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Dineva M, Rayman MP, Levie D, Hunziker S, Guxens M, Peeters RP, Murcia M, Rebagliato M, Irizar A, Jimeno-Romero A, Sunyer J, Korevaar TIM, Bath SC. Exploration of thyroglobulin as a biomarker of iodine status in iodine-sufficient and mildly iodine-deficient pregnant women. Eur J Nutr 2023; 62:2139-2154. [PMID: 36973522 PMCID: PMC10349736 DOI: 10.1007/s00394-023-03131-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 02/27/2023] [Indexed: 03/29/2023]
Abstract
PURPOSE Urinary iodine-to-creatinine ratio (UI/Creat) reflects recent iodine intake but has limitations for assessing habitual intake. Thyroglobulin (Tg) concentration, which increases with thyroid size, appears to be an indicator of longer-term iodine status in children and adults, however, less is known in pregnancy. This study investigated the determinants of serum-Tg in pregnancy and its use as an iodine-status biomarker in settings of iodine-sufficiency and mild-to-moderate deficiency. METHODS Stored blood samples and existing data from pregnant women from the Netherlands-based Generation R (iodine-sufficient) and the Spain-based INMA (mildly-to-moderately iodine-deficient) cohorts were used. Serum-Tg and iodine status (as spot-urine UI/Creat) were measured at median 13 gestational weeks. Using regression models, maternal socio-demographics, diet and iodine-supplement use were investigated as determinants of serum-Tg, as well as the association between UI/Creat and serum-Tg. RESULTS Median serum-Tg was 11.1 ng/ml in Generation R (n = 3548) and 11.5 ng/ml in INMA (n = 1168). When using 150 µg/g threshold for iodine deficiency, serum-Tg was higher in women with UI/Creat < 150 vs ≥ 150 µg/g (Generation R, 12.0 vs 10.4 ng/ml, P = 0.010; INMA, 12.8 vs 10.4 ng/ml, P < 0.001); after confounder adjustment, serum-Tg was still higher when UI/Creat < 150 µg/g (regression coefficients: Generation R, B = 0.111, P = 0.050; INMA, B = 0.157, P = 0.010). Iodine-supplement use and milk intake were negatively associated with serum-Tg, whereas smoking was positively associated. CONCLUSION The association between iodine status and serum-Tg was stronger in the iodine-deficient cohort, than in the iodine-sufficient cohort. Serum-Tg might be a complementary (to UI/Creat) biomarker of iodine status in pregnancy but further evidence is needed.
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Affiliation(s)
- Mariana Dineva
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, GU2 7XH, UK
| | - Margaret P Rayman
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, GU2 7XH, UK
| | - Deborah Levie
- The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands
- Department of Internal Medicine, Academic Centre for Thyroid Diseases, Erasmus University Medical Centre, Rotterdam, The Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Sandra Hunziker
- Human Nutrition Laboratory, Institute of Food, Nutrition, and Health, ETH Zurich, Zurich, Switzerland
| | - Mònica Guxens
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Robin P Peeters
- Department of Internal Medicine, Academic Centre for Thyroid Diseases, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Mario Murcia
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Servicio de Análisis de Sistemas de Información Sanitaria, Conselleria de Sanitat, Generalitat Valenciana, Valencia, Spain
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
| | - Marisa Rebagliato
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
- Predepartamental Unit of Medicine, University Jaume I, Castelló, Spain
| | - Amaia Irizar
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- BIODONOSTIA Health Research Institute, Donostia‑San Sebastián, Spain
- Department of Preventive Medicine and Public Health, Faculty of Medicine and Nursery, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Alba Jimeno-Romero
- BIODONOSTIA Health Research Institute, Donostia‑San Sebastián, Spain
- Department of Preventive Medicine and Public Health, Faculty of Medicine and Nursery, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Jordi Sunyer
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Parc Salut Mar-IMIM, Barcelona, Spain
| | - Tim I M Korevaar
- The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands
- Department of Internal Medicine, Academic Centre for Thyroid Diseases, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Sarah C Bath
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, GU2 7XH, UK.
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Guo W, Wang W, Jin Y, Chen W, Chen L, Lin L, Cheng Y, Cui T, Chen Y, Pan Z, Shen J, Tan L, Gao M, Zhang Y, Zhang W. Trimester-Specific Thyroid Function in Pregnant Women with Different Iodine Statuses. ANNALS OF NUTRITION AND METABOLISM 2020; 76:165-174. [PMID: 32726788 DOI: 10.1159/000506276] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 01/25/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To explore trimester-specific thyroid function changes under different iodine statuses throughout pregnancy. METHODS A cross-sectional study was conducted to assess the pregnancy iodine status, and 2,378 healthy pregnant women covering all 3 trimesters were recruited. Urinary iodine concentration (UIC) was measured by collecting spot urine samples. Blood samples were collected to evaluate thyroid function. Thyroid B-ultrasonography was conducted to measure the thyroid volume (Tvol). RESULTS The median UIC was 168 μg/L (111-263 μg/L). The UIC, free triiodothyronine (FT3), and free thyroxine (FT4) were significantly decreased as the pregnancy progressed (p < 0.001, p for trend <0.001), while Tvol increased (p < 0.001, p for trend <0.001). Thyrotropin (TSH) was significantly different between the 3 trimesters and showed an upward trend (p < 0.001), but the p for trend was not significant (p for trend = 0.88). After stratification by UIC, there were no significant differences in serum TSH, FT4, or FT3 level between UIC groups. Tvol was significantly higher in the UIC ≥500 μg/L group in the first trimester (β: 2.41, 95% CI: 1.09-3.72, p <0.001), as well as in the 250 ≤ UIC < 500 μg/L group (β: 1.65, 95% CI: 0.61-2.70, p < 0.001) and UIC ≥500 μg/L group (β: 3.35, 95% CI: 1.96-4.74, p < 0.001) in the third trimester. CONCLUSIONS No difference was observed in TSH, FT3, or FT4 among the different iodine status groups throughout pregnancy. Tvol increased as the pregnancy progressed, and it was especially higher in the UIC ≥500 μg/L group in the first and third trimesters.
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Affiliation(s)
- Wenxing Guo
- The Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wei Wang
- The Department of Health Services and Management, School of Management, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Ya Jin
- The Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wen Chen
- The Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Lu Chen
- Shandong Institute of Geophysical & Geochemical Exploration, Shandong, China
| | - Laixiang Lin
- Tianjin Institution of Endocrinology, Tianjin, China
| | - Yuangui Cheng
- Gaoqing Center for Disease Control and Prevention, Shandong, China
| | - Tingkai Cui
- The Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yanting Chen
- The Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Ziyun Pan
- The Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Jun Shen
- Department of Sanitary Chemistry, Tianjin Medical University, Tianjin, China
| | - Long Tan
- The Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Min Gao
- The Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yixin Zhang
- The Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wanqi Zhang
- The Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China, .,Key Laboratory of Environment, Nutrition and Population Health of Tianjin, Tianjin, China, .,Key Laboratory of Hormones and Development (Ministry of Health), Tianjin, China,
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3
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Atmospheric Pollution and Thyroid Function of Pregnant Women in Athens, Greece: A Pilot Study. Med Sci (Basel) 2020; 8:medsci8020019. [PMID: 32260367 PMCID: PMC7353503 DOI: 10.3390/medsci8020019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 03/18/2020] [Accepted: 04/01/2020] [Indexed: 11/16/2022] Open
Abstract
Exposure to air pollution and, in particular, to nitrogen dioxide (NO2) or particulate pollutants less than 2.5 μm (PM2.5) or 10 μm (PM10) in diameter has been linked to thyroid (dys)function in pregnant women. We hypothesized that there may be a dose-effect relationship between air pollutants and thyroid function parameters. We retrospectively evaluated thyrotropin (TSH) in 293 women, NO2, PM2.5 and PM10 levels in Athens. All the women were diagnosed with hypothyroidism for the first time during their pregnancy. Exposure to air pollution for each woman was considered according to her place of residence. Statistical analysis of age, pregnancy weight change, and air pollutants versus TSH was performed with ordinary least squares regression (OLS-R) and quantile regression (Q-R). A positive correlation for logTSH and PM2.5(r = +0.13, p = 0.02) was found, using OLS-R. Further analysis with Q-R showed that each incremental unit increase (for the 10th to the 90th response quantile) in PM2.5 increased logTSH(±SE) between +0.029 (0.001) to +0.025 (0.001) mIU/L (p < 0.01). The other parameters and pollutants (PM10 and NO2) had no significant effect on TSH. Our results indeed show a dose-response relationship between PM2.5 and TSH. The mechanisms involved in the pathophysiological effects of atmospheric pollutants, in particular PM2.5, are being investigated.
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Censi S, Watutantrige-Fernando S, Groccia G, Manso J, Plebani M, Faggian D, Mion MM, Venturini R, Andrisani A, Casaro A, Vita P, Avogadro A, Camilot M, Scaroni C, Bertazza L, Barollo S, Mian C. The Effects of Iodine Supplementation in Pregnancy on Iodine Status, Thyroglobulin Levels and Thyroid Function Parameters: Results from a Randomized Controlled Clinical Trial in a Mild-to-Moderate Iodine Deficiency Area. Nutrients 2019; 11:nu11112639. [PMID: 31689890 PMCID: PMC6893432 DOI: 10.3390/nu11112639] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 10/10/2019] [Accepted: 10/23/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Iodine supplementation during pregnancy in areas with mild-to-moderate iodine deficiency is still debated. METHODS A single-center, randomized, single-blind and placebo-controlled (3:2) trial was conducted. We enrolled 90 women before 12 weeks of gestation. From enrollment up until 8 weeks after delivery, 52 women were given an iodine supplement (225 ug/day, potassium iodide tablets) and 38 were given placebo. At recruitment (T0), in the second (T1) and third trimesters (T2), and 8 weeks after delivery (T3), we measured participants' urinary iodine-to-creatinine ratio (UI/Creat), thyroid function parameters (thyroglobulin (Tg), TSH, FT3, and FT4), and thyroid volume (TV). The newborns' urinary iodine concentrations were evaluated in 16 cases. RESULTS Median UI/Creat at recruitment was 53.3 ug/g. UI/Creat was significantly higher in supplemented women at T1 and T2. Tg levels were lower at T1 and T2 in women with UI/Creat ≥ 150 ug/g, and in the Iodine group at T2 (p = 0.02). There was a negative correlation between Tg and UI/Creat throughout the study (p = 0.03, r = -0.1268). A lower TSH level was found in the Iodine group at T3 (p = 0.001). TV increased by +Δ7.43% in the Iodine group, and by +Δ11.17% in the Placebo group. No differences were found between the newborns' TSH levels on screening the two groups. CONCLUSION Tg proved a good parameter for measuring iodine intake in our placebo-controlled series. Iodine supplementation did not prove harmful to pregnancy in areas of mild-to-moderate iodine deficiency, with no appreciable harmful effect on thyroid function.
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Affiliation(s)
- Simona Censi
- Department of Medicine (DIMED), Endocrinology Unit; University of Padova, 35121 Padova, Italy.
| | | | - Giulia Groccia
- Department of Medicine (DIMED), Endocrinology Unit; University of Padova, 35121 Padova, Italy.
| | - Jacopo Manso
- Department of Medicine (DIMED), Endocrinology Unit; University of Padova, 35121 Padova, Italy.
| | - Mario Plebani
- Laboratory Medicine, Department of Medical and Surgical Sciences, University of Padua, 35121 Padua, Italy.
| | - Diego Faggian
- Laboratory Medicine, Department of Medical and Surgical Sciences, University of Padua, 35121 Padua, Italy.
| | - Monica Maria Mion
- Laboratory Medicine, Department of Medical and Surgical Sciences, University of Padua, 35121 Padua, Italy.
| | - Roberta Venturini
- Laboratory Medicine, Department of Medical and Surgical Sciences, University of Padua, 35121 Padua, Italy.
| | - Alessandra Andrisani
- Department of Women's and Children's Health, University of Padua, Salus Pueri, 35128 Padua, Italy.
| | - Anna Casaro
- Department of Medicine (DIMED), Endocrinology Unit; University of Padova, 35121 Padova, Italy.
| | - Pietro Vita
- Department of Medicine (DIMED), Endocrinology Unit; University of Padova, 35121 Padova, Italy.
| | - Alessandra Avogadro
- Department of Medicine (DIMED), Endocrinology Unit; University of Padova, 35121 Padova, Italy.
| | - Marta Camilot
- Department of Pediatrics, Regional Centre for Newborn Screening, Diagnosis and Treatment of Inherited Metabolic Diseases and Congenital Endocrine Diseases, Azienda Ospedaliera Universitaria Integrata, 37134 Verona, Italy.
| | - Carla Scaroni
- Department of Medicine (DIMED), Endocrinology Unit; University of Padova, 35121 Padova, Italy.
| | - Loris Bertazza
- Department of Medicine (DIMED), Endocrinology Unit; University of Padova, 35121 Padova, Italy.
| | - Susi Barollo
- Department of Medicine (DIMED), Endocrinology Unit; University of Padova, 35121 Padova, Italy.
| | - Caterina Mian
- Department of Medicine (DIMED), Endocrinology Unit; University of Padova, 35121 Padova, Italy.
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Zhao W, Li X, Xia X, Gao Z, Han C. Iodine Nutrition During Pregnancy: Past, Present, and Future. Biol Trace Elem Res 2019; 188:196-207. [PMID: 30218312 DOI: 10.1007/s12011-018-1502-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Accepted: 08/30/2018] [Indexed: 12/22/2022]
Abstract
Iodine is a trace element that is important for the synthesis of thyroid hormones. During pregnancy, iodine requirements are increased by approximately 50% because of physiological changes. Adequate iodine status in pregnancy is crucial for maternal health and fetal growth. The World Health Organization (WHO) recommends a daily intake of 250 μg iodine for pregnant women to maintain adequate iodine status. Severe iodine deficiency during pregnancy can result in a series of detrimental effects on maternal and fetal health including hypothyroidism, goiter, stillbirth, abortion, increased neonatal mortality, neurological damage, and intellectual impairment. Correction of severe iodine deficiency can reduce the risk of adverse impacts. However, the influences of mild-to-moderate maternal iodine deficiency on fetal neural development and cognitive function are less clear. The safety and efficacy of iodine supplementation in mildly-to-moderately iodine-deficient women also remain uncertain. In addition, excess iodine during pregnancy carries a risk of adverse effects, and the recommended safe upper limits of iodine intake are controversial. Effective iodine supplementation should be implemented, and routine monitoring is necessary to guarantee adequate iodine status.
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Affiliation(s)
- Wei Zhao
- Department of Endocrinology, Dalian Municipal Central Hospital Affiliated of Dalian Medical University, No. 826 Xinan Street, Dalian, 116033, Liaoning Province, People's Republic of China
| | - Xinyu Li
- Department of Endocrinology, Dalian Municipal Central Hospital Affiliated of Dalian Medical University, No. 826 Xinan Street, Dalian, 116033, Liaoning Province, People's Republic of China
| | - Xinghai Xia
- Department of Cellular and Molecular Physiology, Pennsylvania State University, College of Medicine, 500 University Dr, Hershey, PA, 17033, USA
| | - Zhengnan Gao
- Department of Endocrinology, Dalian Municipal Central Hospital Affiliated of Dalian Medical University, No. 826 Xinan Street, Dalian, 116033, Liaoning Province, People's Republic of China.
| | - Cheng Han
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Forchheimer 216, the Bronx, New York, NY, 10461, USA.
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Yu S, Yin Y, Cheng Q, Han J, Cheng X, Guo Y, Sun D, Xie S, Qiu L. Validation of a simple inductively coupled plasma mass spectrometry method for detecting urine and serum iodine and evaluation of iodine status of pregnant women in Beijing. Scandinavian Journal of Clinical and Laboratory Investigation 2018; 78:501-507. [PMID: 30261754 DOI: 10.1080/00365513.2018.1512150] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Rapid and simple method for serum and urine iodine is necessary for iodine-related diseases. This study aimed to establish and validate a simple and rapid method for quantification of iodine in human urine and serum using inductively coupled plasma mass spectrometry (ICP-MS). Generally, samples were diluted using water with 1.5% isopropanol and 7 mmol hydrous ammonium before analysis by the ICP-MS. Performance of the method was validated, and the urine and serum iodine levels of 72 pregnant women were analyzed. Results showed that the lower limit of detection of the ICP-MS method was 0.87 µg/L. No significant memory effects were observed. Recovery in both serum and urine was approximately 100%. Compared with NIST SRM3668, bias was <1%, exhibiting good accuracy. The inter-run coefficients of variation (CVs) for serum and urine iodine were 2.8-3.5% and 3.5-6.7%, respectively, and total CVs for serum and urine iodine were 3.2-3.7% and 3.9-6.7%, respectively. Comparison of the iodine results obtained by the ICP-MS method and the conventional S-K method revealed excellent correlation (r = 0.984, mean bias = -1.7%). The median urine iodine of pregnant women (125.5 μg/L) was lower than that of WHO criteria for iodine deficiency (median urinary iodine <150 μg/L) while 55.6% of the individuals with urine iodine level less than 150 μg/L. The median serum iodine level of the pregnant women was 69.0 μg/L. In conclusion, a rapid and simple ICP-MS method for urine and serum iodine measurements has been established and validated, and the pregnant women in Beijing may still suffer from insufficient iodine intake. Abbreviations CV coefficients of variation HPLC high-performance liquid chromatography ICP-MS inductively coupled plasma mass spectrometry KED kinetic energy discrimination KI potassium iodide LOD limit of detection S-K Sandell-Kolthoff reaction PUMCH Peking Union Medical College Hospital.
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Affiliation(s)
- Songlin Yu
- a Department of Clinical Laboratory , Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences , Beijing , China
| | - Yicong Yin
- a Department of Clinical Laboratory , Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences , Beijing , China
| | - Qian Cheng
- a Department of Clinical Laboratory , Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences , Beijing , China
| | - Jianhua Han
- a Department of Clinical Laboratory , Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences , Beijing , China
| | - Xinqi Cheng
- a Department of Clinical Laboratory , Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences , Beijing , China
| | - Ye Guo
- a Department of Clinical Laboratory , Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences , Beijing , China
| | - Dandan Sun
- a Department of Clinical Laboratory , Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences , Beijing , China
| | - Shaowei Xie
- a Department of Clinical Laboratory , Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences , Beijing , China
| | - Ling Qiu
- a Department of Clinical Laboratory , Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences , Beijing , China
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Ittermann T, Johner S, Below H, Leiterer M, Thamm M, Remer T, Völzke H. Interlaboratory variability of urinary iodine measurements. ACTA ACUST UNITED AC 2017; 56:441-447. [DOI: 10.1515/cclm-2017-0580] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 07/31/2017] [Indexed: 11/15/2022]
Abstract
Abstract
Background:
The iodine status of populations is usually assessed by median urinary iodine concentrations (UIC) in population-based studies, but it is unclear to which extent UIC are comparable across different laboratories. The aim of our study was to investigate the variability of UIC measurements across three well-established German laboratories with long-term clinical-chemical expertise in iodine measurements and to compare these results to the gold standard inductively coupled plasma mass spectrometry (ICP-MS).
Methods:
UIC levels were measured from 303 urine samples derived from the “Dortmund Nutritional and Anthropometric Longitudinally Designed Study” and from volunteers of the University Medicine Greifswald at four different German laboratories. Three of these laboratories used Sandell-Kolthoff reaction with different digestion methods for UIC measurement (Lab1–Lab3), whereas one laboratory used ICP-MS as gold standard.
Results:
Median UIC levels were significantly different across the four laboratories (ICP-MS: 77 μg/L; Lab1: 69 μg/L; Lab2: 73 μg/L; Lab3: 111 μg/L). Linear regressions associating UIC levels of Lab1–Lab3 with UIC levels of ICP-MS showed intercepts significantly different from 0 and slopes significantly different from 1. Intraclass correlations (ICC) in comparison to ICP-MS were 0.91 for Lab1, 0.98 for Lab2, and 0.69 for Lab3. Using the digestion method of Lab2 in Lab3 improved the comparison of UIC levels of Lab3 with those from the ICP-MS (ICC=0.89).
Conclusions:
We have demonstrated larger interlaboratory variations across high-quality laboratories with long-lasting experience in iodine measurements indicating a relevant non-comparability of UIC measurements in iodine monitoring studies. Therefore, standardization of UIC measurements has to be expedited.
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Affiliation(s)
- Till Ittermann
- Institute for Community Medicine , University Medicine Greifswald , Greifswald , Germany
| | - Simone Johner
- DONALD Study Dortmund, Department of Nutritional Epidemiology , Institute of Nutrition and Food Science (IEL) , University of Bonn , Dortmund , Germany
| | - Harald Below
- Institute of Hygiene and Environmental Medicine , University Medicine Greifswald , Greifswald , Germany
| | | | - Michael Thamm
- Department of Epidemiology and Health Monitoring , Robert Koch Institute , Berlin , Germany
| | - Thomas Remer
- DONALD Study Dortmund, Department of Nutritional Epidemiology , Institute of Nutrition and Food Science (IEL) , University of Bonn , Dortmund , Germany
| | - Henry Völzke
- Institute for Community Medicine , University Medicine Greifswald , Greifswald , Germany
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8
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Koukkou EG, Markou KB. Re: "Thyroglobulin as a Functional Biomarker of Iodine Status in a Cohort Study of Pregnant Women in the United Kingdom" by Bath et al. (Thyroid 2017;27:426-433). Thyroid 2017; 27:1208. [PMID: 28599610 DOI: 10.1089/thy.2017.0168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
| | - Kostas B Markou
- 2 Division of Endocrinology, University Medical School, University Hospital , Patras, Greece
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9
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Katko M, Gazso AA, Hircsu I, Bhattoa HP, Molnar Z, Kovacs B, Andrasi D, Aranyosi J, Makai R, Veress L, Torok O, Bodor M, Samson L, Nagy EV. Thyroglobulin level at week 16 of pregnancy is superior to urinary iodine concentration in revealing preconceptual and first trimester iodine supply. MATERNAL AND CHILD NUTRITION 2017; 14. [PMID: 28593684 PMCID: PMC5763325 DOI: 10.1111/mcn.12470] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 04/26/2017] [Accepted: 05/09/2017] [Indexed: 11/30/2022]
Abstract
Pregnant women are prone to iodine deficiency due to the increased need for iodine during gestation. Progress has recently occurred in establishing serum thyroglobulin (Tg) as an iodine status biomarker, but there is no accepted reference range for iodine sufficiency during pregnancy. An observational study was conducted in 164 pregnant women. At week 16 of gestation urinary iodine concentration (UIC), serum Tg, and thyroid functions were measured, and information on the type of iodine supplementation and smoking were recorded. The parameters of those who started iodine supplementation (≥150 μg/day) at least 4 weeks before pregnancy (n = 27), who started at the detection of pregnancy (n = 51), and who had no iodine supplementation (n = 74) were compared. Sufficient iodine supply was found in the studied population based on median UIC (162 μg/L). Iodine supplementation ≥150 μg/day resulted in higher median UIC regardless of its duration (nonusers: 130 μg/L vs. prepregnancy iodine starters: 240 μg/L, and pregnancy iodine starters: 205 μg/L, p < .001, and p = .023, respectively). Median Tg value of pregnancy starters was identical to that of nonusers (14.5 vs. 14.6 μg/L), whereas prepregnancy starters had lower median Tg (9.1 μg/L, p = .018). Serum Tg concentration at week 16 of pregnancy showed negative relationship (p = .010) with duration of iodine supplementation and positive relationship (p = .008) with smoking, a known interfering factor of iodine metabolism, by multiple regression analysis. Serum Tg at week 16 of pregnancy may be a promising biomarker of preconceptual and first trimester maternal iodine status, the critical early phase of foetal brain development.
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Affiliation(s)
- Monika Katko
- Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Andrea Anett Gazso
- Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Ildiko Hircsu
- Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Harjit Pal Bhattoa
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Zsuzsanna Molnar
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Bela Kovacs
- Institute of Food Science, University of Debrecen, Debrecen, Hungary
| | - David Andrasi
- Institute of Food Science, University of Debrecen, Debrecen, Hungary
| | | | - Rita Makai
- Kenézy Gyula Hospital, Debrecen, Hungary
| | - Lajos Veress
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Olga Torok
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Miklos Bodor
- Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Laszlo Samson
- Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Endre V Nagy
- Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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