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Fu M, Guo W, Ren Z, Zhang H, Wu W, Sun Y, Pan Z, Ji F, Zhang W. Iodine-specific food frequency questionnaire can evaluate iodine intakes of Chinese pregnant women. Nutr Res 2023; 118:146-153. [PMID: 37703645 DOI: 10.1016/j.nutres.2023.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 08/13/2023] [Accepted: 08/13/2023] [Indexed: 09/15/2023]
Abstract
Iodine is an essential trace element for the synthesis of thyroid hormones, which play an important role in growth and development, metabolism, and body organ function. There is no iodine-specific food frequency questionnaire (I-FFQ) for pregnant women in China. This study aimed to validate and optimize an I-FFQ. A total of 1802 pregnant women were included in this study. The iodine nutrition survey was performed using I-FFQ and 3-day estimated food diary (3DEFD). Seventy-one women of reproductive age repeated the I-FFQ twice to assess for FFQ reproducibility. Further optimization of the I-FFQ was accomplished by integrating iodine contributions to simplified questionnaire items. Correlation and Bland-Altman analyses were used to verify the consistency of I-FFQ with 3DEFD, as well as the stability and feasibility of I-FFQ optimization. The I-FFQ and 3DEFD had a strong correlation (R = 0.76, P < .001) and agreement (Kappa = 0.731, P < .001). A Bland-Altman plot showed that 5.1% of participants exceeded the limit of agreement. Nonpregnant women of reproductive age completed the I-FFQ twice, and the results had a strong correlation (R = 0.72, P < .001). A Bland-Altman analysis showed that 5.6% of individuals were located outside the limit of agreement. The consistency of I-FFQ before and after optimization was good (Kappa = 0.982, P < .001). Therefore, I-FFQ could be used as a valid tool to estimate iodine intake among Chinese pregnant women. The optimized I-FFQ could shorten survey time without affecting its accuracy.
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Affiliation(s)
- Min Fu
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Wenxing Guo
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Zhiyuan Ren
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Haixia Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Wen Wu
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Yu Sun
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Ziyun Pan
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Fengying Ji
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao, China; Qingdao Institute of Preventive Medicine, Qingdao, China.
| | - Wanqi Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, 300070, China; Tianjin Key Laboratory of Hormones and Development (Ministry of Health), Tianjin, China.
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Li Y, Wang J, Liu X, Li W, Mao D, Lu J, Li X, Tan H, Liu Y, Yan J, Yu W, Guo C, Liu X, Yang X. Re-exploring the requirement of dietary iodine intake in Chinese female adults based on 'iodine overflow theory'. Eur J Nutr 2023; 62:1467-1478. [PMID: 36651989 PMCID: PMC10030447 DOI: 10.1007/s00394-022-03065-w] [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: 02/21/2022] [Accepted: 12/01/2022] [Indexed: 01/19/2023]
Abstract
PURPOSE We re-explored the basal iodine requirement based on healthy Chinese female and a new iodine overflow theory was proposed for iodine balance study. METHODS Thirty-six Chinese healthy female adults (age 20.7 ± 1.1) were recruited for this study, which included 40 days low iodine depletion period and six stages of 30 days supplementation period. Uniform diets with low iodine were provided and the content of iodine in the diet was regulated by dairy products. The total iodine intake from food and the total iodine excretion through 24-h urine and staged feces were completely gathered and monitored. The incremental (Δ) intake and excretion over the range were calculated. RESULTS The iodine intake and excretion were 13.6 μg/day and 48.6 μg/day at the first stage, respectively. The incremental iodine intakes and excretions were 21.1 μg/day to 120.3 μg/day and 25.8 μg/day to 105.4 μg/day for the supplementation stages, respectively. According to the 'iodine overflow theory', the zero iodine balance (Δ iodine intake = Δ iodine excretion) derived from a mixed effect model indicated a mean iodine intake of 52.2 μg/d (1.0 μg/d kg). The RNI for iodine to healthy Chinese female adult was 73.1 μg/d (1.4 μg/d kg). CONCLUSION A daily iodine intake of 52.2 μg/d may meet the basal iodine requirement for healthy Chinese female adults, and Chinese female may need more than 20% iodine intake than male based on the 'iodine overflow theory'. The trial was registered at the Chinese Clinical Trial Registry in May 2018 (No: ChiCTR1800016184).
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Affiliation(s)
- Yajie Li
- Changzhi Medical College, No. 360, Jiefang East Street, Changzhi, 046000, Shanxi, People's Republic of China
| | - Jun Wang
- School of Food and Drug, Shenzhen Polytechnic, Shenzhen, 518055, Guangdong, People's Republic of China
| | - Xiaobing Liu
- Chinese Center for Disease Control and Prevention, National Institute of Nutrition and Health, Key Laboratory of Trace Element Nutrition of National Health Commission, No. 29, Nanwei Road, Beijing, 100050, People's Republic of China
| | - Weidong Li
- Chinese Center for Disease Control and Prevention, National Institute of Nutrition and Health, Key Laboratory of Trace Element Nutrition of National Health Commission, No. 29, Nanwei Road, Beijing, 100050, People's Republic of China
| | - Deqian Mao
- Chinese Center for Disease Control and Prevention, National Institute of Nutrition and Health, Key Laboratory of Trace Element Nutrition of National Health Commission, No. 29, Nanwei Road, Beijing, 100050, People's Republic of China
| | - Jiaxi Lu
- Chinese Center for Disease Control and Prevention, National Institute of Nutrition and Health, Key Laboratory of Trace Element Nutrition of National Health Commission, No. 29, Nanwei Road, Beijing, 100050, People's Republic of China
| | - Xiuwei Li
- National Reference Laboratory for iodine deficiency disorders, Chinese Center for Disease Control and Prevention, Beijing, 100050, People's Republic of China
| | - Hongxing Tan
- Shenzhen Center for Chronic Disease Control, No. 2021, Buxin Road, Shenzhen, 518020, Guangdong, People's Republic of China
| | - Yanyan Liu
- Shenzhen Center for Chronic Disease Control, No. 2021, Buxin Road, Shenzhen, 518020, Guangdong, People's Republic of China
| | - Junan Yan
- Shenzhen Center for Chronic Disease Control, No. 2021, Buxin Road, Shenzhen, 518020, Guangdong, People's Republic of China
| | - Wei Yu
- Shenzhen Center for Chronic Disease Control, No. 2021, Buxin Road, Shenzhen, 518020, Guangdong, People's Republic of China
| | - Chongzheng Guo
- Changzhi Medical College, No. 360, Jiefang East Street, Changzhi, 046000, Shanxi, People's Republic of China
| | - Xiaoli Liu
- Shenzhen Center for Chronic Disease Control, No. 2021, Buxin Road, Shenzhen, 518020, Guangdong, People's Republic of China
| | - Xiaoguang Yang
- Chinese Center for Disease Control and Prevention, National Institute of Nutrition and Health, Key Laboratory of Trace Element Nutrition of National Health Commission, No. 29, Nanwei Road, Beijing, 100050, People's Republic of China.
- Shenzhen Center for Chronic Disease Control, No. 2021, Buxin Road, Shenzhen, 518020, Guangdong, People's Republic of China.
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Shi Y, Zhong H, Pang L. Maternal micronutrient disturbance as risks of offspring metabolic syndrome. J Trace Elem Med Biol 2023; 75:127097. [PMID: 36272194 DOI: 10.1016/j.jtemb.2022.127097] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 10/08/2022] [Accepted: 10/13/2022] [Indexed: 11/06/2022]
Abstract
Metabolic syndrome (MetS) is defined as a constellation of individual metabolic disturbances, including central obesity, hypertension, dyslipidemia, and insulin resistance. The established pathogenesis of MetS varies extensively with gender, age, ethnic background, and nutritional status. In terms of nutritional status, micronutrients are more likely to be discounted as essential components of required nutrition than macronutrients due to the small amount required. Numerous observational studies have shown that pregnant women frequently experience malnutrition, especially in developing and low-income countries, resulting in chronic MetS in the offspring due to the urgent and increasing demands for micronutrients during gestation and lactation. Over the past few decades, scientific developments have revolutionized our understanding of the association between balanced maternal micronutrients and MetS in the offspring. Examples of successful individual, dual, or multiple maternal micronutrient interventions on the offspring include iron for hypertension, selenium for type 2 diabetes, and a combination of folate and vitamin D for adiposity. In this review, we aim to elucidate the effects of maternal micronutrient intake on offspring metabolic homeostasis and discuss potential perspectives and challenges in the field of maternal micronutrient interventions.
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Affiliation(s)
- Yujie Shi
- Nanjing Maternal and Child Health Medical Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, China.
| | - Hong Zhong
- Nanjing Maternal and Child Health Medical Institute, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, China
| | - Lingxia Pang
- Department of Child Healthcare, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, China.
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Rahmati M, Nazarpour S, Minooee S, Behboudi-Gandevani S, Azizi F, Tehrani FR. A Bayesian model to estimate the cutoff value of TSH for management of preterm birth. PLoS One 2023; 18:e0283503. [PMID: 36989309 PMCID: PMC10058148 DOI: 10.1371/journal.pone.0283503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 03/06/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Determining a thyroid hormone cutoff value in pregnancy is challenging issue and several approaches have been introduced to optimize a utility function. We aimed to estimate the cutoff value of TSH using Bayesian method for prediction of preterm-birth. METHODS This study was a secondary-analysis of the population-based data collected prospectively within the framework of the Tehran Thyroid and Pregnancy Study. A total of 1,538 pregnant women attending prenatal clinics. RESULTS Using Bayesian method resulted a TSH-cutoff of (3.97mIU/L,95%CI:3.95-4.00) for distinguishing pregnant women at risk of preterm-birth. The cutoff was associated with acceptable positive predictive and negative predictive values (0.84,95% CI:0.80-0.88) and 0.92 (95%CI: 0.91-0.94), respectively). In women who were negative for thyroid peroxides antibody (TPOAb) with sufficient urinary iodine concentration (UIC), the TSH cutoff of 3.92 mIU/L(95%CI:3.70-4) had the highest predictive value; whereas in TPOAb positive women with insufficient UIC, the cutoff of 4.0 mIU/L(95%:CI 3.94-4) could better predict preterm birth. Cutoffs estimated in this study are close to the revised TSH value of 4.0mIU/L which is currently recommended by the American Thyroid Association. CONCLUSION Regardless of TPOAb status or iodine insufficiency, risk of preterm labor is increased in pregnant women with TSH value of > 3.92 mIU/L; these women may benefit from Levothyroxine (LT4) therapy for preventing preterm birth.
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Affiliation(s)
- Maryam Rahmati
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sima Nazarpour
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Midwifery, Varamin-Pishva Branch, Islamic Azad University, Tehran, Iran
| | - Sonia Minooee
- Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | | | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Wang J, Zhang H, Mao D, Tan H, Yu W, Xu J, Hong W, Piao J, Yang L, Liu X, Lu J, Li W, Li Y, Liu X, Yang X. Exploration of the lower threshold of iodine intake in Southern Chinese young adults based on ‘overflow theory’ in an iodine balance study. Nutr J 2022; 21:35. [PMID: 35644684 PMCID: PMC9150309 DOI: 10.1186/s12937-022-00775-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 04/14/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Appropriate iodine intake for adults is essential to reduce the prevalence of thyroid diseases, but there is little research data on iodine requirement of Chinese population. This study aimed to explore the iodine requirement of young adults to maintain a healthy status based on ‘overflow theory’.
Methods
Iodine-balance experiment has been performed in this project. We conducted an 18-day study consisted of a 6-day acclimation period and 3 consecutive experimental stages in 37 Chinese healthy young adults (23 female and 14 male). Each stage was consumed for 4 days. Strictly-controlled low-iodine intake diets were provided for adults in the first period, an egg or 125mL milk was added in the second and third period, respectively. The dietary samples, 24-h urine specimens and faeces of volunteers were collected daily for assessment of iodine intake and excretion in volunteers.
Results
Mean values of iodine intake (22.7±3.6, 35.1±3.7, and 52.2±3.8μg/d), excretion (64.7±13.9, 62.3±12.6, and 94.3±14.5μg/d) and iodine balance (-35.2±19.5, -21.0±19.8, and -33.5±26.9μg/d) were significantly different among three periods for male (P<0.001 for all); mean values of iodine intake (16.6±3.1, 29.7±2.7, and 48.0±2.7μg/d), and excretion (47.0±9.9, 55.5±8.1, and 75.7±12.4μg/d) were significantly different among three periods for female (P < 0.001 for all). No significant difference was observed among the 3 periods for female in the iodine balance (-30.5±9.3, -25.9±7.3, and -27.6±12.1μg/d). The linear regression equation of iodine excretion on iodine intake was Y=0.979X+37.04 (male) and Y=0.895X+31.48 (female). Compared with stage 2, iodine excretion increments in stage 3 had exceeded the iodine intake increment for men. The ratio of increment was 1.675 for male when the average iodine intake was 52.2μg/d in stage 3. When the iodine excretion increment equaled to the iodine intake increment, the daily iodine intake of men was 47.0μg.
Conclusion
We have evaluated the iodine requirement of young adults in southern China based on overflow theory. Our results indicate the lower limit of iodine requirement for Chinese young men is 47.0μg/d. The trial was registered at www.chictr.org.cn as ChiCTR1800014877.
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Liu Z, Lin Y, Wu J, Chen D, Wu X, Lan Y, Chen Z. Is the urinary iodine/creatinine ratio applicable to assess short term individual iodine status in Chinese adults? Comparison of iodine estimates from 24-h urine and timed-spot urine samples in different periods of the day. Nutr Metab (Lond) 2022; 19:27. [PMID: 35392953 PMCID: PMC8991982 DOI: 10.1186/s12986-022-00656-6] [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: 10/01/2021] [Accepted: 03/01/2022] [Indexed: 12/02/2022] Open
Abstract
Background Urinary iodine concentration (UIC) is routinely used to evaluate the population iodine status while the uniform method for the individual level assessment is uncertain. Objectives To explore the 24-h urinary iodine excretion (UIE) in five different periods of the day and the corresponding prediction equations respect by the use of creatinine-corrected UIC. Methods We collected 24-h, spot and fasting urine in five periods of the day to estimate 24-h UIE by the six different prediction equations. We compared the estimated creatinine-corrected UIC to the collected 24-h UIE and identified the most suitable equations in each period of the day. Results Among the six different prediction equations, the equation of Kawasaki T was the best to estimate the 24-h UIE by fasting urine among Chinese adults. Among the five periods of time, the equation of Knudsen N was the best to estimate the 24-h UIE in the non-morning period. Conclusion Urinary iodine status at the individual level could be estimated by different creatinine-based equations at different periods of the day.
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Affiliation(s)
- Zhuan Liu
- The Department of Endemic Diseases, Fujian Center for Disease Control and Prevention Fujian, No. 386 Chong'an Road, Fuzhou, 350012, Fujian, People's Republic of China.,The Department of Disease Control and Prevention, The First Hospital of Quanzhou Affiliated to Fujian Medical University, No.248-252, Dongjie Road, Quanzhou, 362000, Fujian, People's Republic of China
| | - Yixuan Lin
- School of Public Health, Fujian Medical University, University of New Area, No.1 Xueyuan Road, Fuzhou, 350122, Fujian, People's Republic of China
| | - Jiani Wu
- The Department of Endemic Diseases, Fujian Center for Disease Control and Prevention Fujian, No. 386 Chong'an Road, Fuzhou, 350012, Fujian, People's Republic of China
| | - Diqun Chen
- The Department of Endemic Diseases, Fujian Center for Disease Control and Prevention Fujian, No. 386 Chong'an Road, Fuzhou, 350012, Fujian, People's Republic of China
| | - Xiaoyan Wu
- The Department of Endemic Diseases, Fujian Center for Disease Control and Prevention Fujian, No. 386 Chong'an Road, Fuzhou, 350012, Fujian, People's Republic of China
| | - Ying Lan
- The Department of Endemic Diseases, Fujian Center for Disease Control and Prevention Fujian, No. 386 Chong'an Road, Fuzhou, 350012, Fujian, People's Republic of China
| | - Zhihui Chen
- The Department of Endemic Diseases, Fujian Center for Disease Control and Prevention Fujian, No. 386 Chong'an Road, Fuzhou, 350012, Fujian, People's Republic of China. .,School of Public Health, Fujian Medical University, University of New Area, No.1 Xueyuan Road, Fuzhou, 350122, Fujian, People's Republic of China.
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Wang T, Liu Y, Kong Q, Cao X, Liu Y, Xia S, Zheng T, Yu L. Effect of Moderate-to-Severe Iodine Deficiency in Early Pregnancy on Subclinical Hypothyroidism: A Longitudinal Study in an Iodine-Sufficient Region in China. Front Nutr 2022; 9:839651. [PMID: 35433796 PMCID: PMC9011046 DOI: 10.3389/fnut.2022.839651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 03/14/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveTo investigate iodine status among pregnant women in an iodine-sufficient region in China after the implementation of revised universal salt iodization (USI) standards in 2012 and assess the association between urinary iodine concentrations (UIC) in early pregnancy and the incidence of subclinical hypothyroidism (SCH) in euthyroid women negative for antithyroid Ab during different trimesters.MethodsWe measured the iodine status of 1,264 pregnant women, and performed follow-up assessment of thyroid function at 20 and 30 weeks of gestation among a cohort of 250 euthyroid women. We assessed the association of UIC in the 1st trimester with the incidence of SCH in subsequent trimesters. UIC and serum free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), and thyroglobulin antibody (TgAb) were measured.ResultsThe median UIC was 135.95 μg/L among 1,264 women. Serum FT4 level was significantly higher in the group of UIC 150 to 249 μg/L compared with other UIC groups (P < 0.001). TSH was significantly higher in the UIC more than or equal to 250 μg/L group than the UIC 150 to 249 g/L group (P = 0.043). Of the 250 euthyroid women negative for antithyroid Ab (TSH value of 2.5–3.55 mU/L) in the 1st trimester, pregnant women with UIC lower than 100 μg/L in the 1st trimester exhibited a significantly increased risk of SCH (odds ratio [OR] = 2.47; 95% confidence interval [CI] = 1.22–5.71; P = 0.012, according to the Chinese Medical Association criteria; OR = 5.22, 95% CI = 1.73–6.09, P = 0.004, according to ATA criteria) during the latter half of pregnancy compared with the UIC 150 to 249 μg/L group.ConclusionModerate-to-severe iodine deficiency (UIC lower than 100 μg/L) in the 1st trimester was associated with a significantly higher risk of SCH during the 2nd or 3rd trimesters among euthyroid pregnant women who had negative for antithyroid Ab. Women with SCH during pregnancy require regular UIC tests to maintain appropriate iodine status.
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Affiliation(s)
- Taotao Wang
- Department of Endocrinology and Clinical Nutrition, Affiliated Hospital of Jiangsu University, Zhenjiang, China
- *Correspondence: Taotao Wang
| | - Yanqiu Liu
- Department of Obstetrics, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Qianqian Kong
- Department of Radiology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Xiaoxia Cao
- Department of Obstetrics, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Yuzhou Liu
- Department of Obstetrics, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Song Xia
- Department of Endocrinology and Clinical Nutrition, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Tingting Zheng
- Department of Nuclear Medicine, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Li Yu
- Department of Endocrinology and Clinical Nutrition, Affiliated Hospital of Jiangsu University, Zhenjiang, China
- Li Yu
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Ngounda J, Baumgartner J, Nel M, Walsh CM. Iodine status of pregnant women residing in the urban Free State Province of South Africa is borderline adequate: The NuEMI study. Nutr Res 2022; 98:18-26. [DOI: 10.1016/j.nutres.2021.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 11/30/2021] [Accepted: 12/02/2021] [Indexed: 10/19/2022]
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Zhou Y, Chen F, Wang L, Tian C, Zhang S, Ding F, Deng J. Establishment of an iodine model for prevention of iodine-excess-induced thyroid dysfunction in pregnant women. Open Life Sci 2021; 16:1357-1364. [PMID: 35071770 PMCID: PMC8760181 DOI: 10.1515/biol-2021-0142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 11/08/2021] [Accepted: 11/21/2021] [Indexed: 11/30/2022] Open
Abstract
This study aims to explore the relationship between the iodine status and thyroid dysfunction (TD) in pregnant women and establish a model to guide them to prevent excessive iodine intake. A total of 515 pregnant women were enrolled in the study. Urinary iodine concentration (UIC), thyroid hormones, and thyroid autoantibodies were measured, and then a logistic regression model was established. The median UIC of pregnant women was 174 ± 120 μg/L. Multivariate logistic regression analysis indicated that multivitamin supplements containing iodine and frequent seafood consumption were risk factors for excessive iodine (UIC ≥500 μg/L). Besides, excessive iodine was a risk factor for TD. Iodine excess was associated with a high prevalence of TD in pregnant women, especially TPOAb-positive women (P < 0.05). A logistic regression model based on potential risk factors was established to predict the risk of excessive iodine intake among pregnant women and provide guidance to minimize the risk of excessive iodine intake, thus reducing the risk of TD.
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Affiliation(s)
- Yuhan Zhou
- Department of Obstetrics, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine , No. 15 Jiefang Road, Fancheng District , Xiangyang , 441000 , People’s Republic of China
| | - Fen Chen
- Department of Obstetrics, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine , No. 15 Jiefang Road, Fancheng District , Xiangyang , 441000 , People’s Republic of China
| | - Lingyu Wang
- Department of Obstetrics, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine , No. 15 Jiefang Road, Fancheng District , Xiangyang , 441000 , People’s Republic of China
| | - Chunhui Tian
- Department of Obstetrics, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine , No. 15 Jiefang Road, Fancheng District , Xiangyang , 441000 , People’s Republic of China
| | - Shuo Zhang
- Department of Technology, Biotecan Medical Diagnostics Co., Ltd, Zhangjiang Center for Translational Medicine , Shanghai 201204 , People’s Republic of China
| | - Feifei Ding
- Department of Technology, Biotecan Medical Diagnostics Co., Ltd, Zhangjiang Center for Translational Medicine , Shanghai 201204 , People’s Republic of China
| | - Jie Deng
- Department of Obstetrics, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine , No. 15 Jiefang Road, Fancheng District , Xiangyang , 441000 , People’s Republic of China
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Exploration of the optimal range of urinary iodine concentration in Chinese pregnant women in mildly iodine-deficient and -sufficient areas. Eur J Nutr 2021; 61:1221-1230. [PMID: 34739565 DOI: 10.1007/s00394-021-02693-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 09/28/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE There is some uncertainty about the optimal ranges for urinary iodine concentration (UIC) during pregnancy. This study aimed to explore associations between maternal UIC and thyroid function in iodine sufficient and mildly iodine deficient areas. METHODS It was a cross-sectional study in which 1461 healthy pregnant women were enrolled to collect their blood and urine samples during their routine antenatal care in Tianjin and Wuqiang, China. Wuqiang was a mildly iodine-deficient region, while Tianjin was iodine sufficient. UIC, free triiodothyronine (FT3), free thyroid hormone (FT4), thyroid stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb), serum iodine concentration (SIC) including total serum iodine concentration (tSIC) and non-protein bound serum iodine concentration (nbSIC) were assessed during the routine antenatal care visits. RESULTS The median UIC in pregnant women was 174 (113, 249) μg/L in Tianjin and 111 (63, 167) μg/L in Wuqiang, respectively. Compared with Tianjin, UIC, FT3 and TSH were lower, and FT4, tSIC, nbSIC, rates of TPOAb and TgAb positivity and the thyroid dysfunction rate (TDR) were higher in Wuqiang (P < 0.001). FT3, FT4, tSIC and nbSIC increased during pregnancy in Tianjin with increasing UIC, while only FT3 and nbSIC increased in Wuqiang (P < 0.05). In Tianjin, the TDR increased with UIC and peaked at UIC ≥ 500 μg/L (P = 0.002), while in Wuqiang, the TDR showed a weak "U-shaped" relationship with UIC and the rate was lowest with UIC 100-149 μg/L. CONCLUSIONS In iodine-deficient areas, there was a lower TDR in pregnant women with UIC 100-149 μg/L. We suspected that the optimal UIC criteria recommended by WHO may be a little high for pregnant women in mild-to-moderate iodine-deficient countries.
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Wu H, Zhang W, Zhang Y, Kang Z, Miao X, Na X. Novel insights into di‑(2‑ethylhexyl)phthalate activation: Implications for the hypothalamus‑pituitary‑thyroid axis. Mol Med Rep 2021; 23:290. [PMID: 33649816 PMCID: PMC7930932 DOI: 10.3892/mmr.2021.11930] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 09/09/2020] [Indexed: 11/06/2022] Open
Abstract
Di (2‑ethylhexyl) phthalate (DEHP), an environmental pollutant, is widely used as a plasticizer and causes serious pollution in the ecological environment. As previously reported, exposure to DEHP may cause thyroid dysfunction of the hypothalamic‑pituitary‑thyroid (HPT) axis. However, the underlying role of DEHP remains to be elucidated. The present study performed intragastrical administration of DEHP (150, 300 and 600 mg/kg) once a day for 90 consecutive days. DEHP‑stimulated oxidative stress increased the thyroid follicular cavity diameter and caused thyrocyte oedema. Furthermore, DEHP exposure altered mRNA and protein levels. Thus, DEHP may perturb TH homeostasis by affecting biosynthesis, biotransformation, bio‑transportation, receptor levels and metabolism through disruption of the HPT axis and activation of the thyroid‑stimulating hormone (TSH)/TSH receptor signaling pathway. These results identified the formerly unappreciated endocrine‑disrupting activities of phthalates and the molecular mechanisms of DEHP‑induced thyrotoxicity.
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Affiliation(s)
- Haoyu Wu
- Department of Environmental Hygiene, School of Public Health, Harbin Medical University, Harbin, Heilongjiang 150081, P.R. China
| | - Wanying Zhang
- Department of Environmental Hygiene, School of Public Health, Harbin Medical University, Harbin, Heilongjiang 150081, P.R. China
- Department of Logistics Support, Chengdu Blood Center, Chengdu, Sichuan 610041, P.R. China
| | - Yunbo Zhang
- Department of Environmental Hygiene, School of Public Health, Harbin Medical University, Harbin, Heilongjiang 150081, P.R. China
| | - Zhen Kang
- Department of Environmental Hygiene, School of Public Health, Harbin Medical University, Harbin, Heilongjiang 150081, P.R. China
- Department of Environmental Hygiene, Harbin Center for Disease Control and Prevention, Harbin, Heilongjiang 150001, P.R. China
| | - Xinxiunan Miao
- Department of Environmental Hygiene, School of Public Health, Harbin Medical University, Harbin, Heilongjiang 150081, P.R. China
| | - Xiaolin Na
- Department of Environmental Hygiene, School of Public Health, Harbin Medical University, Harbin, Heilongjiang 150081, P.R. China
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Luo J, Li C, Zhang X, Shan Z, Teng W. Reference Intervals of the Ratio of Urine Iodine to Creatinine in Pregnant Women in an Iodine-Replete Area of China. Biol Trace Elem Res 2021; 199:62-69. [PMID: 32249377 DOI: 10.1007/s12011-020-02133-8] [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: 12/11/2019] [Accepted: 03/25/2020] [Indexed: 11/28/2022]
Abstract
The assessment method of iodine nutrition for pregnant women lacks strong evidence-based medicine. The prevalence of iodine deficiency in pregnant women may be overestimated using urinary iodine concentration (UIC). The reference intervals of UIC-to-urinary creatinine concentration ratio (UIC/UCr) were established using a self-sequential longitudinal study of pregnant women with singleton gestation who were recruited using the criteria of the National Academy of Clinical Biochemistry in Dandong City, which is a long-term iodine-replete area. Nine thousand one hundred sixty-four pregnant women in the first trimester from Dalian City, Dandong City, and Shenyang City were included to verify our proposed reference intervals. UIC and concentrations of urinary creatinine, serum iodine, TSH, FT4, TPOAb, and TgAb were measured. The reference intervals of UIC/UCr were 38.63-489.46 μg/g for the first trimester, 58.48-644.03 μg/g for the second trimester, and 56.27-644.93 μg/g for the third trimester. The prevalence of iodine deficiency was 49.50% using UIC as the indicator (< 150 μg/L), while the prevalence was 3.28% using UIC/UCr (< 38.63 μg/g). The prevalence of iodine excess was 3.21% using UIC as the indicator (> 500 μg/L) while the prevalence was 1.45% using UIC/UCr (> 489.46 μg/g). The highest prevalence of overt hypothyroidism and positive thyroid antibodies was in the group with UIC/UCr < 38.63 μg/g. In contrast to the place of residence and age, BMI was an influencing factor for UIC/UCr. The reference intervals of UIC/UCr were established. UIC/UCr may eliminate the effect of urine volume and reflect the actual prevalence of iodine deficiency in pregnant women.
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Affiliation(s)
- Jingyi Luo
- Department of Endocrinology and Metabolism and the Institute of Endocrinology, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China
| | - Chenyan Li
- Department of Endocrinology and Metabolism and the Institute of Endocrinology, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China
| | - Xiaomei Zhang
- Department of Endocrinology and Metabolism, Peking University International Hospital, Beijing, 100000, People's Republic of China
| | - Zhongyan Shan
- Department of Endocrinology and Metabolism and the Institute of Endocrinology, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China
| | - Weiping Teng
- Department of Endocrinology and Metabolism and the Institute of Endocrinology, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China.
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13
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Yu Z, Zheng C, Zheng W, Wan Z, Bu Y, Zhang G, Ding S, Wang E, Zhai D, Ma ZF. Mild-to-moderate iodine deficiency in a sample of pregnant women and salt iodine concentration from Zhejiang province, China. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2020; 42:3811-3818. [PMID: 32596780 DOI: 10.1007/s10653-020-00640-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 06/16/2020] [Indexed: 06/11/2023]
Abstract
Since 2011, Zhejiang province has eliminated iodine deficiency disorders (IDD) in its populations. Following this achievement, a new revised iodine concentration in iodised salt was implemented in Zhejiang in 2012. However, the re-emergence of iodine deficiency has been reported in pregnant women. Therefore, the aim of this study was to assess household salt iodine concentration and iodine status of pregnant women in Zhejiang province, China. We conducted a cross-sectional study between April 2018 and August 2018 in Quzhou, Zhejiang province. Pregnant women aged ≥ 18 years who did not have a history of thyroid disease were recruited into the study. They were asked to complete socio-demographic questionnaires including a food frequency questionnaire (FFQ). In addition, a spot urine sample and a household table salt sample were also provided by each participant. A total of 625 pregnant women agreed to participate. The overall median urinary iodine concentration (UIC) was 130 µg/L, indicating mild-to-moderate iodine deficiency in pregnant women. The coverage of iodised salt was 85.2%, and of these, the rate of adequately iodised salt was 98.1%. In conclusion, our results confirmed the re-emergence of iodine deficiency in pregnant women as reported by other studies conducted in Zhejiang province. Therefore, urgent public health actions are needed to improve iodine status of pregnant women in order to prevent the adverse consequences of IDD on the neurodevelopment of foetus.
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Affiliation(s)
- Zengli Yu
- School of Public Health, Xinxiang Medical University, Xinxiang, 453003, People's Republic of China
- School of Public Health, Zhengzhou University, Science Road 100, Zhengzhou, 450001, People's Republic of China
| | - Canjie Zheng
- Quzhou Center for Disease Control and Prevention, 154 Xi'an Road, Quzhou, 324000, Zhejiang Province, People's Republic of China
| | - Wangfeng Zheng
- Quzhou Hospital of Traditional Chinese Medicine, 117 Quhua Road, Quzhou, 324000, Zhejiang Province, People's Republic of China
| | - Zhongxiao Wan
- School of Public Health, Zhengzhou University, Science Road 100, Zhengzhou, 450001, People's Republic of China
- School of Public Health, Soochow University, Suzhou, 215123, People's Republic of China
| | - Yongjun Bu
- School of Public Health, Xinxiang Medical University, Xinxiang, 453003, People's Republic of China
| | - Guofu Zhang
- School of Public Health, Xinxiang Medical University, Xinxiang, 453003, People's Republic of China
| | - Shibin Ding
- School of Public Health, Xinxiang Medical University, Xinxiang, 453003, People's Republic of China
| | - Erhui Wang
- School of Public Health, Xinxiang Medical University, Xinxiang, 453003, People's Republic of China
| | - Desheng Zhai
- School of Public Health, Xinxiang Medical University, Xinxiang, 453003, People's Republic of China
| | - Zheng Feei Ma
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, 215123, People's Republic of China.
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14
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An iodine balance study to explore the recommended nutrient intake of iodine in Chinese young adults. Br J Nutr 2020; 124:1156-1165. [PMID: 32624007 DOI: 10.1017/s0007114520002196] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Data on average iodine requirements for the Chinese population are limited following implementation of long-term universal salt iodisation. We explored the minimum iodine requirements of young adults in China using a balance experiment and the 'iodine overflow' hypothesis proposed by our team. Sixty healthy young adults were enrolled to consume a sequential experimental diet containing low, medium and high levels of iodine (about 20, 40 and 60 μg/d, respectively). Each dose was consumed for 4 d, and daily iodine intake, excretion and retention were assessed. All participants were in negative iodine balance throughout the study. Iodine intake, excretion and retention differed among the three iodine levels (P < 0·01 for all groups). The zero-iodine balance derived from a random effect model indicated a mean iodine intake of 102 μg/d, but poor correlation coefficients between observed and predicted iodine excretion (r 0·538 for μg/d data) and retention (r 0·304 for μg/d data). As iodine intake increased from medium to high, all of the increased iodine was excreted ('overflow') through urine and faeces by males, and 89·5 % was excreted by females. Although the high iodine level (63·4 μg/d) might be adequate in males, the corresponding level of 61·6 μg/d in females did not meet optimal requirements. Our findings indicate that a daily iodine intake of approximately half the current recommended nutrient intake (120 μg/d) may satisfy the minimum iodine requirements of young male adults in China, while a similar level is insufficient for females based on the 'iodine overflow' hypothesis.
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Yang L, Li M, Liu X, Wu M, Zhang J, Zhao L, Ding G, Yang X. Evaluation of Iodine Nutritional Status Among Pregnant Women in China. Thyroid 2020; 30:443-450. [PMID: 31964276 DOI: 10.1089/thy.2019.0001] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Remarkable achievements have been made for over two decades by implementing a universal salt iodization policy in China. However, changes in the standards and manufacturing of iodized salt have made it necessary to regularly monitor iodine intake and thyroid function in the population. Therefore, we aimed to evaluate iodine nutritional status using thyroid function and urinary iodine levels in pregnant women via a national survey. Methods: Participants included pregnant women enrolled in the 2015 Chinese Adults Chronic Diseases and Nutrition Surveillance (CACDNS). Urinary iodine concentration (UIC) was measured using arsenic and cerium catalysis spectrophotometry. Plasma levels of thyrotropin (TSH), fT4 (free thyroxine), thyroid peroxidase antibodies (TPO-Ab), and thyroglobulin antibodies (TG-Ab) were determined using an automated chemiluminescence immunoassay analyzer. Results: UIC was analyzed in a total of 6173 urinary samples collected from pregnant women residing in 31 provinces of China. The median urinary iodine concentration was 146 μg/L. Pregnant women with UIC >250 μg/L had higher TSH levels than those with UIC 120-149 and 150-249 μg/L. After excluding women with positive TPO-Ab and TG-Ab, a total 2097 plasma samples collected from pregnant women during three periods were analyzed for TSH and fT4. The frequency of normal thyroid function in this study was >85%. The most common type of abnormal thyroid function, subclinical hypothyroidism, was similar to the 2010-2012 China Nutrition and Health Surveillance (CNHS), but its prevalence decreased to 6.8% compared with that in the 2010-2012 CNHS. Compared with pregnant women who had UIC <250 μg/L, the prevalence of subclinical hypothyroidism was significantly increased in those with UIC >250 μg/L. Even with UIC levels 120-149 μg/L, the iodine status of Chinese pregnant women in the 2015 CACDNS is acceptable. Conclusions: The iodine status of pregnant women is generally adequate, but urinary iodine levels are close to the cutoff for suitable iodine status (150 μg/L). With noniodized salt widely available, continued improvement in monitoring of iodine nutritional status and thyroid function is important in this population.
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Affiliation(s)
- Lichen Yang
- The Key Laboratory of Trace Element Nutrition, National Health Commission, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, P.R. China
| | - Min Li
- The Key Laboratory of Trace Element Nutrition, National Health Commission, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, P.R. China
| | - Xiaobing Liu
- The Key Laboratory of Trace Element Nutrition, National Health Commission, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, P.R. China
| | - Meng Wu
- Shanxi Provincial Center for Disease Control and Prevention, Xian, P.R. China
| | - Jian Zhang
- The Key Laboratory of Trace Element Nutrition, National Health Commission, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, P.R. China
| | - Liyun Zhao
- The Key Laboratory of Trace Element Nutrition, National Health Commission, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, P.R. China
| | - Gangqiang Ding
- The Key Laboratory of Trace Element Nutrition, National Health Commission, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, P.R. China
| | - Xiaoguang Yang
- The Key Laboratory of Trace Element Nutrition, National Health Commission, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, P.R. China
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