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Bath SC. Thyroid function and iodine intake: global recommendations and relevant dietary trends. Nat Rev Endocrinol 2024; 20:474-486. [PMID: 38693274 DOI: 10.1038/s41574-024-00983-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/20/2024] [Indexed: 05/03/2024]
Abstract
Iodine is a micronutrient that is essential for thyroid hormone production. Adequate iodine intake is especially important during pregnancy and early life, when brain development is dependent on thyroid hormones. Iodine intake recommendations vary around the world, but most recommendations generally reflect the increased requirements during pregnancy and lactation, although adequate iodine intake before pregnancy is also important. Tremendous progress has been made in improving iodine intake across the world over the past 30 years, mainly through salt-iodization programmes. However, in countries without strong iodine fortification programmes, and with shifts in dietary patterns, a need has arisen for health organizations, governments and clinicians to ensure that adequate iodine is consumed by everyone in the population. For example, in countries in which adequate iodine intake depends on individual food choice, particularly of iodine-rich milk and dairy products, intake can be highly variable and is also vulnerable to changing dietary patterns. In this Review, iodine is considered in the wider context of the increasing prevalence of overweight and obesity, the dietary trends for salt restriction for cardiovascular health and the increasing uptake of plant-based diets.
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Affiliation(s)
- Sarah C Bath
- Department of Nutrition, Food and Exercise Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK.
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Li J, Liu JX, Shen XL, Wang YQ, Yan CH. A national survey of iodine nutrition in children aged 3-6 years in China and its relationship with children's physical growth. MATERNAL & CHILD NUTRITION 2024:e13685. [PMID: 38886166 DOI: 10.1111/mcn.13685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 05/11/2024] [Accepted: 05/29/2024] [Indexed: 06/20/2024]
Abstract
Iodine, an essential trace element for the human body, plays a pivotal role in sustaining health. Malnutrition has emerged as a pressing public health concern, posing a significant threat to human well-being. Iodine deficiency poses a substantial threat to the development of children, potentially leading to neurological developmental disorders and mental retardation. Conversely, excessive iodine intake can result in structural and functional abnormalities in the thyroid gland. In this study, we selected children aged 3-6 years through a stratified cluster sampling approach in six regions across China to explore the correlation between iodine nutrition and their physical growth. A total of 5920 preschool children participated in this study, with a median urinary iodine concentration (UIC) of 177.33 [107.06, 269.92] μg/L. Among these children, 250 (4.2%) exhibited stunting, 180 (3.0%) were underweight, 198 (3.3%) experienced wasting, 787 (3.3%) were overweight and 414 (7.0%) were classified as obese. The multivariate linear regression revealed that UIC exhibited a positive correlation with body mass index z-Score (BMIZ) in overweight children (β = 0.038; 95% CI: 0.001, 0.075). In normally growing children, the associations between UIC and height-for-age z-score, weight-for-age z-score and BMIZ displayed nonlinear patterns. Our findings suggest that iodine nutrition is adequate for Chinese children aged 3-6 years. Furthermore, iodine nutrition is intricately linked to the growth and development of these children. Consequently, it is imperative to implement decisive measures to prevent both iodine deficiency and excess.
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Affiliation(s)
- Jing Li
- MOE-Shanghai Key Laboratory of Children's Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun-Xia Liu
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiao-Li Shen
- MOE-Shanghai Key Laboratory of Children's Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu-Qing Wang
- MOE-Shanghai Key Laboratory of Children's Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chong-Huai Yan
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Deveci Sevim R, Gök M, Öztürk S, Çevik Ö, Erdoğan Ö, Güneş S, Ünüvar T, Anık A. Thyroid volume in Turkish school-age children living in an iodine-sufficient region. J Pediatr Endocrinol Metab 2024; 37:228-235. [PMID: 38366903 DOI: 10.1515/jpem-2023-0442] [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: 10/05/2023] [Accepted: 01/12/2024] [Indexed: 02/18/2024]
Abstract
OBJECTIVES We aimed to obtain local normative data on thyroid volume evaluated by ultrasonography and iodine status by measuring urine iodine levels in school-age children living in Aydın province. METHODS In this cross-sectional study, a sample comprising 1,553 cases was meticulously selected from a total cohort of 170,461 children aged 6-17, drawn from 21 distinct educational institutions located within the Aydın region, as participants in the investigation. Those with a known chronic disease or thyroid disease were excluded from the study. The children underwent physical examinations and ultrasonography imaging of the thyroid gland, and urine samples were collected to measure urinary iodine concentration (UIC). RESULTS The median UIC was 189.5 (IQR=134.4) μg/L, which was optimal according to WHO criteria. Thyroid volume was found to be 4.6 (IQR=3.5) mL in girls and 4.2 (IQR=4.0) mL in boys (p=0.883). The thyroid volumes in our study were found to be smaller when compared to the WHO. According to WHO age and body surface area criteria, thyroid volume was over 97 % in 0.9 % (n=15) of cases. Thyroid volume was found to have a positive correlation with age, height, weight, body mass index (BMI), and body surface area (BSA) in both genders (p<0.001). However, there was no significant correlation between thyroid volume and UIC. CONCLUSIONS This cross-sectional study provides normative data on thyroid volume and iodine status in school-age children in iodine-sufficient population, revealing a low prevalence of goiter and correlations between thyroid volume and anthropometric measures.
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Affiliation(s)
- Reyhan Deveci Sevim
- Division of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medicine, Aydın Adnan Menderes University, Aydın, Turkiye
| | - Mustafa Gök
- Department of Radiology, Faculty of Medicine, Aydın Adnan Menderes University, Aydın, Turkiye
- Research Affiliate in Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Sercan Öztürk
- Department of Pediatrics, Faculty of Medicine, Aydın Adnan Menderes University, Aydın, Turkiye
| | - Özge Çevik
- Department Biochemistry, Faculty of Medicine, Aydın Adnan Menderes University, Aydın, Turkiye
| | - Ömer Erdoğan
- Department Biochemistry, Faculty of Medicine, Aydın Adnan Menderes University, Aydın, Turkiye
| | - Sebla Güneş
- Division of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medicine, Aydın Adnan Menderes University, Aydın, Turkiye
| | - Tolga Ünüvar
- Division of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medicine, Aydın Adnan Menderes University, Aydın, Turkiye
| | - Ahmet Anık
- Division of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medicine, Aydın Adnan Menderes University, Aydın, Turkiye
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De Angelis S, Medda E, Rotondi D, Masocco M, Minardi V, Contoli B, Possenti V, Sorbo A, D’Amato M, Turco AC, Pastorelli AA, Stacchini P, Cas RD, Bagnasco M, Bonofiglio D, Gasperi M, Meringolo D, Mian C, Moleti M, Vermiglio F, Puxeddu E, Taccaliti A, Tonacchera M, Ulisse S, Dimida A, Rago T, Nazzari E, Schiavo M, Bossert I, Sturniolo G, Corbetta C, Cereda C, Cappelletti L, Camilot M, Teofoli F, Ciatti R, Tarsi E, Perrotti N, Marasco O, Scozzafava G, Righetti F, Andò S, Catalano S, Cristofaro M, Sorrenti G, Censi S, Morelli S, Baldini E, Plutino G, Copparoni R, Alonzo E, Giacomozzi C, Silano M, Olivieri A. Fifteen Years of Iodine Prophylaxis in Italy: Results of a Nationwide Surveillance (Period 2015-2019). J Clin Endocrinol Metab 2024; 109:e495-e507. [PMID: 37820735 PMCID: PMC10795908 DOI: 10.1210/clinem/dgad593] [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: 06/13/2023] [Revised: 09/05/2023] [Accepted: 10/05/2023] [Indexed: 10/13/2023]
Abstract
CONTEXT In 2005, a nationwide program of iodine prophylaxis on a voluntary basis was implemented in Italy by law. However, recent data on iodine status are lacking. OBJECTIVE The aim of this study was to evaluate efficiency, effectiveness, and possible adverse effects (increased occurrence of thyroid autoimmunity and hyperthyroidism) of the Italian iodine prophylaxis program. METHODS From 2015 to 2019, a nationwide survey was performed. The use of iodized salt was evaluated in a sample of 164 593 adults and in 998 school canteens. A sample of 4233 schoolchildren (aged 11-13 years) was recruited to assess urinary iodine concentration, prevalence of goiter, and thyroid hypoechogenicity on ultrasound, with the latter being an indirect indicator of thyroid autoimmunity. Neonatal TSH values of 197 677 infants screened in regions representative of Northern, Central, and Southern Italy were analyzed to investigate the percentage of TSH values >5.0 mIU/L. Data on methimazole prescriptions were analyzed as indirect indicators of new cases of hyperthyroidism. RESULTS The prevalence of the use of iodized salt was 71.5% in adult population and 78% in school canteens. A median urinary iodine concentration of 124 μg/L, a prevalence of goiter of 2.2%, and a prevalence of thyroid hypoechogenicity of 5.7% were observed in schoolchildren. The percentage of neonatal TSH values >5.0 mIU/L resulted still higher (5.1%) than the World Health Organization threshold of 3.0%, whereas the prescriptions of methimazole showed a reduction of 13.5%. CONCLUSION Fifteen years of iodine prophylaxis have led to iodine sufficiency in Italy, although there still is concern about iodine nutritional status during pregnancy.
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Affiliation(s)
- Simona De Angelis
- Department of Cardiovascular and Endocrine-Metabolic Diseases and Aging, Italian National Institute of Health, Rome 00161, Italy
| | - Emanuela Medda
- Reference Center for Behavioral Sciences and Mental Health, Italian National Institute of Health, Rome 00161, Italy
| | - Daniela Rotondi
- Department of Cardiovascular and Endocrine-Metabolic Diseases and Aging, Italian National Institute of Health, Rome 00161, Italy
| | - Maria Masocco
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome 00161, Italy
| | - Valentina Minardi
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome 00161, Italy
| | - Benedetta Contoli
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome 00161, Italy
| | - Valentina Possenti
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome 00161, Italy
| | - Angela Sorbo
- Department of Food Safety, Nutrition and Veterinary Public Health, Italian National Institute of Health, Rome 00161, Italy
| | - Marilena D’Amato
- Department of Food Safety, Nutrition and Veterinary Public Health, Italian National Institute of Health, Rome 00161, Italy
| | - Anna Chiara Turco
- Department of Food Safety, Nutrition and Veterinary Public Health, Italian National Institute of Health, Rome 00161, Italy
| | - Alberto Augusto Pastorelli
- Department of Food Safety, Nutrition and Veterinary Public Health, Italian National Institute of Health, Rome 00161, Italy
| | - Paolo Stacchini
- Department of Food Safety, Nutrition and Veterinary Public Health, Italian National Institute of Health, Rome 00161, Italy
| | - Roberto Da Cas
- National Centre for Drug Research and Evaluation, Italian National Institute of Health, Rome 00161, Italy
| | - Marcello Bagnasco
- Department of Internal Medicine and Medical Specialties, University of Genoa, Genoa 16132, Italy
| | - Daniela Bonofiglio
- Department of Pharmacy, Health and Nutritional Sciences, Centro Sanitario, University of Calabria, Cosenza 87036, Italy
| | - Maurizio Gasperi
- Department of Medicine and Health Sciences “V. Tiberio,” University of Molise, Campobasso 86100, Italy
| | | | - Caterina Mian
- Department of Medicine, University of Padua, Padua 35128, Italy
| | - Mariacarla Moleti
- Department of Clinical and Experimental Medicine, University of Messina, Messina 98125, Italy
| | - Francesco Vermiglio
- Department of Clinical and Experimental Medicine, University of Messina, Messina 98125, Italy
| | - Efisio Puxeddu
- Department of Medicine and Surgery, University of Perugia, Perugia 06132, Italy
| | - Augusto Taccaliti
- Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona 60126, Italy
| | - Massimo Tonacchera
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa 56124, Italy
| | - Salvatore Ulisse
- Department of Surgery, “Sapienza” University of Rome, Rome 00185, Italy
| | - Antonio Dimida
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa 56124, Italy
| | - Teresa Rago
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa 56124, Italy
| | - Elena Nazzari
- Department of Internal Medicine and Medical Specialties, University of Genoa, Genoa 16132, Italy
| | - Mara Schiavo
- Department of Internal Medicine and Medical Specialties, University of Genoa, Genoa 16132, Italy
| | - Irene Bossert
- Department of Internal Medicine and Medical Specialties, University of Genoa, Genoa 16132, Italy
| | - Giacomo Sturniolo
- Department of Clinical and Experimental Medicine, University of Messina, Messina 98125, Italy
| | - Carlo Corbetta
- Department of Woman, Mother and Neonate, “Vittore Buzzi” Children's Hospital, Milan 20154, Italy
| | - Cristina Cereda
- Department of Pediatrics, “Vittore Buzzi” Children's Hospital, Milan 20154, Italy
| | - Laura Cappelletti
- Department of Pediatrics, “Vittore Buzzi” Children's Hospital, Milan 20154, Italy
| | - Marta Camilot
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Verona 37134, Italy
| | - Francesca Teofoli
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Verona 37134, Italy
| | - Renzo Ciatti
- Azienda Ospedaliera Ospedali Riuniti Marche Nord, Presidio Ospedaliero Santa Croce, Fano 61032, Italy
| | - Elisabetta Tarsi
- Azienda Ospedaliera Ospedali Riuniti Marche Nord, Presidio Ospedaliero Santa Croce, Fano 61032, Italy
| | - Nicola Perrotti
- Department of Health Sciences, University Magna Graecia, Catanzaro 88100, Italy
| | - Onorina Marasco
- Regional Neonatal Screening Laboratory, Azienda Ospedaliera Mater Domini, Catanzaro 88100, Italy
| | - Giovanna Scozzafava
- Regional Neonatal Screening Laboratory, Azienda Ospedaliera Mater Domini, Catanzaro 88100, Italy
| | - Francesca Righetti
- Regional Laboratory for Neonatal Screening and Endocrine-Metabolic Diseases, IRCCS University Sant'Orsola Hospital, Bologna 40138, Italy
| | - Sebastiano Andò
- Department of Pharmacy, Health and Nutritional Sciences, Centro Sanitario, University of Calabria, Cosenza 87036, Italy
| | - Stefania Catalano
- Department of Pharmacy, Health and Nutritional Sciences, Centro Sanitario, University of Calabria, Cosenza 87036, Italy
- Annunziata Hospital, Cosenza 87100, Italy
| | | | | | - Simona Censi
- Department of Medicine, University of Padua, Padua 35128, Italy
| | - Silvia Morelli
- Department of Medicine and Surgery, University of Perugia, Perugia 06132, Italy
| | - Enke Baldini
- Department of Surgery, “Sapienza” University of Rome, Rome 00185, Italy
| | - Giuseppe Plutino
- General Direction of Food Safety and Nutrition, Italian Ministry of Health, Rome 00144, Italy
| | - Roberto Copparoni
- General Direction of Food Safety and Nutrition, Italian Ministry of Health, Rome 00144, Italy
| | - Elena Alonzo
- Food Hygiene and Nutrition Service–SIAN, Local Health Authority of Catania, Catania 95027, Italy
| | - Claudia Giacomozzi
- Department of Cardiovascular and Endocrine-Metabolic Diseases and Aging, Italian National Institute of Health, Rome 00161, Italy
| | - Marco Silano
- Department of Cardiovascular and Endocrine-Metabolic Diseases and Aging, Italian National Institute of Health, Rome 00161, Italy
| | - Antonella Olivieri
- Department of Cardiovascular and Endocrine-Metabolic Diseases and Aging, Italian National Institute of Health, Rome 00161, Italy
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Guardiola-Márquez CE, Santos-Ramírez MT, Segura-Jiménez ME, Figueroa-Montes ML, Jacobo-Velázquez DA. Fighting Obesity-Related Micronutrient Deficiencies through Biofortification of Agri-Food Crops with Sustainable Fertilization Practices. PLANTS (BASEL, SWITZERLAND) 2022; 11:3477. [PMID: 36559589 PMCID: PMC9784404 DOI: 10.3390/plants11243477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 12/03/2022] [Accepted: 12/06/2022] [Indexed: 06/17/2023]
Abstract
Obesity is a critical medical condition worldwide that is increasingly involved with nutritional derangements associated with micronutrient deficiencies, including iron, zinc, calcium, magnesium, selenium, and vitamins A, C, D, and E. Nutritional deficiencies in obesity are mainly caused by poor-quality diets, higher nutrient requirements, alterations in micronutrient metabolism, and invasive obesity treatments. The current conventional agricultural system is designed for intensive food production, focusing on food quantity rather than food quality, consuming excessive agricultural inputs, and producing nutrient-deficient foods, thus generating severe health and environmental problems; agricultural food products may worsen obesity-related malnutrition. Therefore, modern agriculture is adopting new biofortification technologies to combat micronutrient deficiencies and improve agricultural productivity and sustainability. Biofertilization and nanofertilization practices are increasingly used due to their efficiency, safety, and reduced environmental impact. Biofertilizers are preparations of PGP-microorganisms that promote plant growth by influencing plant metabolism and improving the nutrient uptake, and nanofertilizers consist of synthesized nanoparticles with unique physicochemical properties that are capable of increasing plant nutrition and enriching agricultural products. This review presents the current micronutrient deficiencies associated with obesity, the modern unsustainable agri-food system contributing to obesity progression, and the development of bio- and nanofertilizers capable of biofortifying agri-food crops with micronutrients commonly deficient in patients with obesity.
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Affiliation(s)
| | - María Teresa Santos-Ramírez
- Tecnologico de Monterrey, Escuela de Ingenieria y Ciencias, Ave. General Ramon Corona 2514, Zapopan 45138, Jalisco, Mexico
| | - M. Eugenia Segura-Jiménez
- Tecnologico de Monterrey, Escuela de Ingenieria y Ciencias, Ave. General Ramon Corona 2514, Zapopan 45138, Jalisco, Mexico
| | - Melina Lizeth Figueroa-Montes
- Tecnologico de Monterrey, Escuela de Ingenieria y Ciencias, Ave. General Ramon Corona 2514, Zapopan 45138, Jalisco, Mexico
| | - Daniel A. Jacobo-Velázquez
- Tecnologico de Monterrey, Escuela de Ingenieria y Ciencias, Ave. General Ramon Corona 2514, Zapopan 45138, Jalisco, Mexico
- Tecnologico de Monterrey, The Institute for Obesity Research, Ave. General Ramon Corona 2514, Zapopan 45201, Jalisco, Mexico
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Wang Y, Teng W, Zhang Z, Ma S, Jin Z, Zhou X, Ye Y, Zhang C, Gou Z, Yu X, Ye Z, Ren Y. Remote Eradication of Bacteria on Orthopedic Implants via Delayed Delivery of Polycaprolactone Stabilized Polyvinylpyrrolidone Iodine. J Funct Biomater 2022; 13:jfb13040195. [PMID: 36278664 PMCID: PMC9589933 DOI: 10.3390/jfb13040195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 10/08/2022] [Accepted: 10/15/2022] [Indexed: 11/16/2022] Open
Abstract
Bacteria-associated late infection of the orthopedic devices would further lead to the failure of the implantation. However, present ordinary antimicrobial strategies usually deal with early infection but fail to combat the late infection of the implants due to the burst release of the antibiotics. Thus, to fabricate long-term antimicrobial (early antibacterial, late antibacterial) orthopedic implants is essential to address this issue. Herein, we developed a sophisticated MAO-I2-PCLx coating system incorporating an underlying iodine layer and an upper layer of polycaprolactone (PCL)-controlled coating, which could effectively eradicate the late bacterial infection throughout the implantation. Firstly, micro-arc oxidation was used to form a microarray tubular structure on the surface of the implants, laying the foundation for iodine loading and PCL bonding. Secondly, electrophoresis was applied to load iodine in the tubular structure as an efficient bactericidal agent. Finally, the surface-bonded PCL coating acts as a controller to regulate the release of iodine. The hybrid coatings displayed great stability and control release capacity. Excellent antibacterial ability was validated at 30 days post-implantation via in vitro experiments and in vivo rat osteomyelitis model. Expectedly, it can become a promising bench-to-bedside strategy for current infection challenges in the orthopedic field.
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Affiliation(s)
- Yikai Wang
- Department of Orthopedics, Renmin Hospital of Wuhan University, Jiefang Road 238, Wuhan 430060, China
| | - Wangsiyuan Teng
- Department of Orthopedics, Centre for Orthopaedic Research, Orthopedics Research Institute of Zhejiang University, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
- Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, Hangzhou 310009, China
| | - Zengjie Zhang
- Department of Orthopedics, Centre for Orthopaedic Research, Orthopedics Research Institute of Zhejiang University, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
- Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, Hangzhou 310009, China
| | - Siyuan Ma
- Department of Orthopedics, Renmin Hospital of Wuhan University, Jiefang Road 238, Wuhan 430060, China
| | - Zhihui Jin
- Department of Orthopedics, Renmin Hospital of Wuhan University, Jiefang Road 238, Wuhan 430060, China
| | - Xingzhi Zhou
- Department of Orthopedics, Centre for Orthopaedic Research, Orthopedics Research Institute of Zhejiang University, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
- Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, Hangzhou 310009, China
| | - Yuxiao Ye
- School of Material Science and Engineering, University of New South Wales, Sydney 2052, Australia
| | - Chongda Zhang
- New York University Medical Center, New York University, New York, NY 10016, USA
| | - Zhongru Gou
- Bio-Nanomaterials and Regenerative Medicine Research Division, Zhejiang-California International Nanosystem Institute, Zhejiang University, Hangzhou 310058, China
| | - Xiaohua Yu
- Department of Orthopedics, Centre for Orthopaedic Research, Orthopedics Research Institute of Zhejiang University, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
- Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, Hangzhou 310009, China
| | - Zhaoming Ye
- Department of Orthopedics, Centre for Orthopaedic Research, Orthopedics Research Institute of Zhejiang University, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
- Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, Hangzhou 310009, China
- Correspondence: (Z.Y.); (Y.R.); Tel.: +86-571-8778-3777 (Z.Y.); +86-027-8804-1911 (ext. 83380) (Y.R.)
| | - Yijun Ren
- Department of Orthopedics, Renmin Hospital of Wuhan University, Jiefang Road 238, Wuhan 430060, China
- Correspondence: (Z.Y.); (Y.R.); Tel.: +86-571-8778-3777 (Z.Y.); +86-027-8804-1911 (ext. 83380) (Y.R.)
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7
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Nista F, Bagnasco M, Gatto F, Albertelli M, Vera L, Boschetti M, Musso N, Ferone D. The effect of sodium restriction on iodine prophylaxis: a review. J Endocrinol Invest 2022; 45:1121-1138. [PMID: 35079975 DOI: 10.1007/s40618-022-01749-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 01/16/2022] [Indexed: 01/06/2023]
Abstract
PURPOSE Sodium is essential to life. However, its dietary excess is detrimental to the cardiovascular system, and sodium restriction is a crucial step in cardiovascular prevention. Iodine deficiency has been fought worldwide for decades, and substantial success has been achieved introducing the use of iodine-enriched salt. Nevertheless, areas of iodine deficiency persist around the world, both in developing and industrialized countries, and a major concern affecting dietary sodium reduction programs is represented by a possible iodine intake deficiency. There are substantial differences in the source of alimentary iodine among countries, such as iodized salt added, household tap water, seafood, or salt employed in packaged food. It is clear that a sodium-restricted diet can induce differences in terms of iodine intake, depending on the country considered. Moreover, iodine status has undergone relevant changes in many countries in the last years. METHODS Systematic review of literature evidence about the possible effects of sodium restriction on population iodine status. RESULTS To date, the available results are conflicting, depending on country, salt iodization policy, as well as time frame of data collection. However, to ensure an optimal iodine supply by salt fortification, without exceeding the current recommendation by World Health Organization for salt intake, seems to be an achievable goal. CONCLUSION A balanced approach may be obtained by an adequate iodine concentration in fortified salt and by promoting the availability of iodized salt for household consumption and food industry use. In this scenario, updated prospective studies are strongly needed.
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Affiliation(s)
- F Nista
- Endocrinology Unit, Department of Internal Medicine and Center of Excellence for Biomedical Research, University of Genoa, Genoa, Italy
| | - M Bagnasco
- Department of Internal Medicine and Medical Specialties, President-elect of the Italian Thyroid Association, University of Genoa, Genoa, Italy
| | - F Gatto
- Endocrinology Unit, IRCCS Ospedale Policlinico San Martino, 16132, Genoa, Italy.
| | - M Albertelli
- Endocrinology Unit, Department of Internal Medicine and Center of Excellence for Biomedical Research, University of Genoa, Genoa, Italy
| | - L Vera
- Endocrinology Unit, IRCCS Ospedale Policlinico San Martino, 16132, Genoa, Italy
| | - M Boschetti
- Endocrinology Unit, Department of Internal Medicine and Center of Excellence for Biomedical Research, University of Genoa, Genoa, Italy
| | - N Musso
- Endocrinology Unit, IRCCS Ospedale Policlinico San Martino, 16132, Genoa, Italy
| | - D Ferone
- Endocrinology Unit, Department of Internal Medicine and Center of Excellence for Biomedical Research, University of Genoa, Genoa, Italy
- Endocrinology Unit, IRCCS Ospedale Policlinico San Martino, 16132, Genoa, Italy
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Abstract
The policy of Universal Salt Iodisation (USI) could reduce population's thyroid volume (TVOL) in iodine deficiency areas. Conversely, the improved growth and developmental status of children might increase the TVOL accordingly. Whether the decreased TVOL by USI conceals the increase effect of height and weight on TVOL is unclear. The aim of this study was to analyse the association between height, weight, iodine supplementation and TVOL. Five national Iodine Deficiency Disorder surveys were matched into four pairs according to the purpose of analysis. County-level data of both detected by paired surveys were incorporated; 1:1 random pairing method was used to match counties or individuals. The difference of TVOL between different height, weight, different iodine supplementation measures groups and the association between TVOL and them were studied. The mean height and weight of children aged 8-10 years increased from 129·9 cm and 26·9 kg in 2002 to 136·2 cm and 32·1 kg in 2019, while the median TVOL decreased from 3·10 ml to 2·61 ml. Iodine supplementation measures can affect TVOL; after excluding iodine effects, the median TVOL was increased with the height and weight. On the other side, after excluding the influence of height and weight, the median TVOL remained decreased. Only age, weight and salt iodine were significantly associated with TVOL in multiple linear models. Development of height and weight in children is the evidence of improved nutrition. The decreased TVOL caused by iodised salt measures conceals the increase effect of height and weight on TVOL. Age, weight and salt iodine affect TVOL significantly.
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Fuse Y, Ito Y, Shishiba Y, Irie M. Current Iodine Status in Japan: A Cross-sectional Nationwide Survey of Schoolchildren, 2014-2019. J Clin Endocrinol Metab 2022; 107:e2065-e2079. [PMID: 34935958 DOI: 10.1210/clinem/dgab919] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT Japan has been regarded as a long-standing iodine-sufficient country without iodine fortification; however, data on nationwide iodine status are lacking. OBJECTIVE This study aimed to characterize the iodine status in Japan. METHODS From 2014 through 2019, a nationwide school-based survey was conducted across all districts in Japan. Urinary iodine concentration (UIC), creatinine (Cr) concentration, and anthropometry were assessed in healthy school-aged children (SAC) aged 6 to 12 years. Their iodine status is regarded as generally representative of the nation's iodine status. RESULTS A total of 32 025 children participated. The overall median UIC was 269 μg/L, which was within the World Health Organization's adequacy range. There was a regional difference in UIC values within 14 regions, and the lowest and highest median UICs were found in Tanegashima Island (209 μg/L) and Nakashibetsu, Hokkaido (1071 μg/L), respectively. The median UIC ≥ 300 μg/L was observed in 12 of 46 regions. By using estimated 24-hour urinary iodine excretion (UIE), the prevalence of SAC exceeding the upper tolerable limit of iodine for Japanese children was from 5.2% to 13.7%. The UIC values did not change with age, body surface area and body mass index percentile, whereas the Cr concentration simultaneously increased suggesting the effect of urinary creatinine on UI/Cr and estimated 24-hour UIE values. CONCLUSIONS The iodine intake of Japanese people is adequate, but in some areas it is excessive. The incidence and prevalence of thyroid disorders associated with iodine intake should be obtained, especially in the areas where high amounts of iodine are consumed.
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Affiliation(s)
- Yozen Fuse
- Research Committee on Iodine Related Health Problems, Foundation for Growth Science, Tokyo 113-0033, Japan
| | - Yoshiya Ito
- Research Committee on Iodine Related Health Problems, Foundation for Growth Science, Tokyo 113-0033, Japan
- Division of Clinical Medicine, Japanese Red Cross Hokkaido College of Nursing, Kitami, Hokkaido 090-0011, Japan
| | - Yoshimasa Shishiba
- Research Committee on Iodine Related Health Problems, Foundation for Growth Science, Tokyo 113-0033, Japan
| | - Minoru Irie
- Research Committee on Iodine Related Health Problems, Foundation for Growth Science, Tokyo 113-0033, Japan
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10
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Liu L, Qian T, Sun R, Du Y, Li M, Liu L, Liu P, Fan L, Meng F. Comparative Analysis of Five Correction Methods for Thyroid Volume by Ultrasound and Their Recommended Reference Values in Chinese Children Aged 8-10 Years. Br J Nutr 2022; 129:1-28. [PMID: 35416137 DOI: 10.1017/s0007114522001003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Considering the influence of body's growth and development on thyroid volume (TVOL), whether five existed corrected methods could be applied to correct TVOL remains unclear, in terms of Chinese children's increased growth and development trends. This study aimed to compare the applicability of five correction methods for TVOL: Body Surface Area corrected Volume (BSAV), Body Mass Indicator corrected Volume (BMIV), Weight and Height corrected Volume Indicator (WHVI), Height corrected Volume Indicator 1 (HVI1) and Height corrected Volume Indicator 2 (HVI2); to establish the reference values for correction methods. The data of Iodine Nutrition and Thyroid Function Survey was used to analyse the differences in TVOL between normal and abnormal thyroid function children. Data of National Iodine Deficiency Disorders Survey were used to compare five correction methods and to establish their reference values. The median urinary iodine concentration of children surveyed were 256.1μg/L in 2009 and 192.6μg/L in 2019, respectively. No significant difference was found in TVOL and thyroid goitre rate between children with normal and abnormal thyroid function. In the determination of goitre, HVI1, HVI2, BSAV and BMIV all showed high agreement with TVOL, while the area under the ROC curve (AUC) of WHVI was relatively low for children aged 8(AUC=0.8993) and 9(AUC=0.8866). Most differences of TVOL between light and heavy weight, short and tall height children can be eliminated by BSAV correction. BSAV was the best method of TVOL correction in this research. Reference values were established for corrected thyroid volumes in Chinese children aged 8-10 years by sex.
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Affiliation(s)
- Lanchun Liu
- Key lab of Etiology and Epidemiology, National Health Commission & Education Bureau of Heilongjiang Province (23618504) & Key Laboratory of Trace Elements and Human Health, Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, 150081
| | - Tingting Qian
- Key lab of Etiology and Epidemiology, National Health Commission & Education Bureau of Heilongjiang Province (23618504) & Key Laboratory of Trace Elements and Human Health, Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, 150081
| | - Rong Sun
- Key lab of Etiology and Epidemiology, National Health Commission & Education Bureau of Heilongjiang Province (23618504) & Key Laboratory of Trace Elements and Human Health, Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, 150081
| | - Yang Du
- Key lab of Etiology and Epidemiology, National Health Commission & Education Bureau of Heilongjiang Province (23618504) & Key Laboratory of Trace Elements and Human Health, Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, 150081
| | - Ming Li
- Key lab of Etiology and Epidemiology, National Health Commission & Education Bureau of Heilongjiang Province (23618504) & Key Laboratory of Trace Elements and Human Health, Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, 150081
| | - Lixiang Liu
- Key lab of Etiology and Epidemiology, National Health Commission & Education Bureau of Heilongjiang Province (23618504) & Key Laboratory of Trace Elements and Human Health, Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, 150081
| | - Peng Liu
- Key lab of Etiology and Epidemiology, National Health Commission & Education Bureau of Heilongjiang Province (23618504) & Key Laboratory of Trace Elements and Human Health, Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, 150081
| | - Lijun Fan
- Key lab of Etiology and Epidemiology, National Health Commission & Education Bureau of Heilongjiang Province (23618504) & Key Laboratory of Trace Elements and Human Health, Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, 150081
| | - Fangang Meng
- Key lab of Etiology and Epidemiology, National Health Commission & Education Bureau of Heilongjiang Province (23618504) & Key Laboratory of Trace Elements and Human Health, Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, 150081
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11
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Yan Y, Xu M, Wu M, Wang X, Li F, Zhang J, You L, Pan X, Feng W, Wu J, Chen C, Li X, Yan L. Obesity is associated with subclinical hypothyroidism in the presence of thyroid autoantibodies: a cross-sectional study. BMC Endocr Disord 2022; 22:94. [PMID: 35395842 PMCID: PMC8991961 DOI: 10.1186/s12902-022-00981-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 02/24/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Both obesity and subclinical hypothyroidism (SCH) have adverse effects on human body, but the relationship between these two conditions remains inconsistent. The presence of thyroid autoantibodies influences thyroid hormone levels, and may further mediate the interaction between obesity and SCH. This study aimed to explore the association among obesity, SCH and thyroid autoantibodies. METHODS This study was a cross-sectional survey of 2505 subjects. Obesity was defined as a body mass index ≥28 kg/m2. Serum concentrations of thyroid hormones, thyroid peroxidase antibody (TPO-Ab) and thyroglobulin antibody (Tg-Ab) were examined. Logistic analysis was used to explore the relation among obesity, SCH and thyroid autoantibodies. RESULTS A proportion of 11.54% (289/2505) subjects were obese, and 165 subjects had SCH. The positive rates of thyroid autoantibodies, TPO-Ab and Tg-Ab were 17.64% (442/2505), 11.02% (276/2505) and 14.13% (354/2505), respectively. The proportion of SCH was significantly higher in obese than nonobese subjects among those with positive thyroid autoantibodies [22.41% (13/58) vs. 11.72% (45/384), p = 0.025, χ2 test]. Moreover, obesity was significantly associated with SCH in the presence of thyroid autoantibodies after adjusting for confounding factors (OR 2.212, 95% CI 1.103 to 4.433, p = 0.025). A higher proportion of subjects with obesity had Tg-Ab positivity [17.99% (52/289) vs. 13.63% (302/2216), p = 0.045, χ2 test], and obesity remained significantly associated with Tg-Ab positivity by multiple logistic analysis (OR 1.504, 95% CI 1.077 to 2.101, p = 0.017). CONCLUSIONS Obesity was associated with SCH in the presence of thyroid autoantibodies. Examination of SCH is recommended in obese subjects with thyroid autoantibody positivity.
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Affiliation(s)
- Yuerong Yan
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang West Road, Guangzhou, 510120, China
| | - Mingtong Xu
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang West Road, Guangzhou, 510120, China.
| | - Muchao Wu
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang West Road, Guangzhou, 510120, China
| | - Xiaoyi Wang
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang West Road, Guangzhou, 510120, China
| | - Feng Li
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang West Road, Guangzhou, 510120, China
| | - Jin Zhang
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang West Road, Guangzhou, 510120, China
| | - Lili You
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang West Road, Guangzhou, 510120, China
| | - Xiaofang Pan
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang West Road, Guangzhou, 510120, China
| | - Weilian Feng
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang West Road, Guangzhou, 510120, China
| | - Jiayun Wu
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang West Road, Guangzhou, 510120, China
| | - Caixia Chen
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang West Road, Guangzhou, 510120, China
| | - Xiaohui Li
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang West Road, Guangzhou, 510120, China
| | - Li Yan
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107 Yanjiang West Road, Guangzhou, 510120, China
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12
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De Angelis S, Rotondi D, Gilardi E, Stacchini P, Pastorelli AA, Sorbo A, D’Amato M, Turco AC, Medda E, Da Cas R, Andò S, Bonofiglio D, Bagnasco M, Gasperi M, Meringolo D, Mian C, Puxeddu E, Regalbuto C, Moleti M, Taccaliti A, Ulisse S, Tonacchera M, Tanda ML, Boi F, Ruggiero V, Mariotti S, Corbetta C, Ciatti R, Tarsi E, Stoppioni V, Perrotti N, Marasco O, Scozzafava G, Camilot M, Teofoli F, Righetti F, Dimida A, Plutino G, Carrano E, Copparoni R, Gabbianelli M, Vitti P, Olivieri A. Aggiornamento sulla nutrizione iodica in Italia: i risultati della seconda sorveglianza dell’Osservatorio per il Monitoraggio della Iodoprofilassi in Italia-OSNAMI (2015-2019). L'ENDOCRINOLOGO 2022. [PMCID: PMC8790550 DOI: 10.1007/s40619-022-01018-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Affiliation(s)
- Simona De Angelis
- Dipartimento di Malattie Cardiovascolari, Endocrino-Metaboliche e Invecchiamento, Istituto Superiore di Sanità, Roma, Italia
| | - Daniela Rotondi
- Dipartimento di Malattie Cardiovascolari, Endocrino-Metaboliche e Invecchiamento, Istituto Superiore di Sanità, Roma, Italia
| | - Enzo Gilardi
- Dipartimento di Malattie Cardiovascolari, Endocrino-Metaboliche e Invecchiamento, Istituto Superiore di Sanità, Roma, Italia
| | - Paolo Stacchini
- Dipartimento di Sanità Pubblica Veterinaria e Sicurezza Alimentare, Istituto Superiore di Sanità, Roma, Italia
| | - Augusto Alberto Pastorelli
- Dipartimento di Sanità Pubblica Veterinaria e Sicurezza Alimentare, Istituto Superiore di Sanità, Roma, Italia
| | - Angela Sorbo
- Dipartimento di Sanità Pubblica Veterinaria e Sicurezza Alimentare, Istituto Superiore di Sanità, Roma, Italia
| | - Marilena D’Amato
- Dipartimento di Sanità Pubblica Veterinaria e Sicurezza Alimentare, Istituto Superiore di Sanità, Roma, Italia
| | - Anna Chiara Turco
- Dipartimento di Sanità Pubblica Veterinaria e Sicurezza Alimentare, Istituto Superiore di Sanità, Roma, Italia
| | - Emanuela Medda
- Centro di Riferimento per le Scienze Comportamentali e la Salute Mentale, Istituto Superiore di Sanità, Roma, Italia
| | - Roberto Da Cas
- Centro Nazionale Ricerca e Valutazione Preclinica e Clinica dei Farmaci, Istituto Superiore di Sanità, Roma, Italia
| | - Sebastiano Andò
- Centro Sanitario, Dipartimento di Farmacia e Scienze della Salute e della Nutrizione, Università della Calabria, Cosenza, Italia
| | - Daniela Bonofiglio
- Centro Sanitario, Dipartimento di Farmacia e Scienze della Salute e della Nutrizione, Università della Calabria, Cosenza, Italia
| | - Marcello Bagnasco
- Dipartimento di Medicina Interna e Specialità Mediche, Università di Genova, IRCCS Ospedale Policlinico S. Martino, Genova, Italia
| | - Maurizio Gasperi
- Dipartimento di Medicina e Scienze per la Salute, Università degli Studi del Molise, Campobasso, Italia
| | | | - Caterina Mian
- Dipartimento di Medicina, Azienda Ospedaliera di Padova, Padova, Italia
| | - Efisio Puxeddu
- Dipartimento di Medicina, Università degli Studi di Perugia, Perugia, Italia
| | - Concetto Regalbuto
- Dipartimento di Biomedicina Clinica e Molecolare, Università di Catania, Catania, Italia
| | - Mariacarla Moleti
- Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Messina, Messina, Italia
| | - Augusto Taccaliti
- Clinica di Endocrinologia e Malattie del Metabolismo, Università Politecnica delle Marche, Ancona, Italia
| | - Salvatore Ulisse
- Dipartimento di Scienze Chirurgiche, “Sapienza” Università di Roma, Roma, Italia
| | - Massimo Tonacchera
- Dipartimento di Medicina Clinica e Sperimentale, Università di Pisa, Pisa, Italia
| | - Maria Laura Tanda
- Dipartimento di Medicina e Chirurgia, Università degli Studi dell’Insubria, ASST-Settelaghi, Varese, Italia
| | - Francesco Boi
- Dipartimento di Scienze Mediche e Sanità Pubblica, Università degli Studi di Cagliari, Cagliari, Italia
| | - Valeria Ruggiero
- Dipartimento di Scienze Mediche e Sanità Pubblica, Università degli Studi di Cagliari, Cagliari, Italia
| | - Stefano Mariotti
- Dipartimento di Scienze Mediche e Sanità Pubblica, Università degli Studi di Cagliari, Cagliari, Italia
| | - Carlo Corbetta
- Laboratorio di Riferimento Regionale per lo Screening Neonatale, Ospedale V. Buzzi, Milano, Italia
| | - Renzo Ciatti
- Centro Screening Neonatale Regione Marche, UOC di Neuropsichiatria Infantile, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Presidio Ospedaliero Santa Croce, Fano, Italia
| | - Elisabetta Tarsi
- Centro Screening Neonatale Regione Marche, UOC di Neuropsichiatria Infantile, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Presidio Ospedaliero Santa Croce, Fano, Italia
| | - Vera Stoppioni
- Centro Screening Neonatale Regione Marche, UOC di Neuropsichiatria Infantile, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Presidio Ospedaliero Santa Croce, Fano, Italia
| | - Nicola Perrotti
- Dipartimento Scienze della Salute, Università Magna Graecia, Catanzaro, Italia
| | - Onorina Marasco
- Laboratorio Regionale di Screening Neonatale, Azienda Ospedaliera Mater Domini, Catanzaro, Italia
| | - Giovanna Scozzafava
- Laboratorio Regionale di Screening Neonatale, Azienda Ospedaliera Mater Domini, Catanzaro, Italia
| | - Marta Camilot
- Laboratorio Regionale di Screening Neonatale, Azienda Ospedaliera Universitaria Integrata di Verona, Ospedale Borgo Roma, Verona, Italia
| | - Francesca Teofoli
- Laboratorio Regionale di Screening Neonatale, Azienda Ospedaliera Universitaria Integrata di Verona, Ospedale Borgo Roma, Verona, Italia
| | - Francesca Righetti
- Centro Laboratoristico Regionale di Riferimento per lo Screening Neonatale e Malattie Endocrino-Metaboliche, Azienda Ospedaliero-Universitaria Policlinico Sant’Orsola-Malpighi, Bologna, Italia
| | - Antonio Dimida
- Dipartimento di Medicina Clinica e Sperimentale, Università di Pisa, Pisa, Italia
| | - Giuseppe Plutino
- Direzione Generale per l’Igiene e la Sicurezza degli Alimenti e la Nutrizione, Ministero della Salute, Roma, Italia
| | - Elena Carrano
- Direzione Generale per l’Igiene e la Sicurezza degli Alimenti e la Nutrizione, Ministero della Salute, Roma, Italia
| | - Roberto Copparoni
- Direzione Generale per l’Igiene e la Sicurezza degli Alimenti e la Nutrizione, Ministero della Salute, Roma, Italia
| | - Marco Gabbianelli
- Dipartimento di Malattie Cardiovascolari, Endocrino-Metaboliche e Invecchiamento, Istituto Superiore di Sanità, Roma, Italia
| | - Paolo Vitti
- Dipartimento di Medicina Clinica e Sperimentale, Università di Pisa, Pisa, Italia
| | - Antonella Olivieri
- Dipartimento di Malattie Cardiovascolari, Endocrino-Metaboliche e Invecchiamento, Istituto Superiore di Sanità, Roma, Italia
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13
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Moleti M, Di Mauro M, Paola G, Olivieri A, Vermiglio F. Nutritional iodine status and obesity. Thyroid Res 2021; 14:25. [PMID: 34838106 PMCID: PMC8626876 DOI: 10.1186/s13044-021-00116-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 11/10/2021] [Indexed: 02/08/2023] Open
Abstract
Iodine is an essential component of the thyroid hormones, thyroxine and triiodothyronine. Its availability strictly depends on iodine content of foods, which may vary from very low to very high. Inadequate iodine intake (deficiency or excess) may affect thyroid function resulting in hypothyroidism or hyperthyroidism. Based on median urinary iodine concentrations, epidemiological criteria have been established for the categorization and monitoring of nutritional iodine status of a population (or subgroups of populations). Additional methods for iodine intake assessment include measurement of thyroid size (by thyroid palpation or ultrasonography) and of biochemical parameters, such as neonatal thyroid stimulating hormone, thyroglobulin and thyroid hormones. Recent studies carried out in overweight/obese children and adults provide evidence that body mass index (BMI) may significantly influence the above indicators, thus theoretically affecting the epidemiological evaluation of nutritional iodine status in populations. In this short review, we analyze current knowledge on the effects of overweight and obesity on indicators of adequacy and monitoring of iodine status, namely urinary iodine excretion and thyroid volume and echogenicity. Data on urinary iodine excretion in overweight/obese children are divergent, as both increased and reduced levels have been reported in overweight/obese children compared to normal-weight controls. Whether gastrointestinal surgery may affect iodine absorption and lead to iodine deficiency in patients undergoing bariatric surgery has been evaluated in a limited number of studies, which excluded iodine deficiency, thus suggesting that supplements usually recommended after bariatric surgery do not need to include iodine. Albeit limited, evidence on thyroid volume and obesity is consistent with a direct relationship between thyroid volume and BMI, irrespective of nutritional iodine status. Finally, a higher frequency of thyroid hypoechoic pattern has been described in overweight/obese children. This finding has been recently related to an increased adipocyte infiltration and thyroid parenchyma imbibition mediated by inflammatory cytokines and should be considered when the frequency of thyroid hypoechoic pattern is used as non-invasive marker to indirectly assess thyroid autoimmunity in monitoring Universal Salt Iodization programs. Further studies, specifically addressing the role of schoolchildren body mass index as a factor potentially influencing iodine intake indicators are needed.
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Affiliation(s)
- Mariacarla Moleti
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Maria Di Mauro
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Giuseppe Paola
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Antonella Olivieri
- Department of Cardiovascular and Endocrine-Metabolic Diseases and Aging, Italian National Institute of Health, Rome, Italy
| | - Francesco Vermiglio
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
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14
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Abstract
Adequate iodine intake is necessary for normal thyroid function. Iodine deficiency is associated with serious complications, but also iodine excess can lead to thyroid dysfunction, and iodine supplementation aimed to prevent iodine deficiency disorders has been associated with development of thyroid autoimmunity. The epidemiology of thyroid diseases has undergone profound changes since the implementation of iodoprophylaxis, notably by means of iodine-enriched salt, specifically resulting in decreased prevalence of goiter and neonatal hypothyroidism, improved cognitive function development in infancy, and reduced incidence of more aggressive forms of thyroid cancer. The main question we address with this review is the clinical relevance of the possible effect on autoimmunity exerted by the use of iodine-enriched salt to correct iodine deficiency. In animal models, exogenous iodine is able to trigger or exacerbate thyroid autoimmunity, but it is still not clear whether the observed immunological changes are due to a direct effect of iodine on immune response, or whether they represent a secondary response to a toxic effect of iodine on thyroid tissue. Previous iodine status of a population seems to influence the functional thyroid response to increased iodine intake and possibly the development of thyroid autoimmunity. Moreover, the prevalence of thyroid antibodies, regarded as hallmark of autoimmune thyroid disease, varies between populations under the influence of genetic and environmental factors, and the presence of thyroid antibodies does not always coincide with the presence of thyroid disease or its future development. In addition, the incidence of autoimmune diseases shows a general increasing trend in the last decades. For all these reasons, available data are quite heterogeneous and difficult to analyze and compare. In conclusion, available data from long-term population surveys show that a higher than adequate population iodine intake due to a poorly controlled program of iodine prophylaxis could induce thyroid dysfunction, including thyroid autoimmunity mostly represented by euthyroid or subclinical hypothyroid autoimmune thyroiditis. Close monitoring iodine prophylaxis is therefore advised to ensure that effects of both iodine deficiency and iodine excess are avoided.
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15
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Shan X, Liu C, Luo X, Zou Y, Huang L, Zhou W, Qin Q, Mao D, Li M, Yang L. Iodine Nutritional Status and Related Factors among Chinese School-Age Children in Three Different Areas: A Cross-Sectional Study. Nutrients 2021; 13:1404. [PMID: 33921931 PMCID: PMC8143470 DOI: 10.3390/nu13051404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/12/2021] [Accepted: 04/17/2021] [Indexed: 11/17/2022] Open
Abstract
We evaluated the iodine nutritional status and related factors among school-age children based on the 2016 National Nutrition and Health Surveillance of Children and Lactating Women; 3808 children from Hebei, Guangxi, and Zhejiang province were included in the study. Urinary iodine concentration (UIC), thyroid-stimulating hormone (TSH), body mass index (BMI), vitamin A (VA), and vitamin D (VD) were measured. The abnormal rate of UIC and TSH were assessed. Relationships between UIC/TSH and the possible factors were analyzed. The overall median UIC was 185.14 µg/L, and the median UIC of children aged 8-10 was 164.60 µg/L. Prevalence of iodine deficiency and excess was 13.84% and 14.36%, respectively, and 12.87% of children showed TSH excess. UIC, as well as the abnormal rates of iodine deficiency (ID) and TSH, were significantly different among the three provinces. The median UICs and excess rates increased with age, reaching 211.45 µg/L and 21.35% at age of 14~, while TSH showed the opposite trend. Overweight children tended to have lower UIC and higher TSH. Higher UIC and TSH were found in VA sufficient group (p < 0.01). Further, the VD deficient group had a higher TSH compared to the sufficient group (p < 0.01). Moreover, UI and TSH distribution was obviously different among different vitamin A/D status (p < 0.05). Although the median UIC of school-age children was optimal, there were pockets of inadequate and excessive UI in the three provinces. Compared to the national IDD monitoring results in 2014, the iodine nutritional status of children was greatly improved. Considerations of region, age, BMI, VA, or VD are needed in the future iodine evaluation and surveillance.
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Affiliation(s)
- Xiaoyun Shan
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Key Laboratory of Trace Element Nutrition, National Health Commission of the People’s Republic of China, 29 Nanwei Road, Beijing 100050, China; (X.S.); (D.M.); (M.L.)
- School of Public Health, University of South China, 28 Changsheng West Road, Hengyang 421001, China
| | - Changqing Liu
- Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang 050011, China; (C.L.); (X.L.)
| | - Xiaoyan Luo
- Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang 050011, China; (C.L.); (X.L.)
| | - Yan Zou
- Zhejiang Provincial Center for Disease Prevention and Control, 3399 Binsheng Road, Hangzhou 310051, China; (Y.Z.); (L.H.)
| | - Lichun Huang
- Zhejiang Provincial Center for Disease Prevention and Control, 3399 Binsheng Road, Hangzhou 310051, China; (Y.Z.); (L.H.)
| | - Weiwen Zhou
- Guangxi Center for Disease Prevention and Control, 18 Jinzhou Road, Nanning 530028, China; (W.Z.); (Q.Q.)
| | - Qiulan Qin
- Guangxi Center for Disease Prevention and Control, 18 Jinzhou Road, Nanning 530028, China; (W.Z.); (Q.Q.)
| | - Deqian Mao
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Key Laboratory of Trace Element Nutrition, National Health Commission of the People’s Republic of China, 29 Nanwei Road, Beijing 100050, China; (X.S.); (D.M.); (M.L.)
| | - Min Li
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Key Laboratory of Trace Element Nutrition, National Health Commission of the People’s Republic of China, 29 Nanwei Road, Beijing 100050, China; (X.S.); (D.M.); (M.L.)
| | - Lichen Yang
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Key Laboratory of Trace Element Nutrition, National Health Commission of the People’s Republic of China, 29 Nanwei Road, Beijing 100050, China; (X.S.); (D.M.); (M.L.)
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