricultural Sciences, Nanjing, 210014, People's Republic of China
| | - Xia Zhang
- Institute of Animal Science, Jiangsu Academy of Agricultural Sciences, Nanjing, 210014, People's Republic of China
| | - Beiyi Liu
- Institute of Animal Science, Jiangsu Academy of Agricultural Sciences, Nanjing, 210014, People's Republic of China
| | - Jian Li
- Institute of Animal Science, Jiangsu Academy of Agricultural Sciences, Nanjing, 210014, People's Republic of China
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Bonelli N, Rossetto R, Castagno D, Anselmino M, Vignolo F, Parasiliti Caprino M, Gaita F, Ghigo E, Garberoglio R, Grimaldi R, Maccario M. Hyperthyroidism in patients with ischaemic heart disease after iodine load induced by coronary angiography: Long-term follow-up and influence of baseline thyroid functional status. Clin Endocrinol (Oxf) 2018; 88:272-278. [PMID: 29023926 DOI: 10.1111/cen.13494] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 10/06/2017] [Accepted: 10/08/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To study the effect of a iodine load on thyroid function of patients with ischaemic heart disease (IHD) and the long-term influence of unknown subclinical hyperthyroidism. CONTEXT Subclinical hyperthyroidism is considered an independent risk factors for cardiovascular morbidity of patients with IHD. They routinely undergo coronary angiography with iodine contrast media (ICM) which may induce or even worsen hyperthyroidism. DESIGN A cross-sectional study followed by a longitudinal study on patients with subclinical hyperthyroidism. PATIENTS 810 consecutive IHD outpatients without known thyroid diseases or treatment with drugs influencing thyroid activity undergoing elective coronary angiography. MEASUREMENTS We evaluated thyroid function either before and 1 month after ICM; patients with thyrotoxicosis at baseline or after ICM were then followed up for 1 year. RESULTS 58 patients had hyperthyroidism at baseline (HB, 7.2%), independently associated to FT4 levels, thyroid nodules and family history of thyroid diseases. After ICM, the prevalence of hyperthyroidism was 81 (10%). Hyperthyroidism after ICM was positively predicted by baseline fT4 levels, thyroid nodules, age over 60, male gender, family history of thyroid diseases. Three months after ICM, 34 patients (4.2%) still showed hyperthyroidism (22 from HB, 13 treated with methimazole). One year after ICM, hyperthyroidism was still present in 20 patients (2.5%, all from HB, 13 treated). CONCLUSIONS The prevalence of spontaneous subclinical hyperthyroidism in IHD is surprisingly elevated and is further increased by iodine load, particularly in patients with thyroid nodules and familial history of thyroid diseases, persisting in a not negligible number of them even after one year.
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Affiliation(s)
- Nadia Bonelli
- Division of Endocrinology, Diabetology, and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Ruth Rossetto
- Division of Endocrinology, Diabetology, and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Davide Castagno
- Division of Cardiology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Matteo Anselmino
- Division of Cardiology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Francesca Vignolo
- Division of Endocrinology, Diabetology, and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Mirko Parasiliti Caprino
- Division of Endocrinology, Diabetology, and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Fiorenzo Gaita
- Division of Cardiology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Ezio Ghigo
- Division of Endocrinology, Diabetology, and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Roberto Garberoglio
- Division of Endocrinology, Diabetology, and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Roberto Grimaldi
- Division of Cardiology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Mauro Maccario
- Division of Endocrinology, Diabetology, and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy
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Severe Thyrotoxicosis Secondary to Povidone-Iodine from Peritoneal Dialysis. Case Rep Endocrinol 2017; 2017:2683120. [PMID: 28912982 PMCID: PMC5587962 DOI: 10.1155/2017/2683120] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 07/27/2017] [Indexed: 11/17/2022] Open
Abstract
A 73-year-old male on home peritoneal dialysis (PD) with recent diagnosis of atrial fibrillation presented with fatigue and dyspnea. Hyperthyroidism was diagnosed with TSH < 0.01 mIU/L and FT4 > 100 pmol/L. He had no personal or family history of thyroid disease. There had been no exposures to CT contrast, amiodarone, or iodine. Technetium thyroid scan showed diffusely decreased uptake. He was discharged with a presumptive diagnosis of thyroiditis. Three weeks later, he had deteriorated clinically. Possible iodine sources were again reviewed, and it was determined that povidone-iodine solution was used with each PD cycle. Methimazole 25 mg daily was initiated; however, he had difficulty tolerating the medication and continued to clinically deteriorate. He was readmitted to hospital where methimazole was restarted at 20 mg bid with high dose prednisone 25 mg and daily plasma exchange (PLEX) therapy. Biochemical improvement was observed with FT4 dropping to 48.5 pmol/L by day 10, but FT4 rebounded to 67.8 pmol/L after PLEX was discontinued. PLEX was restarted and thyroidectomy was performed. Pathology revealed nodular hyperplasia with no evidence of thyroiditis. Preoperative plasma iodine levels were greater than 5 times the upper limit of normal range. We hypothesize that the patient had underlying autonomous thyroid hormone production exacerbated by exogenous iodine exposure from a previously unreported PD-related source.
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Kempker K, Güssow A, Cook AM, Rick M, Neiger R. [Alimentary thyrotoxcicosis in two dogs]. TIERAERZTLICHE PRAXIS AUSGABE KLEINTIERE HEIMTIERE 2017; 45:193-198. [PMID: 28368068 DOI: 10.15654/tpk-160554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Accepted: 08/12/2016] [Indexed: 11/13/2022]
Abstract
Two dogs with increased thyroxin concentrations compatible with hyperthyroidism were referred for further examinations. One dog displayed clinical signs of hyperthyroidism. Based on history, clinical examination, laboratory evaluation and scintigraphy an alimentary thyrotoxicosis was identified. It was caused by feeding a BARF diet containing thyroidal tissue in one dog and by conventional dog food in the other patient. After changing the diet the clinical signs resolved in the affected dog. A control examination revealed thyroxin concentrations within the reference range in both dogs.
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Affiliation(s)
- Karsten Kempker
- Karsten Kempker, Klinik für Kleintiere - Innere Medizin, Justus-Liebig-Universität Gießen, Frankfurter Straße 126, 35392 Gießen, E-Mail:
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