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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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2
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Öztürk M. Is there a relationship between the urinary iodine of pregnant and diabetic patients? J Family Med Prim Care 2023; 12:1083-1086. [PMID: 37636175 PMCID: PMC10451571 DOI: 10.4103/jfmpc.jfmpc_270_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/27/2021] [Accepted: 12/05/2022] [Indexed: 08/29/2023] Open
Abstract
Objectives We investigated the iodine status in this study in pregnant women, diabetic women-men, and nondiabetic men-women living in our region. Methods A total of 385 cases who applied to the endocrine clinic between 2015 and 2020 were reviewed retrospectively. The gender, age, free T3 (pg/ml), free T4 (ng/dl), TSH (μIU/mL), anti-TPO antibody (IU/ml), anti-thyroglobulin antibody (IU/ml), and random urine iodine concentration (μg/L) levels of cases were recorded. The cases were grouped as pregnant, female, male, diabetic female, and diabetic male. Cases with overt thyroid disease, heart failure, liver failure, and kidney failure were excluded. Results There were 6.75% (n = 26) pregnant, 54.8% (n = 211) nondiabetic female patients, 18.9% (n = 73) diabetic female patients, 12.7% (n = 49) nondiabetic male, and 4.15% (n = 16) diabetic male patients. The random urinary iodine level was significantly higher in nondiabetic women (112.9 ± 77.21) and diabetic women (140.7 ± 97.8) than in pregnant women (77.8 ± 31.8) (P = 0.00 and P = 0.03). There was no significant relationship between random urine levels of pregnant women and nondiabetic men (104.1 ± 82.6) (P = 0.16). The random urinary iodine level was significantly higher in diabetic men (170.0 ± 112.1) than in pregnant women (P = 0.00). Conclusions In our region (xxx Region), pregnant women had iodine deficiency. The iodine level in men and women was very close to the lower limit. The urinary iodine level was higher in diabetic women and diabetic men than in both pregnant women and nondiabetic women and nondiabetic men. The results brought us the question: Could the high spot urinary iodine level in diabetic patients be a clue to nephropathy?
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Affiliation(s)
- Mine Öztürk
- Department of Endocrinology and Metabolism, KTO Karatay University Medicine Faculty Hospital, Konya, Turkey
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3
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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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Evaluation of first and second trimester maternal thyroid profile on the prediction of gestational diabetes mellitus and post load glycemia. PLoS One 2023; 18:e0280513. [PMID: 36638142 PMCID: PMC9838876 DOI: 10.1371/journal.pone.0280513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 01/02/2023] [Indexed: 01/14/2023] Open
Abstract
Maternal thyroid alterations have been widely associated with the risk of gestational diabetes mellitus (GDM). This study aims to 1) test the first and the second trimester full maternal thyroid profile on the prediction of GDM, both alone and combined with non-thyroid data; and 2) make that prediction independent of the diagnostic criteria, by evaluating the effectiveness of the different maternal variables on the prediction of oral glucose tolerance test (OGTT) post load glycemia. Pregnant women were recruited in Concepción, Chile. GDM diagnosis was performed at 24-28 weeks of pregnancy by an OGTT (n = 54 for normal glucose tolerance, n = 12 for GDM). 75 maternal thyroid and non-thyroid parameters were recorded in the first and the second trimester of pregnancy. Various combinations of variables were assessed for GDM and post load glycemia prediction through different classification and regression machine learning techniques. The best predictive models were simplified by variable selection. Every model was subjected to leave-one-out cross-validation. Our results indicate that thyroid markers are useful for the prediction of GDM and post load glycemia, especially at the second trimester of pregnancy. Thus, they could be used as an alternative screening tool for GDM, independently of the diagnostic criteria used. The final classification models predict GDM with cross-validation areas under the receiver operating characteristic curve of 0.867 (p<0.001) and 0.920 (p<0.001) in the first and the second trimester of pregnancy, respectively. The final regression models predict post load glycemia with cross-validation Spearman r correlation coefficients of 0.259 (p = 0.036) and 0.457 (p<0.001) in the first and the second trimester of pregnancy, respectively. This investigation constitutes the first attempt to test the performance of the whole maternal thyroid profile on GDM and OGTT post load glycemia prediction. Future external validation studies are needed to confirm these findings in larger cohorts and different populations.
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Raizada N, Madhu SV. Maternal Iodine Status and Pregnancy Outcomes: Looking Beyond Cretinism. Indian J Endocrinol Metab 2023; 27:1-2. [PMID: 37215261 PMCID: PMC10198194 DOI: 10.4103/2230-8210.370910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2023] Open
Affiliation(s)
- Nishant Raizada
- Department of Endocrinology, Centre for Diabetes, Endocrinology and Metabolism, University College of Medical Sciences and GTB Hospital, Delhi, India
| | - SV Madhu
- Department of Endocrinology, Centre for Diabetes, Endocrinology and Metabolism, University College of Medical Sciences and GTB Hospital, Delhi, India
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Zhang W, Liang H. Relationships Between Maternal Selected Metals (Cu, Mg, Zn and Fe), Thyroid Function and Blood Glucose Levels During Pregnancy. Biol Trace Elem Res 2022:10.1007/s12011-022-03455-5. [PMID: 36418636 DOI: 10.1007/s12011-022-03455-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 10/18/2022] [Indexed: 11/27/2022]
Abstract
The aim of this study were to understand the intake of selected metals (copper (Cu), zinc (Zn), iron (Fe) and magnesium (Mg)) during pregnancy; to detect serum Cu, Mg, Zn and Fe levels in pregnant women; to analyze the relationships among the selected metals, maternal thyroid function and fasting blood glucose (FBG) levels; to investigate the impact of the selected metals and maternal thyroid function on the risk of gestational diabetes mellitus (GDM); and to provide clinical value for the rational intake of the selected metals and iodine during pregnancy to ensure normal fetal development. The population was recruited from pregnant women presenting to the obstetrics outpatient clinic of Shanxi Provincial People's Hospital (February 2021 to April 2022). Selected metal, thyroid hormone (TH (free thyroxine (FT4), free tri-iodothyronine (FT3), and thyroid-stimulating hormone (TSH)) and FBG levels were measured in pregnant women during early, middle and late pregnancy. Covariance analysis was used to analyze the overall trends in selected metal, TH and FBG levels during pregnancy, and binary logistic regression models were used to assess the impacts of the selected metals and thyroid function on the risk of GDM. In addtion, the potential mediation effects of thyroid functions were explored in the mediation analyses. A total of 65 pregnant women were included in this study. Regression models showed that maternal Mg and Cu levels were positively associated with the risk of GDM, conversely, logFT4 was negatively associated with the risk of GDM. Mediation analyses suggested that the associations between the selected metals (Zn, Cu and Mg) and GDM might be mediated by FT3 levels, and that the Cu-GDM and Zn-GDM association could be explained by FT4 levels. Additionally, the Zn-GDM association could also potentially be mediated by the FT3/FT4 ratio. Our findings suggest that Mg, Cu and FT4 levels may act as influencing factors for the development of GDM, and maternal FT3, FT4 and the FT3/FT4 ratio might be the potential mediators of the associations between the selected metals and GDM risk during pregnancy.
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Affiliation(s)
- WeiYi Zhang
- The Fifth Clinical Medical College of Shanxi Medical University, Taiyuan, 030000, Shanxi, China
| | - HongPing Liang
- The Fifth Clinical Medical College of Shanxi Medical University, Taiyuan, 030000, Shanxi, China.
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Wang Y, Sun F, Wu P, Huang Y, Ye Y, Yang X, Yuan J, Liu Y, Zeng H, Wen Y, Qi X, Yang CX, Wang Y, Liu G, Chen D, Li L, Pan XF, Pan A. A Prospective Study of Early-pregnancy Thyroid Markers, Lipid Species, and Risk of Gestational Diabetes Mellitus. J Clin Endocrinol Metab 2022; 107:e804-e814. [PMID: 34453541 DOI: 10.1210/clinem/dgab637] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/23/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT While the associations between thyroid markers and gestational diabetes mellitus (GDM) have been extensively studied, the results are inconclusive and the mechanisms remain unclear. OBJECTIVE We aimed to investigate the prospective associations of thyroid markers in early gestation with GDM risk, and examine the mediating effects through lipid species. METHODS This study included 6068 pregnant women from the Tongji-Shuangliu Birth Cohort. Maternal serum thyroid markers (free triiodothyronine (fT3), free thyroxine (fT4), thyroid-stimulating hormone, thyroid peroxidase antibody, and thyroglobulin antibody) were measured before 15 weeks. Deiodinase activity was assessed by fT3/fT4 ratio. Plasma lipidome were quantified in a subset of 883 participants. RESULTS Mean age of the participants was 26.6 ± 3.7 years, and mean gestational age was 10.3 ± 2.0 weeks. Higher levels of fT4 were associated with a decreased risk of GDM (OR = 0.73 comparing the extreme quartiles; 95% CI 0.54, 0.98, Ptrend = .043), while higher fT3/fT4 ratio was associated with an increased risk of GDM (OR = 1.43 comparing the extreme quartiles; 95% CI 1.06, 1.93, Ptrend = .010) after adjusting for potential confounders. Multiple linear regression suggested that fT3/fT4 ratio was positively associated with alkylphosphatidylcholine 36:1, phosphatidylethanolamine plasmalogen 38:6, diacylglyceride 18:0/18:1, sphingomyelin 34:1, and phosphatidylcholine 40:7 (false discovery rate [FDR] adjusted P < .05). Mediation analysis indicated 67.9% of the association between fT3/fT4 ratio and GDM might be mediated through the composite effect of these lipids. CONCLUSION Lower concentration of serum fT4 or higher fT3/fT4 ratio in early pregnancy was associated with an increased risk of GDM. The association of fT3/fT4 ratio with GDM was largely mediated by specific lipid species.
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Affiliation(s)
- Yi Wang
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Fengjiang Sun
- School of Environment and Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou 511436, China
| | - Ping Wu
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Yichao Huang
- School of Environment and Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou 511436, China
- Department of Toxicology, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Yi Ye
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Xue Yang
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - Jiaying Yuan
- Department of Science and Education, Shuangliu Maternal and Child Health Hospital, Chengdu 610200, China
| | - Yan Liu
- Department of Obstetrics and Gynecology, Shuangliu Maternal and Child Health Hospital, Chengdu 610200, China
| | - Huayan Zeng
- Nutrition Department, Shuangliu Maternal and Child Health Hospital, Chengdu 610200, China
| | - Ying Wen
- Department of Communicable Diseases Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen 518055, China
| | - Xiaorong Qi
- Department of Gynecology and Obstetrics, West China Second Hospital, State Key Laboratory of Biotherapy, Sichuan University, Chengdu 610041, China
| | - Chun-Xia Yang
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - Yixin Wang
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Gang Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Da Chen
- School of Environment and Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou 511436, China
| | - Liangzhong Li
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Ecology and Environment, Guangzhou 510655, China
| | - Xiong-Fei Pan
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - An Pan
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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Purdue-Smithe AC, Männistö T, Reische E, Kannan K, Kim UJ, Suvanto E, Surcel HM, Gissler M, Mills JL. Iodine and thyroid status during pregnancy and risk of stillbirth: A population-based nested case-control study. MATERNAL AND CHILD NUTRITION 2021; 18:e13252. [PMID: 34350728 PMCID: PMC8710109 DOI: 10.1111/mcn.13252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/21/2021] [Accepted: 07/13/2021] [Indexed: 11/26/2022]
Abstract
Prior research suggests that severe iodine deficiency in pregnancy may be associated with stillbirth. However, the relationship between mild to moderate iodine insufficiency, which is prevalent even in developed countries, and risk of stillbirth is unclear. We thus examined associations of iodine status and risk of stillbirth in a prospective population‐based nested case–control study in Finland, a mild to moderately iodine insufficient population. Stillbirth cases (n = 199) and unaffected controls (n = 249) were randomly selected from among all singleton births in Finland from 2012 to 2013. Serum samples were collected between 10 and 14 weeks gestation and analysed for iodide, thyroglobulin (Tg) and thyroid‐stimulating hormone (TSH). Odds ratios (ORs) and 95% confidence intervals (CIs) for stillbirth were estimated using logistic regression. After adjusting for maternal age, prepregnancy body mass index, socio‐economic status and other factors, neither high nor low serum iodide was associated with risk of stillbirth (Q1 vs. Q2–Q3 OR = 0.92, 95% CI = 0.78–1.09; Q4 vs. Q2–Q3 OR = 0.78; 95% CI = 0.45–1.33). Tg and TSH were also not associated with risk of stillbirth in adjusted models. Maternal iodine status was not associated with stillbirth risk in this mildly to moderately iodine‐deficient population. Tg and TSH, which reflect functional iodine status, were also not associated with stillbirth risk. The lack of associations observed between serum iodide, TSH and Tg and risk of stillbirth is reassuring, given that iodine deficiency in pregnancy is prevalent in developed countries.
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Affiliation(s)
- Alexandra C Purdue-Smithe
- Division of Intramural Population Health Research, National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
| | - Tuija Männistö
- Northern Finland Laboratory Center NordLab, Oulu University Hospital, Oulu, Finland
| | - Elijah Reische
- Division of Intramural Population Health Research, National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
| | - Kurunthachalam Kannan
- Department of Pediatrics and Department of Environmental Medicine, New York University School of Medicine, New York, New York, USA
| | - Un-Jung Kim
- Department of Earth and Environmental Sciences, University of Texas at Arlington, Arlington, Texas, USA
| | - Eila Suvanto
- Oulu University Hospital, Department of Children and Women and Oulu University Medical Faculty PEDEGO Research Unit, Medical Research Center, Oulu, Finland
| | - Heljä-Marja Surcel
- Biobank Borealis of Northern Finland, Oulu University Hospital, Oulu, Finland.,Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Mika Gissler
- Information Services Department, Finnish Institute of Health and Welfare, Helsinki, Finland.,Department of Neurobiology, Karolinska Institute, Stockholm, Sweden
| | - James L Mills
- Division of Intramural Population Health Research, National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
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Reische EC, Männistö T, Purdue-Smithe A, Kannan K, Kim UJ, Suvanto E, Surcel HM, Gissler M, Mills JL. The Joint Role of Iodine Status and Thyroid Function on Risk for Preeclampsia in Finnish Women: a Population-Based Nested Case-Control Study. Biol Trace Elem Res 2021; 199:2131-2137. [PMID: 32821998 DOI: 10.1007/s12011-020-02341-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 08/09/2020] [Indexed: 11/25/2022]
Abstract
Preeclampsia, a pregnancy disorder that includes hypertension and proteinuria, is a major cause of maternal and fetal morbidity and mortality. Some studies, but not all, have found that women with preeclampsia have significantly lower iodine levels than healthy pregnant women. Resolving this issue is important because iodine deficiency in pregnancy is common in the USA and parts of Europe including Finland. We conducted a nested case-control study to determine whether the risk for preeclampsia is associated with iodine status. We measured serum iodine, thyroglobulin (Tg), and thyroid stimulating hormone (TSH) at 10-14 weeks gestational age in 204 women with preeclampsia and 246 unaffected controls selected from all births in Finland. We found no significant difference in iodine (case mean = 26.04 ng/mL, control mean = 27.88 ng/mL, p = 0.995), Tg (case mean = 31.11 ng/mL, control mean = 29.61 ng/mL, p = 0.996), and TSH (case mean = 1.30 mIU/L, control mean = 1.24 mIU/L, p = 0.896) levels between cases and controls. There was no significant relationship between preeclampsia risk and iodine, Tg, or TSH after adjustment for known risk factors. These results are reassuring given the high prevalence of iodine deficiency in pregnancy.
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Affiliation(s)
- Elijah C Reische
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Tuija Männistö
- Northern Finland Laboratory Center NordLab, Oulu University Hospital, 90120, Oulu, Finland
| | - Alexandra Purdue-Smithe
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Kurunthachalam Kannan
- Department of Pediatrics and Department of Environmental Medicine, New York University School of Medicine, New York, NY, 10016, USA
| | - Un-Jung Kim
- Department of Earth and Environmental Sciences, University of Texas at Arlington, Arlington, TX, 76019, USA
| | - Eila Suvanto
- Northern Finland Laboratory Center NordLab, Oulu University Hospital, 90120, Oulu, Finland
| | - Heljä-Marja Surcel
- Biobank Borealis of Northern Finland, Oulu University Hospital, 90120, Oulu, Finland
- Faculty of Medicine, University of Oulu, 90120, Oulu, Finland
| | - Mika Gissler
- Finnish Institute of Health and Welfare, 00290, Helsinki, Finland
- Karolinska Institute, 17177, Stockholm, Sweden
| | - James L Mills
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, 20892, USA.
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Neven KY, Cox B, Cosemans C, Gyselaers W, Penders J, Plusquin M, Roels HA, Vrijens K, Ruttens A, Nawrot TS. Lower iodine storage in the placenta is associated with gestational diabetes mellitus. BMC Med 2021; 19:47. [PMID: 33602219 PMCID: PMC7893873 DOI: 10.1186/s12916-021-01919-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 01/19/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The micronutrient iodine is essential for a healthy intrauterine environment and is required for optimal fetal growth and neurodevelopment. Evidence linking urinary iodine concentrations, which mainly reflects short-term iodine intake, to gestational diabetes mellitus (GDM) is inconclusive. Although the placental concentrations would better reflect the long-term gestational iodine status, no studies to date have investigated the association between the placental iodine load and the risk at GDM. Moreover, evidence is lacking whether placental iodine could play a role in biomarkers of insulin resistance and β-cell activity. METHODS We assessed the incidence of GDM between weeks 24 and 28 of gestation for 471 mother-neonate pairs from the ENVIRONAGE birth cohort. In placentas, we determined the iodine concentrations. In maternal and cord blood, we measured the insulin concentrations, the Homeostasis Model Assessment (HOMA) for insulin resistance (IR) index, and β-cell activity. Logistic regression was used to estimate the odds ratios (OR) of GDM, and the population attributable factor (PAF) was calculated. Generalized linear models estimated the changes in insulin, HOMA-IR, and β-cell activity for a 5 μg/kg increase in placental iodine. RESULTS Higher placental iodine concentrations decreased the risk at GDM (OR = 0.82; 95%CI 0.72 to 0.93; p = 0.003). According to the PAF, 54.2% (95%CI 11.4 to 82.3%; p = 0.0006) of the GDM cases could be prevented if the mothers of the lowest tertile of placental iodine would have placental iodine levels as those belonging to the highest tertile. In cord blood, the plasma insulin concentration was inversely associated with the placental iodine load (β = - 4.8%; 95%CI - 8.9 to - 0.6%; p = 0.026). CONCLUSIONS Higher concentrations of placental iodine are linked with a lower incidence of GDM. Moreover, a lower placental iodine load is associated with an altered plasma insulin concentration, HOMA-IR index, and β-cell activity. These findings postulate that a mild-to-moderate iodine deficiency could be linked with subclinical and early-onset alterations in the normal insulin homeostasis in healthy pregnant women. Nevertheless, the functional link between gestational iodine status and GDM warrants further research.
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Affiliation(s)
- Kristof Y Neven
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Bianca Cox
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Charlotte Cosemans
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | | | - Joris Penders
- Laboratory of Clinical Biology, East-Limburg Hospital, Genk, Belgium
| | - Michelle Plusquin
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Harry A Roels
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium.,Louvain Centre for Toxicology and Applied Pharmacology, Université catholique de Louvain, Brussels, Belgium
| | - Karen Vrijens
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Ann Ruttens
- Sciensano, SD Chemical and Physical Health Risks, Tervuren, Belgium
| | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium. .,Department of Public Health & Primary Care, Leuven University, Leuven, Belgium.
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11
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The Joint Role of Thyroid Function and Iodine Status on Risk of Preterm Birth and Small for Gestational Age: A Population-Based Nested Case-Control Study of Finnish Women. Nutrients 2019; 11:nu11112573. [PMID: 31731400 PMCID: PMC6893669 DOI: 10.3390/nu11112573] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 10/21/2019] [Accepted: 10/22/2019] [Indexed: 11/17/2022] Open
Abstract
Normal maternal thyroid function during pregnancy is essential for fetal development and depends upon an adequate supply of iodine. Little is known about how iodine status is associated with preterm birth and small for gestational age (SGA) in mildly iodine insufficient populations. Our objective was to evaluate associations of early pregnancy serum iodine, thyroglobulin (Tg), and thyroid-stimulating hormone (TSH) with odds of preterm birth and SGA in a prospective, population-based, nested case-control study from all births in Finland (2012–2013). Cases of preterm birth (n = 208) and SGA (n = 209) were randomly chosen from among all singleton births. Controls were randomly chosen from among singleton births that were not preterm (n = 242) or SGA (n = 241) infants during the same time period. Women provided blood samples at 10–14 weeks’ gestation for serum iodide, Tg and TSH measurement. We used logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for preterm birth and SGA. Each log-unit increase in serum iodide was associated with higher odds of preterm birth (adjusted OR = 1.19, 95% CI = 1.02–1.40), but was not associated with SGA (adjusted OR = 1.01, 95% CI = 0.86–1.18). Tg was not associated with preterm birth (OR per 1 log-unit increase = 0.87, 95% CI = 0.73–1.05), but was inversely associated with SGA (OR per log-unit increase = 0.78, 95% CI = 0.65–0.94). Neither high nor low TSH (versus normal) were associated with either outcome. These findings suggest that among Finnish women, iodine status is not related to SGA, but higher serum iodide may be positively associated with preterm birth.
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