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Song Q, Xu T, Wang Y, Wei H, Tan F, Chen Y, Fang F, Cui T, Pan Z, Guo X, Chen W, Shen J, Zhang W, Tan L. Exploring the Correlation Between Varied Serum Iodine Nutritional Levels and Anti-Thyroglobulin Antibodies. Biol Trace Elem Res 2024:10.1007/s12011-024-04275-5. [PMID: 38888857 DOI: 10.1007/s12011-024-04275-5] [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: 03/20/2024] [Accepted: 06/12/2024] [Indexed: 06/20/2024]
Abstract
Iodine deficiency results in elevated thyroglobulin (Tg) concentrations, with high iodine Tg being more immunogenic than low iodine Tg. The study investigated the correlation between serum iodine concentration and thyroglobulin autoantibody (TgAb) levels across diverse iodine nutritional statuses as determined by urine iodine concentration (UIC). Demographic information was collected from 1,482 participants through a questionnaire. Blood and spot urine were collected to measure thyroid-stimulating hormone (TSH), TgAb, thyroid anti-peroxidase antibody (TPOAb), serum iodine (SIC), serum non-protein-bound iodine (snPBI), urine iodine (UIC), creatinine (UCr). The median UIC and SIC were 146.5 μg/L and 74.9 μg/L, respectively. A linear relationship was observed between SIC, snPBI, and serum-protein-bound iodine (sPBI) (P < 0.001). The 90% reference intervals for SIC, snPBI, and sPBI were 50.7-120.7 μg/L, 21.9-52.9 μg/L, and 19.7-77.9 μg/L, respectively. The prevalence of elevated TgAb levels was significantly higher in women than in men (P < 0.001). Both low and high levels of snPBI and sPBI were associated with an increased risk of elevated TgAb levels. In women, the risk of positive TgAb in the group below the reference value of snPBI (OR = 2.079, 95%CI: 1.166, 3.705) and sPBI (OR = 2.578, 95%CI: 1.419, 4.684) was higher. In men, the risk of positive TgAb in the group below the reference value of SIC was higher (OR = 3.395, 95%CI: 1.286, 8.962). Iodine might exert an influence on TgAb levels through its binding to proteins, primarily Tg, thereby altering the iodine content of Tg. The interplay of gender factors further enhanced the risk of TgAb emergence.
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Affiliation(s)
- Qiuyi Song
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, China
| | - Tingting Xu
- Department of Nutrition and Food Safety, School of Public Health, Fujian Medical University, Fuzhou, Fujian, China
| | - Yu Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, China
| | - Hongyan Wei
- Tianjin Medical University General Hospital, Tianjin, China
| | - Feng Tan
- No. 6 Department of Internal MedicineYou County Hospital of Traditional Chinese Medicine, Zhuzhou City, Hunan Province, China
| | - Yanting Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, China
| | - Fang Fang
- Tianjin Medical University General Hospital, Tianjin, China
| | - Tingkai Cui
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, China
| | - Ziyun Pan
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, China
| | - Xiaohui Guo
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, China
| | - Wen Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, China
| | - Jun Shen
- Department of Hygienic Chemistry, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wanqi Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, China
| | - Long Tan
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, China.
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Zhang L, Shang F, Liu C, Zhai X. The correlation between iodine and metabolism: a review. Front Nutr 2024; 11:1346452. [PMID: 38567251 PMCID: PMC10985161 DOI: 10.3389/fnut.2024.1346452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 03/08/2024] [Indexed: 04/04/2024] Open
Abstract
Iodine is involved in the synthesis of thyroid hormones and plays a crucial role in human life. Both iodine deficiency and excess are common issues in certain populations. Iodine also has extrathyroidal effects on organs that can uptake it independently of thyroid hormones. Recently, multiple clinical studies have shown a connection between iodine intake and metabolic disorders, such as metabolic syndrome, obesity, diabetes, hypertension, and dyslipidemia. However, the results of these studies have been inconsistent, and the mechanisms behind these associations are still not well understood. Therefore, in this review, we aim to examine the recent research progress regarding the relationship between iodine and metabolic disorders, along with the relevant mechanisms.
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Affiliation(s)
- Le Zhang
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Fangjian Shang
- Department of General Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Cong Liu
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xiaodan Zhai
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China
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Arely RJ, Cristian AE, Omar AX, Antonio PJJ, Isela SR, Yeimy Mar DLR, Xcaret Alexa HD, Omar AH. Iodine Promotes Glucose Uptake through Akt Phosphorylation and Glut-4 in Adipocytes, but Higher Doses Induce Cytotoxic Effects in Pancreatic Beta Cells. BIOLOGY 2024; 13:26. [PMID: 38248457 PMCID: PMC10813031 DOI: 10.3390/biology13010026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/17/2023] [Accepted: 11/29/2023] [Indexed: 01/23/2024]
Abstract
BACKGROUND Epidemiological clinical reports have shown an association between iodine excess with diabetes mellitus type 2 and higher blood glucose. However, the relationship between iodine, the pancreas, adipose tissue, and glucose transport is unclear. The goal of this study was to analyze the effect of iodine concentrations (in Lugol solution) on glucose transport, insulin secretion, and its cytotoxic effects in mature 3T3-L1 adipocytes and pancreatic beta-TC-6 cells. METHODS Fibroblast 3T3-L1, mature adipocytes, and pancreatic beta-TC-6 cells were treated with 1 to 1000 µM of Lugol (molecular iodine dissolved in potassium iodide) for 30 min to 24 h for an MTT proliferation assay. Then, glucose uptake was measured with the fluorescent analog 2-NBDG, insulin receptor, Akt protein, p-Akt (ser-473), PPAR-gamma, and Glut4 by immunoblot; furthermore, insulin, alpha-amylase, oxidative stress, and caspase-3 activation were measured by colorimetric methods and the expression of markers of the apoptotic pathway at the RNAm level by real-time PCR. RESULTS Low concentrations of Lugol significantly induce insulin secretion and glucose uptake in pancreatic beta-TC-6 cells, and in adipose cells, iodine-induced glucose uptake depends on the serine-473 phosphorylation of Akt (p-Akt) and Glut4. Higher doses of Lugol lead to cell growth inhibition, oxidative stress, and cellular apoptosis dependent on PPAR-gamma, Bax mRNA expression, and caspase-3 activation in pancreatic beta-TC-6 cells. CONCLUSIONS Iodine could influence glucose metabolism in mature adipocytes and insulin secretion in pancreatic beta cells, but excessive levels may cause cytotoxic damage to pancreatic beta cells.
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Affiliation(s)
- Reséndiz-Jiménez Arely
- Centro de Investigaciones Biomédicas, Universidad Veracruzana, Av. Luis Castelazo Ayala S/N, Col. Industrial Ánimas, Xalapa 91190, Veracruz, Mexico (A.-X.O.)
| | - Arbez-Evangelista Cristian
- Centro de Investigaciones Biomédicas, Universidad Veracruzana, Av. Luis Castelazo Ayala S/N, Col. Industrial Ánimas, Xalapa 91190, Veracruz, Mexico (A.-X.O.)
| | - Arroyo-Xochihua Omar
- Centro de Investigaciones Biomédicas, Universidad Veracruzana, Av. Luis Castelazo Ayala S/N, Col. Industrial Ánimas, Xalapa 91190, Veracruz, Mexico (A.-X.O.)
| | - Palma-Jacinto José Antonio
- Laboratory of Biochemistry and Neurotoxicology, Faculty of Bioanalysis-Xalapa, Universidad Veracruzana, Médicos y Odontólogos S/N, Unidad del Bosque, Xalapa 91190, Veracruz, Mexico; (P.-J.J.A.); (S.-R.I.)
| | - Santiago-Roque Isela
- Laboratory of Biochemistry and Neurotoxicology, Faculty of Bioanalysis-Xalapa, Universidad Veracruzana, Médicos y Odontólogos S/N, Unidad del Bosque, Xalapa 91190, Veracruz, Mexico; (P.-J.J.A.); (S.-R.I.)
| | - De León-Ramírez Yeimy Mar
- Laboratorio de Biomedicina y Salud Pública, Instituto de Salud Pública, Universidad Veracruzana, Av. Luís Castelazo Ayala S/N, Col. Industrial Animas, Xalapa 91190, Veracruz, Mexico; (D.L.-R.Y.M.)
| | - Hernández-Domínguez Xcaret Alexa
- Laboratorio de Biomedicina y Salud Pública, Instituto de Salud Pública, Universidad Veracruzana, Av. Luís Castelazo Ayala S/N, Col. Industrial Animas, Xalapa 91190, Veracruz, Mexico; (D.L.-R.Y.M.)
| | - Arroyo-Helguera Omar
- Laboratorio de Biomedicina y Salud Pública, Instituto de Salud Pública, Universidad Veracruzana, Av. Luís Castelazo Ayala S/N, Col. Industrial Animas, Xalapa 91190, Veracruz, Mexico; (D.L.-R.Y.M.)
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Wu Z, Li M, Liu J, Xie F, Chen Y, Yang S, Li X, Wu Y. Association study of urinary iodine concentrations and coronary artery disease among adults in the USA: National Health and Nutrition Examination Survey 2003-2018. Br J Nutr 2023; 130:2114-2122. [PMID: 37424297 PMCID: PMC10657749 DOI: 10.1017/s0007114523001277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/19/2023] [Accepted: 05/23/2023] [Indexed: 07/11/2023]
Abstract
Iodine is a vital trace element in the human body and is associated with several important coronary artery disease (CAD) risk factors. We aimed to explore the correlation between urinary iodine concentration (UIC) and CAD. Data from 15 793 US adults in the National Health and Nutrition Examination Survey (2003-2018) were analysed. We conducted multivariable logistic regression models and fitted smoothing curves to study the correlation between UIC and CAD. Furthermore, we performed subgroup analysis to investigate possible effect modifiers between them. We found a J-shaped association between UIC and CAD, with an inflection point at Lg UIC = 2·65 μg/l. This result indicated a neutral association (OR 0·89; 95 % CI 0·68, 1·16) between UIC and CAD as Lg UIC < 2·65 μg/l, but the per natural Lg [UIC] increment was OR 2·29; 95 % CI 1·53, 3·43 as Lg UIC ≥ 2·65 μg/l. An interaction between diabetes and UIC might exist. The increase in UIC results in an increase in CAD prevalence (OR 1·84, 95 % CI 1·32, 2·58) in diabetes but results in little to no difference in non-diabetes (OR 0·98, 95 % CI 0·77, 1·25). The J-shaped correlation between UIC and CAD and the interaction between diabetes and UIC should be confirmed in a prospective study with a series of UIC measurements. If excessive iodine precedes CAD, then this new finding could guide clinical practice and prevent iodine deficiency from being overcorrected.
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Affiliation(s)
- Zhijian Wu
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, 330006Nanchang, Jiangxi, People’s Republic of China
| | - Meng Li
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, 330006Nanchang, Jiangxi, People’s Republic of China
| | - Jiandi Liu
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, 330006Nanchang, Jiangxi, People’s Republic of China
| | - Feng Xie
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, 330006Nanchang, Jiangxi, People’s Republic of China
| | - Yang Chen
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, 330006Nanchang, Jiangxi, People’s Republic of China
| | - Shuai Yang
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, 330006Nanchang, Jiangxi, People’s Republic of China
| | - Xiaozhong Li
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, 330006Nanchang, Jiangxi, People’s Republic of China
| | - Yanqing Wu
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, 330006Nanchang, Jiangxi, People’s Republic of China
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Shen X, Yang L, Liu YY, Zhang XH, Cai P, Huang JF, Jiang L. Associations between urinary iodine concentration and the prevalence of metabolic disorders: a cross-sectional study. Front Endocrinol (Lausanne) 2023; 14:1153462. [PMID: 37223035 PMCID: PMC10200914 DOI: 10.3389/fendo.2023.1153462] [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: 01/29/2023] [Accepted: 04/03/2023] [Indexed: 05/25/2023] Open
Abstract
Background Few studies have examined the role of iodine in extrathyroidal function. Recent research has shown an association between iodine and metabolic syndromes (MetS) in Chinese and Korean populations, but the link in the American participants remains unknown. Purpose This study aimed to examine the relationship between iodine status and metabolic disorders, including components associated with metabolic syndrome, hypertension, hyperglycemia, central obesity, triglyceride abnormalities, and low HDL. Methods The study included 11,545 adults aged ≥ 18 years from the US National Health and Nutrition Examination Survey (2007-2018). Participants were divided into four groups based on their iodine nutritional status(ug/L), as recommended by the World Health Organization: low UIC, < 100; normal UIC, 100-299; high UIC, 300-399; and very high, ≥ 400. The Odds ratio (OR) for MetS basing the UIC group was estimated using logistic regression models for our overall population and subgroups. Results Iodine status was positively associated with the prevalence of MetS in US adults. The risk of MetS was significantly higher in those with high UIC than in those with normal UIC [OR: 1.25; 95% confidence intervals (CI),1.016-1.539; p = 0.035). The risk of MetS was lower in the low UIC group (OR,0.82; 95% CI: 0.708-0.946; p = 0.007). There was a significant nonlinear trend between UIC and the risk of MetS, diabetes, and obesity in overall participants. Participants with high UIC had significantly increased TG elevation (OR, 1.24; 95% CI: 1.002-1.533; P = 0.048) and participants with very high UIC had significantly decreased risk of diabetes (OR, 0.83; 95% CI: 0.731-0.945, p = 0.005). Moreover, subgroup analysis revealed an interaction between UIC and MetS in participants aged < 60 years and ≥ 60 years, and no association between UIC and MetS in older participants aged ≥ 60 years. Conclusion Our study validated the relationship between UIC and MetS and their components in US adults. This association may provide further dietary control strategies for the management of patients with metabolic disorders.
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Affiliation(s)
- Xia Shen
- Department of Nursing, Wuxi Medical College, Jiangnan University, Wuxi, China
| | - Long Yang
- College of Pediatrics, Xinjiang Medical University, Urumqi, China
| | - Yuan-Yuan Liu
- Department of Nursing, Wuxi Medical College, Jiangnan University, Wuxi, China
| | - Xue-He Zhang
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Ping Cai
- Department of Cardiothoracic Surgery, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Jian-Feng Huang
- Department of Radiology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
| | - Lei Jiang
- Department of Radiology, The Convalescent Hospital of East China, Wuxi, China
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Chen J, Liang H, Tan Y, Wen L, Guo Z, Nie J, Lin X, Huang F, Wang J, Xing P, Nie L, Wang L, Jing C. Association of urinary iodine concentration with prediabetes/diabetes in adults: Analysis of the NHANES 2005-2016. J Trace Elem Med Biol 2023; 77:127144. [PMID: 36907050 DOI: 10.1016/j.jtemb.2023.127144] [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: 11/21/2022] [Revised: 02/02/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023]
Abstract
BACKGROUND & AIMS Iodine is required for synthesizing thyroid hormones and regulating human metabolism. Iodine deficiency can lead to thyroid function abnormalities, which are closely associated with disturbances in glucose-insulin homeostasis. Research on the relationship between iodine and diabetes/prediabetes in adults was sparse and inconsistent. We assessed trends in urinary iodine concentration (UIC) and diabetes/prediabetes prevalence and focused on the association between iodine and diabetes/prediabetes among U.S. adults. METHODS We analyzed the National Health and Nutrition Examination Survey (NHANES) data from the 2005-2016 cycles. Linear regression was employed to evaluate UIC and prediabetes/diabetes prevalence trends over time. Both multiple logistic regression and restricted cubic splines (RCS) were performed to evaluate the association of UIC with diabetes/prediabetes. RESULTS A distinctly declining trend in median UIC and a significant increase in diabetes prevalence in U.S. adults from 2005 to 2016 were observed. The fourth quartile of UIC was associated with a 30% lower risk for prediabetes, compared with the first quartile (OR=0.70, 95% CI: 0.56-0.86, Ptrend=0.001). However, UIC was not significantly associated with the prevalence of diabetes. The RCS model suggested a significant nonlinear relationship between UIC and the risk of diabetes (P for nonlinearity =0.0147). Stratification analysis showed that the negative associations of UIC with the risk of prediabetes were more pronounced in participants who were men, aged 46-65, overweight, light alcohol drinkers, and nonactive smokers. CONCLUSIONS Overall, the adults' median UIC in the U.S. population was a declining trend. However, diabetes prevalence increased significantly from 2005 to 2016. Higher UIC was associated with a lower risk of prediabetes.
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Affiliation(s)
- Jingmin Chen
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou 510632, Guangdong, China
| | - Huanzhu Liang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou 510632, Guangdong, China
| | - Yuxuan Tan
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou 510632, Guangdong, China
| | - Lin Wen
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou 510632, Guangdong, China
| | - Ziang Guo
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou 510632, Guangdong, China
| | - Jiyu Nie
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou 510632, Guangdong, China
| | - Xiaoxiao Lin
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou 510632, Guangdong, China
| | - Feng Huang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou 510632, Guangdong, China
| | - Jie Wang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou 510632, Guangdong, China
| | - Puyi Xing
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou 510632, Guangdong, China
| | - Lihong Nie
- Department of Endocrine, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Lihong Wang
- Department of Endocrine, The First Affiliated Hospital of Jinan University, Guangzhou, China.
| | - Chunxia Jing
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou 510632, Guangdong, China; Guangdong Key Laboratory of Environmental Exposure and Health, Jinan University, Guangzhou 510632, Guangdong, China.
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González-Martínez S, Martínez-Morillo E, Avello-Llano N, Escudero-Gomis AI, Delgado-Álvarez E, Menéndez-Torre EL. Iodine status in pregnant women in northern Spain. Effect of iodised salt and iodine supplements on thyroid function. ENDOCRINOLOGÍA, DIABETES Y NUTRICIÓN (ENGLISH ED.) 2023; 70:162-170. [PMID: 37030899 DOI: 10.1016/j.endien.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 11/07/2022] [Indexed: 04/08/2023]
Abstract
INTRODUCTION Iodine deficiency is linked to thyroid dysfunction, particularly in pregnant women. The objective of this study was to ascertain the iodine levels of women in the second trimester of pregnancy, analysing the influence of iodine ingestion on urinary iodine concentration (UIC) and maternal thyroid function. METHODS A prospective observational study of pregnant women from Health Area IV of Asturias (northern Spain) recruited before 13 weeks of gestation between May and June 2017. A questionnaire on iodine intake was completed at the first visit, and urine and serum samples were collected at baseline and again during the second trimester. UIC, thyroid stimulating hormone (TSH) and free thyroxine (FT4) obtained in the second trimester of gestation were analysed and related to iodine intake. Thyroid autoimmunity was also analysed in half of the pregnant women at baseline. RESULTS A total of 241 pregnant women were studied. Of these, 56.7% used iodised salt, 46.7% consumed ≥2 servings of dairy products daily and 88.1% took iodine supplements. Median UIC was 191μg/l (135.3-294μg/l), with 68.1% of the women having UIC ≥150μg/l. Only iodised salt consumption provided protection against iodine deficiency (odds ratio 0.35 [0.20-0.63], p=0.001). In women with no autoimmune thyroid disease (n=88), mean levels of TSH were lower in those that consumed iodised salt than in those that did not (respectively, 2.08±0.89mIU/l vs. 2.56±1.02mIU/l, p=0.025). In women with autoimmune thyroid disease (n=30), mean levels of TSH were higher in those that took iodine supplements than in those that did not (respectively, 2.97±1.25mIU/l vs. 1.16±0.41mIU/l, p=0.002). CONCLUSIONS The pregnant women studied from Health Area IV in Asturias maintain adequate nutritional iodine status in the second trimester of gestation. In our sample, only the consumption of iodised salt was associated with adequate iodine nutrition, without affecting maternal thyroid function. Most of the women used iodine supplements, which was linked to higher levels of TSH in pregnant women with autoimmune thyroid disease.
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Affiliation(s)
- Silvia González-Martínez
- Department of Endocrinology and Nutrition, Hospital Universitario Central de Asturias (HUCA) [Central University Hospital of Asturias], Oviedo, Spain; Endocrinology, Nutrition, Diabetes and Obesity (ENDO) Research Group, Instituto de Investigación Sanitario del Principado de Asturias (ISPA) [Health Research Institute of the Principality of Asturias], Spain.
| | - Eduardo Martínez-Morillo
- Department of Clinical Biochemistry, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
| | - Noelia Avello-Llano
- Department of Clinical Biochemistry, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
| | - Ana Isabel Escudero-Gomis
- Department of Obstetrics and Gynaecology, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
| | - Elías Delgado-Álvarez
- Department of Endocrinology and Nutrition, Hospital Universitario Central de Asturias (HUCA) [Central University Hospital of Asturias], Oviedo, Spain; Endocrinology, Nutrition, Diabetes and Obesity (ENDO) Research Group, Instituto de Investigación Sanitario del Principado de Asturias (ISPA) [Health Research Institute of the Principality of Asturias], Spain; Faculty of Medicine, University of Oviedo, Oviedo, Spain
| | - Edelmiro Luis Menéndez-Torre
- Department of Endocrinology and Nutrition, Hospital Universitario Central de Asturias (HUCA) [Central University Hospital of Asturias], Oviedo, Spain; Endocrinology, Nutrition, Diabetes and Obesity (ENDO) Research Group, Instituto de Investigación Sanitario del Principado de Asturias (ISPA) [Health Research Institute of the Principality of Asturias], Spain; Faculty of Medicine, University of Oviedo, Oviedo, Spain
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Ilias I, Milionis C, Zabuliene L, Rizzo M. Does Iodine Influence the Metabolism of Glucose? MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59020189. [PMID: 36837391 PMCID: PMC9966122 DOI: 10.3390/medicina59020189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/05/2023] [Accepted: 01/13/2023] [Indexed: 01/19/2023]
Abstract
Thyroid function and glucose status are linked; experimental, clinical, and epidemiological studies have shown this. Iodine is a vital trace element that is inextricably linked to thyroid hormone synthesis. The latter is also associated with glucose metabolism and diabetes. Recently, some-but not all-studies have shown that iodine is linked to glucose metabolism, glucose intolerance, impaired fasting glucose, prediabetes, diabetes mellitus, or gestational diabetes. In this concise review, we review these studies, focusing on iodine and glucose metabolism and prediabetic conditions or type 2 diabetes mellitus. The potential beneficial effect of iodine on glucose metabolism may be attributed to its antioxidant properties.
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Affiliation(s)
- Ioannis Ilias
- Department of Endocrinology, Diabetes and Metabolism, Elena Venizelou Hospital, GR-11521 Athens, Greece
- Correspondence:
| | - Charalampos Milionis
- Department of Endocrinology, Diabetes and Metabolism, Elena Venizelou Hospital, GR-11521 Athens, Greece
| | - Lina Zabuliene
- Faculty of Medicine, Vilnius University, M. K. Čiurlionio St. 21/27, LT-03101 Vilnius, Lithuania
| | - Manfredi Rizzo
- Department of Health Promotion Sciences, Maternal and Infantile Care, Internal Medicine and Medical Specialties (Promise), School of Medicine, University of Palermo, Via del Vespro, 141, 90127 Palermo, Italy
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Zhang F, Teng D, Tong N, Wang G, Li Y, Yu X, Shan Z, Teng W. Gender-Specific Associations Between Metabolic Disorders and Thyroid Nodules: A Cross-Sectional Population-Based Study from China. Thyroid 2022; 32:571-580. [PMID: 35317620 DOI: 10.1089/thy.2021.0686] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background: Metabolic disorders (MDs) and the metabolic syndrome (MetS) may be associated with thyroid diseases. The aim of this study was to investigate the relationship between MDs and various types of thyroid nodules (TNs), according to gender. Methods: We analyzed cross-sectional data from the Thyroid Disorders, Iodine Status, and Diabetes Epidemiological (TIDE) survey in China. A total of 56,729 subjects ≥18 years of age were included. Thyroid gland morphology was assessed by thyroid standardized ultrasonography. A multivariate logistic regression model was used to explore the odds ratio (OR) and confidence intervals [CIs] for any associations between MDs and TNs. Subgroup analyses were conducted according to gender and TN type (solitary, S-TN; multiple, M-TNs). Results: The prevalence of TNs was increased in several MDs, and was higher in women than men regardless of whether they suffered from MDs (22.0%, CI [21.6-22.5%] vs. 15.7%, CI [15.3-16.7%], p < 0.001). TNs were associated with the presence of MDs (OR = 1.189, CI [1.107-1.278], p < 0.001), hypercholesterolemia (OR = 1.235, CI [1.177-1.296], p < 0.001), high low-density lipoprotein cholesterol (LDL-C; OR = 1.249, CI [1.186-1.316], p < 0.001), and hyperuricemia (OR = 1.206, CI [1.126-1.293], p < 0.001). MDs and MetS were, respectively, significantly associated with TNs, S-TNs, and M-TNs in men, while MDs were significantly associated with the three TN profiles in women. With respect to dyslipidemia, hypercholesterolemia and high LDL-C had the strongest association with TNs, whereas hypertriglyceridemia had no effect. Conclusions: TNs (especially M-TNs) may be associated with MDs and their various components, and there appear to be some gender-specific associations.
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Affiliation(s)
- Fan Zhang
- Department of Endocrinology and Metabolism, Institute of Endocrinology, National Health Commission Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang, P.R. China
| | - Di Teng
- Department of Endocrinology and Metabolism, Institute of Endocrinology, National Health Commission Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang, P.R. China
| | - Nanwei Tong
- Department of Endocrinology and Metabolism, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Guixia Wang
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, P.R. China
| | - Yongze Li
- Department of Endocrinology and Metabolism, Institute of Endocrinology, National Health Commission Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang, P.R. China
| | - Xiaohui Yu
- Department of Endocrinology and Metabolism, Institute of Endocrinology, National Health Commission Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang, P.R. China
| | - Zhongyan Shan
- Department of Endocrinology and Metabolism, Institute of Endocrinology, National Health Commission Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang, P.R. China
| | - Weiping Teng
- Department of Endocrinology and Metabolism, Institute of Endocrinology, National Health Commission Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang, P.R. China
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Zhao D, Zhang Y, Wehbe A, Wang X, Sun R, Zheng Z. The prevalence of thyroid nodules and risk factors of thyroid nodules with metabolic disorder in Beijing: A cross-sectional study. ENVIRONMENTAL DISEASE 2022. [DOI: 10.4103/ed.ed_14_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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11
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Fang T, Lin L, Ou Q, Lin L, Zhang H, Chen K, Quan H, He Y. An Investigation on the Risk Factors of Thyroid Diseases in Community Population in Hainan. Int J Endocrinol 2022; 2022:4514538. [PMID: 35855806 PMCID: PMC9288325 DOI: 10.1155/2022/4514538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 03/05/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND In recent years, the incidence of thyroid diseases has increased significantly, which has seriously affected people's work and life. The purpose of this study was to explore the epidemiological characteristics of thyroid diseases and autoantibodies. METHOD According to the principle of overall sampling, resident residents ≥18 years and who will not move within 5 years are randomly selected. A total of 2136 eligible individuals were divided into case and control groups according to whether they have thyroid disease. Finally, the impact of potential risk factors on thyroid diseases was evaluated. RESULTS The overall prevalence of thyroid disease was 58.3%, and there was a significant difference in the prevalence of thyroid disease between women and men (p = 0.004). Except for the age group ≥70 years, with the increase in age, the prevalence gradually increased (p < 0.05). Participants with positive thyroid autoantibodies (TPOAb or TgAb) had a higher prevalence than participants with negative autoantibodies. The positive rate of autoantibodies in women was higher than that in men (p < 0.05). UIC (p = 0.004) and free thyroid hormone (FT4) (p = 0.001) levels of men were higher than those of women, and the TSH level of women was higher than that of men (p = 0.002). The regression analysis showed that women, older age, and family history of thyroid disease were independent risk factors for thyroid disease. CONCLUSION The prevalence of thyroid diseases in Hainan was high. Women are more susceptible to thyroid disease than men, and the prevalence increased with age.
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Affiliation(s)
- Tuanyu Fang
- Department of Endocrinology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Leweihua Lin
- Department of Endocrinology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Qianying Ou
- Department of Endocrinology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Lu Lin
- Department of Endocrinology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Huachuan Zhang
- Department of Endocrinology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Kaining Chen
- Department of Endocrinology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Huibiao Quan
- Department of Endocrinology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Yangli He
- Department of Health Care Centre, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
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Li Y, Shan Z, Teng W. The Iodine Status and Prevalence of Thyroid Disorders Among Women of Childbearing Age in China: National Cross-sectional Study. Endocr Pract 2021; 27:1028-1033. [PMID: 33838321 DOI: 10.1016/j.eprac.2021.03.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/16/2021] [Accepted: 03/29/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Mandatory universal salt iodization in China was implemented 20 years ago. However, the current iodine status and prevalence of thyroid disorders among childbearing-age women are unknown. METHODS A nationally representative cross-sectional study with 26 166 enrolled participants aged 18 to 49 years from all 31 provincial regions of mainland China was performed. The participants were given a questionnaire and underwent B-mode ultrasonography of the thyroid. The serum concentrations of thyroid hormones and thyroid antibodies and the urinary iodine concentration (UIC) were measured. RESULTS The median UIC was 178.7 μg/L, indicative of adequate iodine status. pHowever, 19.04% and 19.87% of the participants were classified as having iodine deficiency and excessive iodine, respectively. The weighted prevalence of thyroid disorders was as follows: 1.08% had overt hyperthyroidism, 0.58% had subclinical hyperthyroidism, 0.76% had Graves disease, 1.28% had overt hypothyroidism, 14.28% had subclinical hypothyroidism, 13.53% were positive for thyroid peroxidase antibodies, and 14.55% were positive for thyroglobulin antibodies. Excessive iodine and overweight were associated with higher odds of subclinical hypothyroidism. A family history of thyroid disorders and an age between 40 and 49 years were significantly associated with higher odds of positivity for thyroid peroxidase antibodies and thyroglobulin antibodies. CONCLUSION Iodine deficiency, excessive iodine, subclinical hypothyroidism, and positivity for thyroid autoantibodies remain prevalent among women of childbearing age in China. Women of childbearing age who are relatively older, are overweight, or have a family history of thyroid disorders are encouraged to undergo active screening of their UIC and thyroid function when planning a pregnancy.
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Affiliation(s)
- Yongze Li
- Department of Endocrinology and Metabolism and the Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, First Hospital of China Medical University, Shenyang, China
| | - Zhongyan Shan
- Department of Endocrinology and Metabolism and the Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, First Hospital of China Medical University, Shenyang, China.
| | - Weiping Teng
- Department of Endocrinology and Metabolism and the Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, First Hospital of China Medical University, Shenyang, China.
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Li Y, Shan Z, Teng W. Estimated change in prevalence of abnormal thyroid-stimulating hormone levels in China according to the application of the kit-recommended or NACB standard reference interval. EClinicalMedicine 2021; 32:100723. [PMID: 33554090 PMCID: PMC7848757 DOI: 10.1016/j.eclinm.2021.100723] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 12/29/2020] [Accepted: 01/06/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Both the kit-recommended and United States National Academy of Clinical Biochemistry (NACB) standard thyroid-stimulating hormone (TSH) reference intervals (RIs) are used to determine thyroid dysfunction in clinical practice and epidemiological surveys in China. However, a number of kit-recommended RIs were derived from the European or United States reference population. METHODS A nationally representative cross-sectional study with 78,470 enrolled participants aged 18 years or older from China was performed. Serum concentrations of thyroid hormones, TSH, thyroid antibodies (by Roche Diagnostics), and urine iodine concentration (UIC) were measured. FINDINGS The abnormal TSH weighted prevalence was 15.33% (95% CI, 14.24% to 16.49%) according to the kit-recommended RI and 6.89% (6.46% to 7.34%) according to the NACB standard RI. The NACB standard prevalence of abnormal TSH was associated with an absolute change in abnormal TSH prevalence of -11.20% (-12.23% to -10.18%) among women. When estimating the proportion of supranormal TSH levels according to background characteristics, the NACB standard definition decreased the prevalence by more than 10% in some categories, with the highest absolute difference of -13.92% (-15.52% to -12.33%) observed among the elderly, -12.85% (-13.68% to -12.02%) among those with UIC ≥300 μg/L, and -12.15% (-13.02% to -11.28%) among non-smokers. For subnormal TSH, with the highest absolute difference of 3.17% (2.74% to 3.61%) observed among regular smokers, 3.11% (2.49% to 3.74%) among the elderly, and 2.53% (2.29% to 2.77%) among those with BMI <25. INTERPRETATION For adults in China, the NACB standard RI of TSH reveals a lower estimated prevalence of supranormal TSH levels than the kit-recommended RI. Because of the public health significance of overt and subclinical hypothyroidism and the very large population base in China, the TSH RI should be further assessed. FUNDING National Health Commission of the People's Republic of China and National Natural Science Foundation of China.
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Zhang F, Li Y, Yu X, Wang X, Lin Z, Song B, Tian L, Feng C, Shan Z, Teng W. The Relationship and Gender Disparity Between Thyroid Nodules and Metabolic Syndrome Components Based on a Recent Nationwide Cross-Sectional Study and Meta-Analysis. Front Endocrinol (Lausanne) 2021; 12:736972. [PMID: 34621243 PMCID: PMC8490942 DOI: 10.3389/fendo.2021.736972] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 08/30/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) has a potential connection with thyroid disease, but its relationship with thyroid nodules (TNs) is still controversial. This study aims to clarify the relationship between MetS and TNs, and this relationship in the subgroup of gender. METHODS The recent nationwide cross-sectional study called Thyroid Disorders, Iodine Status, and Diabetes Epidemiological survey provided the newest data on the relationship between MetS and TNs from China and included 56,729 subjects. We also researched related literature in PubMed, EMBASE, Cochrane Library, and MEDLINE until Oct 30, 2020, in order to perform a meta-analysis. The relevant articles were examined, and the eligible studies were included to assess the association between MetS and TNs. RESULTS The meta-analysis included 15 studies (involving 468,845 subjects). Of these, 14 studies were from the databases, and one study was this cross-sectional data. The meta-analysis showed that TNs were associated with a higher prevalence of MetS (OR=1.87, 95% CI: 1.44-2.45) and the components of MetS, including central obesity (OR=1.41, 95% CI: 1.15-1.72), hypertriglyceridemia (OR=1.13, 95% CI: 1.10-1.15), low high-density lipoprotein cholesterolemia (OR=1.11, 95% CI: 1.02-1.20), abnormal blood pressure (OR=1.68, 95% CI: 1.62-1.75), and hyperglycemia (OR=1.59, 95% CI: 1.46-1.74). Central obesity displayed gender differences, being a risk factor in males (OR=1.38, 95% CI: 1.02-1.86) but not in females (OR=1.47, 95% CI: 0.97-2.23). CONCLUSION TNs were indeed associated with a higher prevalence of MetS. In addition, its component diseases, such as central obesity, hypertriglyceridemia, abnormal blood pressure, and hyperglycemia, were also associated with TNs. Females with MetS or its components had a higher risk of suffering from TNs than males.
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Zhang C, Gao X, Han Y, Teng W, Shan Z. Correlation Between Thyroid Nodules and Metabolic Syndrome: A Systematic Review and Meta-Analysis. Front Endocrinol (Lausanne) 2021; 12:730279. [PMID: 34603208 PMCID: PMC8481784 DOI: 10.3389/fendo.2021.730279] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 08/31/2021] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE Thyroid nodules (TNs) are a common thyroid disorder that can be caused by many factors. Several studies have investigated the relationship between TNs and metabolic syndrome (MetS), but the role of sex and age remains controversial. The purpose of this paper was to analyze published data from all relevant studies to reliably estimate the relationship between TNs and MetS. METHODS Thirteen articles were included in this study; articles were identified by searching for publications until July 2021 in PubMed, EMBASE, the Cochrane Library and the Web of Science. The outcomes are presented as the summary odds ratio (OR) and 95% confidence interval (CI) and the pooled prevalence and 95% CI. RESULTS The TNs prevalence was significantly higher in MetS patients than in controls (OR 1.88, 95% CI 1.42-2.50, P < 0.0001) and was independent of sex (male: OR 1.53, 95% CI 1.20-1.94, P = 0.0006; female: OR 1.90, 95% CI 1.54-2.33, P < 0.00001; combined: OR 2.06, 95% CI 1.31-3.25, P = 0.002) and age (< 40 years old: OR 1.62, 95% CI 1.39-1.89, P < 0.0001; 40~50 years old: OR 2.14, 95% CI 1.49-3.08, P < 0.0001;50~60 years old: OR 1.50, 95% CI 1.08-2.07, P = 0. 01; 60 years old: OR 1.70, 95% CI 1.36-2.14, P < 0.00001); the pooled TNs prevalence in MetS patients was 45% (95% CI 36-54%). However, it has not yet been considered that MetS is related to TNs in people with iodine deficiency (OR 3.14, 95% CI 0.92-10.73, P = 0.07). CONCLUSION The meta-analysis results showed a strong correlation between TNs and MetS. Both male and female patients with MetS had an increased TNs prevalence. In addition, the prevalence was independent of age. However, MetS is not considered to be associated with TNs in iodine-deficient populations.
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Chen C, Chen Y, Zhai H, Xia F, Han B, Zhang W, Wang Y, Wan H, Wang N, Lu Y. Iodine nutrition status and its association with microvascular complications in urban dwellers with type 2 diabetes. Nutr Metab (Lond) 2020; 17:70. [PMID: 32821267 PMCID: PMC7433180 DOI: 10.1186/s12986-020-00493-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 08/11/2020] [Indexed: 02/07/2023] Open
Abstract
Background The principal function of iodine acts on thyroid function, but in recent years, the role of iodine deficiency in metabolism has also been gradually revealed. We aimed to investigate the current status of iodized salt consumption and urinary iodine concentration (UIC) in an urban Chinese population with type 2 diabetes, and to further explore whether UIC was associated with diabetic microvascular complications. Methods Four thousand five hundred fifty-nine subjects with diabetes from 7 communities in downtown Shanghai were enrolled in the cross-sectional Metal Study in 2018. UIC was detected using an inductively coupled plasma-mass spectrometer. Diabetic kidney disease (DKD) was defined as urinary albumin-to-creatinine ratio (UACR) > 30 mg/g or estimated glomerular filtration rate < 60 mL/min/1.73 m2. Diabetic retinopathy (DR) was evaluated by high-quality fundus photographs and was remotely read by ophthalmologist. Results The median UIC of subjects with diabetes was 115.4 μg/L (78.9–170.8) in downtown Shanghai. Among all the subjects, 52.7% consumed non-iodized salt and 40.4% were iodine deficient. Iodine deficiency (UIC < 100 μg/L) was associated with an increased odds of DKD (OR 1.17; 95%CI 1.01–1.37) after adjustment for age, sex, education, current smokers, BMI, HbA1c, duration of diabetes, dyslipidemia, thyroid-stimulating hormone and free thyroxine. No association was observed between UIC and DR after multivariable adjustment. Conclusions A concerning number of subjects with diabetes consumed non-iodized salt and suffered from iodine deficiency in coastal regions of China. Low UIC might be a risk factor for DKD, which should be further confirmed by longitudinal prospective studies.
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Affiliation(s)
- Chi Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, 200011 China
| | - Yi Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, 200011 China
| | - Hualing Zhai
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, 200011 China
| | - Fangzhen Xia
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, 200011 China
| | - Bing Han
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, 200011 China
| | - Wen Zhang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, 200011 China
| | - Yuying Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, 200011 China
| | - Heng Wan
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, 200011 China
| | - Ningjian Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, 200011 China
| | - Yingli Lu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, 200011 China
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