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Momentti AC, de Souza Macedo M, de Sousa Silva AF, de Oliveira Souza VC, Júnior FB, do Carmo Castro Franceschini S, Navarro AM. Household Salt Storage and Seasoning Consumption Are Predictors of Insufficient Iodine Status Among Pregnant Women in Southeastern Brazil. Biol Trace Elem Res 2023; 201:5529-5539. [PMID: 36884126 PMCID: PMC9993368 DOI: 10.1007/s12011-023-03615-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 02/25/2023] [Indexed: 03/09/2023]
Abstract
Iodine deficiency in pregnancy may lead to adverse maternal and fetal outcomes, including impaired child development. Sociodemographic factors and different dietary habits may be related to iodine status in pregnant women. The aim of this study was to evaluate the iodine status and its predictors among pregnant women in a city of Southeastern Brazil. This cross-sectional study was conducted with 266 pregnant women receiving prenatal care in 8 primary health care units. Sociodemographic, obstetric and health, habits of acquisition, storage and consumption of iodized salt, and dietary iodine intake data were collected through a questionnaire. The iodine content was evaluated in urinary iodine concentration (UIC), household salt and seasonings, and drinking water samples. Pregnant women were categorized into three groups according to the UIC, determined by iodine coupled plasma-mass spectrometry (ICP-MS): insufficient (< 150 μg/L), adequate (150-249 μg/L), and more than adequate iodine nutrition (≥ 250 μg/L). The median (p25-p75) UIC was 180.2 μg/L (112.8-262.7). It was found 38% and 27.8% of insufficient and more than adequate iodine nutrition, respectively. Number of gestations, KI content of supplement, alcohol consumption, salt storage, and frequency of using industrialized seasoning were associated to iodine status. Alcohol consumption (OR = 6.59; 95%CI 1.24-34.87), pack the salt in opened container (OR = 0.22; 95%CI 0.08-0.57), and use industrialized seasoning weekly (OR = 3.68; 95% CI 1.12-12.11) were predictors of iodine insufficiency. The pregnant women evaluated have adequate iodine nutrition. Household salt storage and seasoning consumption were risk factors for insufficient iodine status.
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Affiliation(s)
- Ana Carolina Momentti
- Nutrition and Metabolism Program, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
| | - Mariana de Souza Macedo
- Department of Nutrition and Health, Federal University of Viçosa, Viçosa, Minas Gerais, Brazil
| | - Ana Flávia de Sousa Silva
- Nutrition and Metabolism Program, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Vanessa Cristina de Oliveira Souza
- Department of Clinical, Toxicological and Bromatological Analysis, Faculty of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Fernando Barbosa Júnior
- Department of Clinical, Toxicological and Bromatological Analysis, Faculty of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | | | - Anderson Marliere Navarro
- Department of Health Sciences, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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Liu ZM, Wu Y, Long HH, Chen CG, Wang C, Ye YB, Shen ZY, Ye MT, Zhang SJ, Li MM, Pan WJ. Associations of Maternal Serum Iodine Concentration with Obstetric Complications and Birth Outcomes-Longitudinal Analysis Based on the Huizhou Mother-Infant Cohort, South China. Nutrients 2023; 15:2868. [PMID: 37447195 DOI: 10.3390/nu15132868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/13/2023] [Accepted: 06/15/2023] [Indexed: 07/15/2023] Open
Abstract
This study aimed to explore the temporal associations between maternal serum iodine concentration (SIC) and common pregnancy outcomes in Chinese women. Eligible singleton pregnant women aged 20-34 years were selected, and their fasting blood samples were collected during early (T1, n = 1101) and mid-pregnancy (T2, n = 403) for SIC testing by inductively coupled plasma mass spectrometry. Multivariable linear regression indicated that log10SIC at T1 (β = -0.082), T2 (β = -0.198), and their % change (β = -0.131) were inversely associated with gestational weight gain (GWG, all p < 0.05). Maternal log10SIC at both T1 (β = 0.077) and T2 (β = 0.105) were positively associated with the Apgar score at 1 min (both p < 0.05). Women in the third quartile (Q3) of SIC at T1 had a lower risk of small for gestational age (SGA, OR = 0.405, 95% CI: 0.198-0.829) compared with those in Q4. Restricted cubic spline regression suggested a U-shaped association between SIC and SGA risk, and SIC above 94 μg/L at T1 was the starting point for an increased risk of SGA. The risk of premature rupture of membrane (PROM) increased by 96% (OR = 1.960, 95% CI: 1.010-3.804) in Q4 compared to that in Q1. Our longitudinal data from an iodine-replete region of China indicated that high maternal SIC could restrict GWG and improve Apgar scores at delivery, but might increase the risk of SGA and PROM.
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Affiliation(s)
- Zhao-Min Liu
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University, North Campus, Guangzhou 510080, China
| | - Yi Wu
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University, North Campus, Guangzhou 510080, China
| | - Huan-Huan Long
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University, North Campus, Guangzhou 510080, China
| | - Chao-Gang Chen
- Department of Clinical Nutrition, Second Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - Cheng Wang
- Department of Clinical Nutrition, Second Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - Yan-Bin Ye
- Department of Clinical Nutrition, The First Affiliated Hospital, Jinan University, Guangzhou 510630, China
| | - Zhen-Yu Shen
- Department of Paediatrics, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
| | - Ming-Tong Ye
- Huizhou First Maternal and Child Health Care Hospital, Huizhou 516000, China
| | - Su-Juan Zhang
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University, North Campus, Guangzhou 510080, China
| | - Min-Min Li
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University, North Campus, Guangzhou 510080, China
| | - Wen-Jing Pan
- Huizhou First Maternal and Child Health Care Hospital, Huizhou 516000, China
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Liu X, Xiao Z, Cheng L, Jian L. Iodine nutrition level and thyroid function in pregnant women in the Yongchuan district of Chongqing. J Clin Transl Res 2022; 8:516-522. [PMID: 36452005 PMCID: PMC9706315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/29/2022] [Accepted: 09/13/2022] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND AND AIM This study aims to investigate thyroid function-associated parameters and the incidence of thyroid disorders in pregnant women, with the overarching aim to ensure that pregnant women do not develop said disorders due to aberrant iodine levels during the course of pregnancy. METHODS A total of 300 pregnant women who underwent routine check-ups at the Yongchuan Hospital Affiliated to Chongqing Medical University from January to December 2021 were enrolled. Venous blood and morning urine were collected. Serum thyroid-stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3) were determined by chemiluminescence immunoassay. Urinary iodine concentration (UIC) was detected by arsenic cerium catalytic spectrophotometry. Thyroid disorders were extrapolated from the measured parameters. RESULTS The overall median UIC was 203 μg/L, which was within normal range. Subgroup analysis revealed that the median UIC in the first trimester was 187.5 μg/L, 211.8 μg/L in the second trimester, and 239.9 μg/L in the third trimester. However, based on the WHO criteria, 32%, 30%, and 18% of pregnant women were iodine deficient during their first, second, and third trimester, respectively. The proportion of women with iodine deficiency in the first and second trimesters was higher compared to the third trimester (P < 0.05). Serum FT3 and FT4 concentrations were higher in subjects in their first and second trimester versus the third trimester, while serum TSH levels were lower in subjects in their first and second trimester versus the third trimester (P < 0.05). The TSH concentration in subjects with inadequate iodine intake (UIC < 150 μg/L) was lower compared to subjects with adequate iodine intake (UIC 150 - 249 μg/L), but higher than in subjects with more than adequate intake (UIC 250 - 499 μg/L) and excess iodine intake (UIC ≥ 500 μg/L) (P < 0.05). TSH concentration and UIC were positively correlated (r = 0.1945, P = 0.0007), while no relationship was observed between UIC and FT3 and FT4 serum levels (r1 = -0.0593, P1 = 0.3053; r2 = -0.0149, P2 = 0.7968). There was no significant difference in FT3 and FT4 concentration between different UIC strata (P > 0.05). The incidence of thyroid disease during pregnancy in iodine-deficient women was greater compared to pregnant women with adequate iodine intake (P < 0.05) and higher in subjects in the more than adequate as well as excessive iodine intake cohorts (P < 0.05). CONCLUSION The iodine nutritional intake by pregnant women in Yongchuan District, Chongqing, was generally sufficient to meet developmental and metabolic needs. However, about a third of women in their first and second trimester exhibited iodine deficiency. Iodine deficiency was associated with an increased incidence of thyroid diseases. RELEVANCE FOR PATIENTS In clinical practice, the UIC of pregnant women should be measured during key stages in the pregnancy to prevent the manifestation of thyroid diseases.
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Affiliation(s)
- Xue Liu
- Department of Obstetrics, Yongchuan Hospital of Chongqing Medical University, Chongqing 402160, China
| | - Zhenghua Xiao
- Department of Obstetrics, Yongchuan Hospital of Chongqing Medical University, Chongqing 402160, China
| | - Lan Cheng
- Department of Obstetrics, Yongchuan Hospital of Chongqing Medical University, Chongqing 402160, China
| | - Luhong Jian
- Department of Obstetrics, Yongchuan Hospital of Chongqing Medical University, Chongqing 402160, China
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Prevalence of insufficient iodine intake in pregnancy worldwide: a systematic review and meta-analysis. Eur J Clin Nutr 2022; 76:703-715. [PMID: 34545212 DOI: 10.1038/s41430-021-01006-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 08/04/2021] [Accepted: 09/03/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND/OBJECTIVES Iodine deficiency in pregnant women is related to impaired foetal growth and development. The objective of this study was to estimate the prevalence of insufficient iodine intake in pregnant women from different regions of the world. SUBJECTS/METHODS Using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, five electronic databases and Google Scholar grey literature were searched until 10 April 2021. Two reviewers independently conducted article selection, data extraction, and assessment of the risk of bias. Meta-analyses with random effects, subgroup analyses, and meta-regressions were performed. RESULTS In total, 4639 observational articles were found, with 61 eligible for inclusion. The population consisted of 163,021 pregnant women adults and adolescents, and the overall prevalence of insufficient iodine intake was 53% (95% confidence interval [CI]: 47-60; I2 = 99.8%). Pregnant women who live in insufficient iodine status country had a higher prevalence (86%; 95% CI: 78-93; I² =97.0%) of inadequate iodine nutritional status than to those living in country considered sufficient (51%; 95% IC: 45-57; I² = 99.8%). CONCLUSION Despite the progress in iodine fortification policies and periodic monitoring of the iodine nutritional status of the population worldwide, salt iodination alone may not be sufficient to provide adequate iodine status to pregnant women. Thus, other actions may be necessary to improve the nutritional clinical care of pregnant group.
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Lee SY, Pearce EN. Assessment and treatment of thyroid disorders in pregnancy and the postpartum period. Nat Rev Endocrinol 2022; 18:158-171. [PMID: 34983968 PMCID: PMC9020832 DOI: 10.1038/s41574-021-00604-z] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/19/2021] [Indexed: 12/13/2022]
Abstract
Thyroid disorders are prevalent in pregnant women. Furthermore, thyroid hormone has a critical role in fetal development and thyroid dysfunction can adversely affect obstetric outcomes. Thus, the appropriate management of hyperthyroidism, most commonly caused by Graves disease, and hypothyroidism, which in iodine sufficient regions is most commonly caused by Hashimoto thyroiditis, in pregnancy is important for the health of both pregnant women and their offspring. Gestational transient thyrotoxicosis can also occur during pregnancy and should be differentiated from Graves disease. Effects of thyroid autoimmunity and subclinical hypothyroidism in pregnancy remain controversial. Iodine deficiency is the leading cause of hypothyroidism worldwide. Despite global efforts to eradicate iodine deficiency disorders, pregnant women remain at risk of iodine deficiency due to increased iodine requirements during gestation. The incidence of thyroid cancer is increasing worldwide, including in young adults. As such, the diagnosis of thyroid nodules or thyroid cancer during pregnancy is becoming more frequent. The evaluation and management of thyroid nodules and thyroid cancer in pregnancy pose a particular challenge. Postpartum thyroiditis can occur up to 1 year after delivery and must be differentiated from other forms of thyroid dysfunction, as treatment differs. This Review provides current evidence and recommendations for the evaluation and management of thyroid disorders in pregnancy and in the postpartum period.
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Affiliation(s)
- Sun Y Lee
- Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, Boston, MA, USA
| | - Elizabeth N Pearce
- Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, Boston, MA, USA.
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Melero V, Runkle I, Garcia de la Torre N, De Miguel P, Valerio J, del Valle L, Barabash A, Sanabria C, Moraga I, Familiar C, Durán A, Torrejón MJ, Diaz JA, Cuesta M, Ruiz JG, Jiménez I, Pazos M, Herraiz MA, Izquierdo N, Pérez N, Matia P, Perez-Ferre N, Marcuello C, Rubio MA, Calle-Pascual AL. The Consumption of Food-Based Iodine in the Immediate Pre-Pregnancy Period in Madrid Is Insufficient. San Carlos and Pregnancy Cohort Study. Nutrients 2021; 13:nu13124458. [PMID: 34960010 PMCID: PMC8707458 DOI: 10.3390/nu13124458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/12/2021] [Accepted: 12/12/2021] [Indexed: 12/01/2022] Open
Abstract
A pre-gestational thyroid reserve of iodine is crucial to guarantee the increased demand for thyroid hormone production of early pregnancy. An iodine intake ≥150 µg/day is currently recommended. The objective of this study was to assess average pre-gestational food-based iodine consumption in pregnant women at their first prenatal visit (<12 gestational weeks), and its association with adverse materno-fetal events (history of miscarriages, early fetal losses, Gestational Diabetes, prematurity, caesarean sections, and new-borns large/small for gestational age). Between 2015–2017, 2523 normoglycemic women out of 3026 eligible had data in the modified Diabetes Nutrition and Complication Trial (DNCT) questionnaire permitting assessment of pre-gestational food-based iodine consumption, and were included in this study. Daily food-based iodine intake was 123 ± 48 µg, with 1922 (76.1%) not reaching 150 µg/day. Attaining this amount was associated with consuming 8 weekly servings of vegetables (3.84; 3.16–4.65), 1 of shellfish (8.72; 6.96–10.93) and/or 2 daily dairy products (6.43; 5.27–7.86). Women who reached a pre-gestational intake ≥150 µg had lower rates of hypothyroxinemia (104 (17.3%)/384 (21.4%); p = 0.026), a lower miscarriage rate, and a decrease in the composite of materno-fetal adverse events (0.81; 0.67–0.98). Reaching the recommended iodine pre-pregnancy intake with foods could benefit the progression of pregnancy.
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Affiliation(s)
- Verónica Melero
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (I.R.); (N.G.d.l.T.); (P.D.M.); (J.V.); (L.d.V.); (A.B.); (C.S.); (I.M.); (C.F.); (A.D.); (J.A.D.); (M.C.); (J.G.R.); (I.J.); (M.P.); (P.M.); (N.P.-F.); (C.M.); (M.A.R.)
| | - Isabelle Runkle
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (I.R.); (N.G.d.l.T.); (P.D.M.); (J.V.); (L.d.V.); (A.B.); (C.S.); (I.M.); (C.F.); (A.D.); (J.A.D.); (M.C.); (J.G.R.); (I.J.); (M.P.); (P.M.); (N.P.-F.); (C.M.); (M.A.R.)
| | - Nuria Garcia de la Torre
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (I.R.); (N.G.d.l.T.); (P.D.M.); (J.V.); (L.d.V.); (A.B.); (C.S.); (I.M.); (C.F.); (A.D.); (J.A.D.); (M.C.); (J.G.R.); (I.J.); (M.P.); (P.M.); (N.P.-F.); (C.M.); (M.A.R.)
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
| | - Paz De Miguel
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (I.R.); (N.G.d.l.T.); (P.D.M.); (J.V.); (L.d.V.); (A.B.); (C.S.); (I.M.); (C.F.); (A.D.); (J.A.D.); (M.C.); (J.G.R.); (I.J.); (M.P.); (P.M.); (N.P.-F.); (C.M.); (M.A.R.)
- Medicina II Department, Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Johanna Valerio
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (I.R.); (N.G.d.l.T.); (P.D.M.); (J.V.); (L.d.V.); (A.B.); (C.S.); (I.M.); (C.F.); (A.D.); (J.A.D.); (M.C.); (J.G.R.); (I.J.); (M.P.); (P.M.); (N.P.-F.); (C.M.); (M.A.R.)
| | - Laura del Valle
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (I.R.); (N.G.d.l.T.); (P.D.M.); (J.V.); (L.d.V.); (A.B.); (C.S.); (I.M.); (C.F.); (A.D.); (J.A.D.); (M.C.); (J.G.R.); (I.J.); (M.P.); (P.M.); (N.P.-F.); (C.M.); (M.A.R.)
| | - Ana Barabash
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (I.R.); (N.G.d.l.T.); (P.D.M.); (J.V.); (L.d.V.); (A.B.); (C.S.); (I.M.); (C.F.); (A.D.); (J.A.D.); (M.C.); (J.G.R.); (I.J.); (M.P.); (P.M.); (N.P.-F.); (C.M.); (M.A.R.)
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
- Medicina II Department, Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Concepción Sanabria
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (I.R.); (N.G.d.l.T.); (P.D.M.); (J.V.); (L.d.V.); (A.B.); (C.S.); (I.M.); (C.F.); (A.D.); (J.A.D.); (M.C.); (J.G.R.); (I.J.); (M.P.); (P.M.); (N.P.-F.); (C.M.); (M.A.R.)
| | - Inmaculada Moraga
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (I.R.); (N.G.d.l.T.); (P.D.M.); (J.V.); (L.d.V.); (A.B.); (C.S.); (I.M.); (C.F.); (A.D.); (J.A.D.); (M.C.); (J.G.R.); (I.J.); (M.P.); (P.M.); (N.P.-F.); (C.M.); (M.A.R.)
| | - Cristina Familiar
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (I.R.); (N.G.d.l.T.); (P.D.M.); (J.V.); (L.d.V.); (A.B.); (C.S.); (I.M.); (C.F.); (A.D.); (J.A.D.); (M.C.); (J.G.R.); (I.J.); (M.P.); (P.M.); (N.P.-F.); (C.M.); (M.A.R.)
| | - Alejandra Durán
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (I.R.); (N.G.d.l.T.); (P.D.M.); (J.V.); (L.d.V.); (A.B.); (C.S.); (I.M.); (C.F.); (A.D.); (J.A.D.); (M.C.); (J.G.R.); (I.J.); (M.P.); (P.M.); (N.P.-F.); (C.M.); (M.A.R.)
- Medicina II Department, Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Maria Jose Torrejón
- Clinical Laboratory Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain;
| | - Jose Angel Diaz
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (I.R.); (N.G.d.l.T.); (P.D.M.); (J.V.); (L.d.V.); (A.B.); (C.S.); (I.M.); (C.F.); (A.D.); (J.A.D.); (M.C.); (J.G.R.); (I.J.); (M.P.); (P.M.); (N.P.-F.); (C.M.); (M.A.R.)
- Medicina II Department, Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Martin Cuesta
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (I.R.); (N.G.d.l.T.); (P.D.M.); (J.V.); (L.d.V.); (A.B.); (C.S.); (I.M.); (C.F.); (A.D.); (J.A.D.); (M.C.); (J.G.R.); (I.J.); (M.P.); (P.M.); (N.P.-F.); (C.M.); (M.A.R.)
| | - Jorge Grabiel Ruiz
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (I.R.); (N.G.d.l.T.); (P.D.M.); (J.V.); (L.d.V.); (A.B.); (C.S.); (I.M.); (C.F.); (A.D.); (J.A.D.); (M.C.); (J.G.R.); (I.J.); (M.P.); (P.M.); (N.P.-F.); (C.M.); (M.A.R.)
| | - Inés Jiménez
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (I.R.); (N.G.d.l.T.); (P.D.M.); (J.V.); (L.d.V.); (A.B.); (C.S.); (I.M.); (C.F.); (A.D.); (J.A.D.); (M.C.); (J.G.R.); (I.J.); (M.P.); (P.M.); (N.P.-F.); (C.M.); (M.A.R.)
| | - Mario Pazos
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (I.R.); (N.G.d.l.T.); (P.D.M.); (J.V.); (L.d.V.); (A.B.); (C.S.); (I.M.); (C.F.); (A.D.); (J.A.D.); (M.C.); (J.G.R.); (I.J.); (M.P.); (P.M.); (N.P.-F.); (C.M.); (M.A.R.)
| | - Miguel Angel Herraiz
- Gynecology and Obstetrics Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.A.H.); (N.I.); (N.P.)
| | - Nuria Izquierdo
- Gynecology and Obstetrics Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.A.H.); (N.I.); (N.P.)
| | - Noelia Pérez
- Gynecology and Obstetrics Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (M.A.H.); (N.I.); (N.P.)
| | - Pilar Matia
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (I.R.); (N.G.d.l.T.); (P.D.M.); (J.V.); (L.d.V.); (A.B.); (C.S.); (I.M.); (C.F.); (A.D.); (J.A.D.); (M.C.); (J.G.R.); (I.J.); (M.P.); (P.M.); (N.P.-F.); (C.M.); (M.A.R.)
- Medicina II Department, Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Natalia Perez-Ferre
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (I.R.); (N.G.d.l.T.); (P.D.M.); (J.V.); (L.d.V.); (A.B.); (C.S.); (I.M.); (C.F.); (A.D.); (J.A.D.); (M.C.); (J.G.R.); (I.J.); (M.P.); (P.M.); (N.P.-F.); (C.M.); (M.A.R.)
- Medicina II Department, Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Clara Marcuello
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (I.R.); (N.G.d.l.T.); (P.D.M.); (J.V.); (L.d.V.); (A.B.); (C.S.); (I.M.); (C.F.); (A.D.); (J.A.D.); (M.C.); (J.G.R.); (I.J.); (M.P.); (P.M.); (N.P.-F.); (C.M.); (M.A.R.)
- Medicina II Department, Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Miguel Angel Rubio
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (I.R.); (N.G.d.l.T.); (P.D.M.); (J.V.); (L.d.V.); (A.B.); (C.S.); (I.M.); (C.F.); (A.D.); (J.A.D.); (M.C.); (J.G.R.); (I.J.); (M.P.); (P.M.); (N.P.-F.); (C.M.); (M.A.R.)
- Medicina II Department, Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Alfonso Luis Calle-Pascual
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain; (V.M.); (I.R.); (N.G.d.l.T.); (P.D.M.); (J.V.); (L.d.V.); (A.B.); (C.S.); (I.M.); (C.F.); (A.D.); (J.A.D.); (M.C.); (J.G.R.); (I.J.); (M.P.); (P.M.); (N.P.-F.); (C.M.); (M.A.R.)
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
- Medicina II Department, Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Correspondence:
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Rates SPM, Capanema FD, Amaral BD, Secundino CM, Michelli LMDS, Pereira RCM, Ued FDV, Nogueira-de-Almeida CA. Nutritional status of iodine in pregnant and non-pregnant adolescents assisted at the Family Health Strategy in Vespasiano, MG. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2021. [DOI: 10.1590/1806-93042021000400005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract Objectives: to evaluate the nutritional status of iodine in pregnant adolescents, taking into account the increase in the demand for iodine during pregnancy and the absence of iodization strategies for this population. Methods: cross-sectional study conducted with 62 pregnant and 71 non-pregnant adolescents assisted in primary care. The nutritional status of iodine was determined by urinary samples. The iodine concentration in the consumed culinary salt was also evaluated. For the comparative analyses of categorical variables, the Chi-square test was used and for the continuous variables, the Kruskal-Wallis test, considering a 95% confidence interval (CI) and significance level of 5%. Results: the mean iodine concentration in household salt was 25.1 mg/kg (CI95%= 11.1-67.5 mg/kg), with higher mean content in culinary salt in the group of pregnant women (p<0.028). Regarding the nutritional status of iodine, 71% of pregnant adolescents were deficient and 29% iodine-sufficient, with significant difference when compared to 38% of deficiency and 62% of sufficiency in the control group (p<0.001). Conclusions: there was an iodic deficiency among pregnant adolescents, even in the face of higher concentrations of iode in household salt, exposing a paradox between higher consumption and lower sufficiency in this group. Thus, it is suggested to consider iodine supplementation during pregnancy, seeking to minimize the effects of this deficiency on maternal and child health.
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Urinary iodine as an important indicator for preeclampsia: a Polish perspective. CURRENT ISSUES IN PHARMACY AND MEDICAL SCIENCES 2021. [DOI: 10.2478/cipms-2021-0023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Abstract
Preeclampsia (PE) is one of the leading causes of perinatal and maternal morbidity. Although subclinical hypothyroidism in pregnancy is one of the established risk factors for PE, the link between iodine deficiency and PE is not fully understood. The aim of our study was to assess urinary iodine concentration (UIC), serum thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), and free thyroxine (fT4) levels in Polish women with PE (PE group, n=78) compared with healthy non-pregnant women (CNP group, n=30), and healthy pregnant women (CP group, n=46). The UIC was determined by inductively coupled plasma mass spectrometry (ICP-MS). Both the mean UIC of 144.6±36.4 μg/L in the CP group and the mean of 125.8±33.6 μg/L in the PE group, respectively, were lower compared to non-pregnant women (149.8±28.8 μg/L), and the difference between the PE and CNP groups was statistically significant. TSH values were the highest in the PE group, while the lowest average level was for the CNP group. The fT3 and fT4 values in the PE group were significantly lower compared to the CNP and CP groups. Despite iodine supplementation during pregnancy, the UIC was lower compared to non-pregnant women, while in women with PE it was at a significantly lower level. To reduce the incidence of possible health complications, proper iodine supplementation and monitoring of the UIC is recommended for pregnant women suffering from PE or at risk of developing PE.
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Mardhiyah D, Komaruddin WN, Jalal FN, Wuryanti S, Bahri S, Qomariah Q, Sosiawan I, Marsiati H, Legiono L, Hanif H, Woskie S, Kongtip P. Comparison of Thyroid Hormone Levels between Women Farmers and Non-Farmers in Banten Indonesia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6618. [PMID: 34205433 PMCID: PMC8296419 DOI: 10.3390/ijerph18126618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/03/2021] [Accepted: 06/08/2021] [Indexed: 11/17/2022]
Abstract
Pesticides are suspected of being endocrine disruptors. This cross-sectional study measured serum samples for levels of thyroid hormones including thyroid stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), free T3 (FT3), and free T4 (FT4) among Indonesian female farmers (n = 127) and non-farmers (n = 127). A questionnaire was used to collect information on demographics and risk factors including work characteristics and frequency, and the use of home and agricultural pesticides. Results showed that there were no significant differences in the distribution of the clinical categories of thyroid levels between farmers and non-farmers except for FT3 and T4. However, in multivariable regression controlling for confounders, FT3 and T4 were significantly higher for farmers compared to non-farmers. In addition, 32% of farmers had clinically low iodine levels and 49% of non-farmers had clinically high iodine levels. We conclude that pesticide exposure may not be as important as iodine intake in explaining these findings. We recommend counseling by health workers about the importance of using iodized salt for farmers and counseling about high iodine foods that need to be avoided for non-farmers.
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Affiliation(s)
- Dian Mardhiyah
- Department of Public Health, YARSI University, Jakarta 10510, Indonesia
| | | | - Fasli Nedra Jalal
- Department of Nutrition, YARSI University, Jakarta 10510, Indonesia; (F.N.J.); (S.W.)
| | - Sri Wuryanti
- Department of Nutrition, YARSI University, Jakarta 10510, Indonesia; (F.N.J.); (S.W.)
| | - Syukrini Bahri
- Department of Clinical Pathology, YARSI University, Jakarta 10510, Indonesia;
| | - Qomariah Qomariah
- Department of Physiology, YARSI University, Jakarta 10510, Indonesia; (Q.Q.); (I.S.); (H.M.); (L.L.)
| | - Insan Sosiawan
- Department of Physiology, YARSI University, Jakarta 10510, Indonesia; (Q.Q.); (I.S.); (H.M.); (L.L.)
| | - Himmi Marsiati
- Department of Physiology, YARSI University, Jakarta 10510, Indonesia; (Q.Q.); (I.S.); (H.M.); (L.L.)
| | - Legiono Legiono
- Department of Physiology, YARSI University, Jakarta 10510, Indonesia; (Q.Q.); (I.S.); (H.M.); (L.L.)
| | - Harliansyah Hanif
- Department of Biomedical Science, YARSI University, Jakarta 10510, Indonesia;
| | - Susan Woskie
- Department of Public Health, University of Massachusetts Lowell, Lowell, MA 01854, USA;
| | - Pornpimol Kongtip
- Department of Occupational Health and Safety, Faculty of Public Health, Mahidol University, Bangkok 10400, Thailand;
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Iron, iodine and vitamin D deficiencies during pregnancy: epidemiology, risk factors and developmental impacts. Proc Nutr Soc 2021; 80:290-302. [PMID: 33988109 DOI: 10.1017/s0029665121001944] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Micronutrient deficiency persists throughout the world, and although the burden is higher in low-resource settings, it is also prevalent in wealthy countries, a phenomenon termed 'hidden hunger'. Due to their high requirements for vitamins and minerals relative to their energy intake, young women and children are particularly vulnerable to hidden hunger. As they share several risk factors and impact on overlapping outcomes, we consider how deficiency of iron, iodine and vitamin D can have profound impacts on perinatal health and infant development. We review the epidemiology of these micronutrient deficiencies during pregnancy, including social, environmental and dietary risk factors. We identify the main challenges in defining nutritional status of these nutrients using validated diagnostic criteria linked with meaningful clinical outcomes. Public health strategies are urgently required to improve the overall health and nutritional status of women of reproductive age. Obesity prevention and early detection of malnutrition with standardised screening methods would detect pregnant women at increased risk of iron deficiency. Development of sensitive, individual biomarkers of iodine status is required to protect maternal health and fetal/infant brain development. Risk assessments of vitamin D requirements during pregnancy need to be revisited from the perspective of fetal and neonatal requirements. International consensus on standardised approaches to micronutrient assessment, analysis and reporting as well as sensitive, clinically validated infant and child neuro-behavioural outcomes will enable progression of useful observational and intervention studies.
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Refaat B, Azzeh F. Factors Associated with Thyroid Disorders and Iodine Adequacy in Pregnant Saudi Women. Biol Trace Elem Res 2021; 199:1715-1728. [PMID: 32710351 DOI: 10.1007/s12011-020-02301-w] [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: 04/07/2020] [Accepted: 07/21/2020] [Indexed: 10/23/2022]
Abstract
Little is known about iodine adequacy and gestational thyroid disorders (GTDs) in Saudi Arabia. This study measured the rates of GTDs and iodine adequacy in 810 healthy Saudi women. Concentrations of serum thyroid hormones and 24-h urine iodine (24-h UIC), and GTDs were diagnosed according to the American Thyroid Association guidelines. Dietary and socioeconomic data to determine factors associated with GTDs and iodine insufficiency were collected. GTDs were detected in 265 women (32.7%) as follows: subclinical (SCH; 20.2%) and overt (OH; 5.8%) hypothyroidism, isolated hypothyroxinemia (ISH; 4.7%) and hyperthyroidism (2%). The SCH (109.2 μg/L; IQR: 77.2-149.7), OH (95.3 μg/L; IQR: 74.3-130.5) and ISH (107.3 μg/L; IQR: 65.5-133.1) groups had median 24-h UIC below the WHO recommended limit, whereas the euthyroid (191.4 μg/L; IQR: 170.03-219.8) and hyperthyroid (159.5 μg/L; IQR: 152.9-238.3) groups were iodine sufficient. Numbers of pregnancies, less education, not consuming iodized salt and not using iodine supplements increased risk of hypothyroidism and ISH. Contrariwise, interval ≥ 3 years from last pregnancy and higher 24-h UIC decreased odds of hypothyroidism and ISH. Moreover, dairy products and egg consumption were markedly lower in all GTD groups. Dairy products and seafood consumption correlated independently with 24-h UIC of the study participants, whereas consuming yogurt, eggs, redfish and shellfish protected against GTDs. In conclusion, GTDs appear to be prevalent in pregnant Saudi women and the hypothyroid and hypothyroxinemia groups had iodine insufficiency. However, consuming iodized salt, iodine supplements, dairy products, seafoods and eggs may protect against GTDs.
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Affiliation(s)
- Bassem Refaat
- Laboratory Medicine Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Al Abdeyah, PO Box 7607, Makkah, Saudi Arabia
| | - Firas Azzeh
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Al Abdeyah, PO Box 7607, Holy Makkah, Saudi Arabia.
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Lee SY. Editorial: Consequences of Iodine Deficiency in Pregnancy. Front Endocrinol (Lausanne) 2021; 12:740239. [PMID: 34394012 PMCID: PMC8355982 DOI: 10.3389/fendo.2021.740239] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 07/16/2021] [Indexed: 11/13/2022] Open
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