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Zhang Y, Li X, Wang J, Ma W, Wang H, Wang J, Xu J. Exploring Salivary Iodine Concentration as a Biomarker for Iodine Status and Thyroid Nodules in Females From Different Water Iodine Areas: a Cross-sectional Study. Am J Clin Nutr 2024:S0002-9165(24)00446-5. [PMID: 38677523 DOI: 10.1016/j.ajcnut.2024.04.023] [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: 01/28/2024] [Revised: 03/24/2024] [Accepted: 04/23/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND It is unclear whether salivary iodine concentration (SIC) can assess iodine status in females from different water iodine regions. OBJECTIVES Through a cross-sectional study, we explored the feasibility of SIC as a biomarker to assess iodine status in females and develop optimal cutoff values. METHODS A total of 1991 females were analyzed in this cross-sectional study from the coastal iodine-deficient areas (CIDAs), inland iodine-deficient areas (IIDAs), iodine-adequate areas (IAAs), iodine-excess areas (IEAs), and iodine extra-high areas (IEHAs). SIC, spot urine iodine concentration (SUIC), and daily total iodine intake (TII) were assessed, and ultrasonography was performed in all subjects. RESULTS There was a positive correlation between SIC and SUIC (r = 0.67; 95% CI: 0.64, 0.69; P < 0.001), and TII (r = 0.47; 95% CI: 0.43, 0.50; P < 0.001). The prevalence of thyroid nodules (TN) showed an upward trend with SIC increasing (Z = -2.83; P-trend = 0.005). The area under the receiver-operating characteristic (ROC) curve for SIC to assess iodine deficiency was 0.62 (95% CI: 0.60, 0.65; P < 0.001) and 0.75 (95% CI: 0.73, 0.77; P < 0.001) for iodine excess. The cutoff values were as follows: SIC < 93.32 μg/L, iodine deficiency; 93.32-224.60 μg/L, iodine adequacy; and >224.60 μg/L, iodine excess. When SIC > 224.60 μg/L, the odds ratio (OR) for UIC > 300 μg/L, excessive TII, and the prevalence of TN were 6.44, 3.68, and 1.27 (95% CI: 4.98, 8.31; 2.83, 4.79; and 1.02, 1.56, respectively; P < 0.05); when SIC < 93.32 μg/L, the OR for UIC < 100 μg/L and insufficient TII were 2.34 and 1.94 (95% CI: 1.73, 3.14 and 1.33, 2.83, respectively; P < 0.05). CONCLUSIONS Using SIC as a biomarker, females in CIDA exhibited mild iodine deficiency, those in IIDA and IAA demonstrated moderate iodine deficiency, and those in IEA and IEHA exhibited an excess of iodine, consistent with SUIC to assess iodine status. SIC can be used as a good biomarker to evaluate the iodine status in population.
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Affiliation(s)
- Ying Zhang
- Key Laboratory of Public Nutrition and Health, National Health Commission of the Peoples' Republic of China, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiuwei Li
- Key Laboratory of Public Nutrition and Health, National Health Commission of the Peoples' Republic of China, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jianqiang Wang
- Key Laboratory of Public Nutrition and Health, National Health Commission of the Peoples' Republic of China, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wei Ma
- Key Laboratory of Public Nutrition and Health, National Health Commission of the Peoples' Republic of China, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Haiyan Wang
- Key Laboratory of Public Nutrition and Health, National Health Commission of the Peoples' Republic of China, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jinpeng Wang
- Key Laboratory of Public Nutrition and Health, National Health Commission of the Peoples' Republic of China, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jing Xu
- Key Laboratory of Public Nutrition and Health, National Health Commission of the Peoples' Republic of China, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China.
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Xing Z, Liu S, Ding P, Yu X, Song J, Sun H, Cui Y, Liu H. A Meta-Analysis of the Prevalence of Children Goiter in High Water Iodine Areas of China. Biol Trace Elem Res 2024:10.1007/s12011-023-04035-x. [PMID: 38172419 DOI: 10.1007/s12011-023-04035-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024]
Abstract
Although there are now a large number of studies confirming that high iodine levels can cause goiter, there is controversy and a lack of quantitative data. A systematic search of PubMed, Web of Science, China National Knowledge Infrastructure, Wanfang Database, and China Biomedical Database for literature on high iodine and goiter in children was performed with a time limit from January 2013 to October 2023. After screening the literature based on the inclusion criteria, extracting the literature data, and evaluating the risk of bias of the included studies, a single-arm meta-analysis was performed using R 4.0.4 software. Twenty-three studies with a total of 50,980 subjects were included. Meta-analysis showed that the prevalence of goiter among children in water-borne iodine-excess areas was 6.0% [95% CI (4.3%, 7.6%)], and subgroup analyses showed that the prevalence of goiter in children with water iodine 100.1-150 µg/L, 150.1-300 µg/L, and > 300 µg/L was 7.5% [95% CI (0.0%, 15.8%)], 5.5% [95% CI (3.1%, 8.0%)], and 10.2% [95% CI (6.7%, 13.6%)], respectively, and the difference was statistically significant (P < 0.01); The prevalence of goiter among children in the northern China (5.8% [95% CI (4.1%, 7.5%)]) was higher than that in the southern China (3.5% [95% CI (1.0%, 6.0%)]) (P < 0.01); the prevalence of goiter in children with urinary iodine levels 100-199 µg/L, 200-299 µg/L, and ≥ 300 µg/L was 2.4% [95% CI (1.9%, 2.9%)], 3.3% [95% CI (1.9%, 4.8%)], and 7.3% [95% CI (4.4%, 9.9%)], respectively, the difference was statistically significant (P < 0.01); the prevalence of goiter in children aged 8, 9, 10, 11, and 12 years old was 5.1% [95% CI (3.9%, 6.4%)], 8.0% [95% CI (4.0%, 11.9%)], 6.2% [95% CI (3.9%, 8.5%)], 5.5% [95% CI (0.0%, 13.2%)], and 5.4% [95% CI (0.0%, 15.1%)], and when age ≥ 9 years, the relationship between goiter prevalence and age showed a trend toward decreasing with age, but the relationship between different age was no statistical difference in the prevalence of goiter between ages. urinary iodine. The prevalence of goiter in children was higher in areas with high water iodine; the prevalence of goiter in children in the north was significantly higher than that in the south; the prevalence of goiter in children tends to increase with increased urinary iodine levels.
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Affiliation(s)
- Zhilei Xing
- School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, People's Republic of China
| | - Siyu Liu
- School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, People's Republic of China
| | - Peisen Ding
- School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, People's Republic of China
| | - Xiaomeng Yu
- School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, People's Republic of China
| | - Jiahui Song
- School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, People's Republic of China
| | - Huajun Sun
- School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, People's Republic of China
| | - Yushan Cui
- Tianjin Centers for Disease Control and Prevention, 6 Huayue Road, Hedong District, Tianjin, 300011, China.
| | - Hongliang Liu
- School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, People's Republic of China.
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Badash I, Moran M, Chambers T, Kokot N. Managing Bethesda IV thyroid nodules in an iodine-deficient population. Gland Surg 2023; 12:1332-1335. [PMID: 38021194 PMCID: PMC10660176 DOI: 10.21037/gs-23-361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 09/12/2023] [Indexed: 12/01/2023]
Affiliation(s)
| | - Marcela Moran
- Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Tamara Chambers
- Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Niels Kokot
- Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Fuse Y, Ito Y, Shishiba Y, Irie M. Current Iodine Status in Japan: A Cross-sectional Nationwide Survey of Schoolchildren, 2014-2019. J Clin Endocrinol Metab 2022; 107:e2065-e2079. [PMID: 34935958 DOI: 10.1210/clinem/dgab919] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT Japan has been regarded as a long-standing iodine-sufficient country without iodine fortification; however, data on nationwide iodine status are lacking. OBJECTIVE This study aimed to characterize the iodine status in Japan. METHODS From 2014 through 2019, a nationwide school-based survey was conducted across all districts in Japan. Urinary iodine concentration (UIC), creatinine (Cr) concentration, and anthropometry were assessed in healthy school-aged children (SAC) aged 6 to 12 years. Their iodine status is regarded as generally representative of the nation's iodine status. RESULTS A total of 32 025 children participated. The overall median UIC was 269 μg/L, which was within the World Health Organization's adequacy range. There was a regional difference in UIC values within 14 regions, and the lowest and highest median UICs were found in Tanegashima Island (209 μg/L) and Nakashibetsu, Hokkaido (1071 μg/L), respectively. The median UIC ≥ 300 μg/L was observed in 12 of 46 regions. By using estimated 24-hour urinary iodine excretion (UIE), the prevalence of SAC exceeding the upper tolerable limit of iodine for Japanese children was from 5.2% to 13.7%. The UIC values did not change with age, body surface area and body mass index percentile, whereas the Cr concentration simultaneously increased suggesting the effect of urinary creatinine on UI/Cr and estimated 24-hour UIE values. CONCLUSIONS The iodine intake of Japanese people is adequate, but in some areas it is excessive. The incidence and prevalence of thyroid disorders associated with iodine intake should be obtained, especially in the areas where high amounts of iodine are consumed.
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Affiliation(s)
- Yozen Fuse
- Research Committee on Iodine Related Health Problems, Foundation for Growth Science, Tokyo 113-0033, Japan
| | - Yoshiya Ito
- Research Committee on Iodine Related Health Problems, Foundation for Growth Science, Tokyo 113-0033, Japan
- Division of Clinical Medicine, Japanese Red Cross Hokkaido College of Nursing, Kitami, Hokkaido 090-0011, Japan
| | - Yoshimasa Shishiba
- Research Committee on Iodine Related Health Problems, Foundation for Growth Science, Tokyo 113-0033, Japan
| | - Minoru Irie
- Research Committee on Iodine Related Health Problems, Foundation for Growth Science, Tokyo 113-0033, Japan
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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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Chávarro Bermeo FE, Arteaga Diaz JM, Roth Deubel AN. Política mundial de yodación de sal: desafíos. Rev Salud Publica (Bogota) 2021. [DOI: 10.15446/rsap.v23n6.98302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objetivo Identificar los desafíos que conlleva la implementación de la política mundial de yodación de sal para el consumo humano.
Métodos Se realizó una revisión de la literatura publicada entre el año 2000 y 2021 en PubMed, con los términos MeSH yodo, política pública, cloruro de sodio y los términos complementarios yodo/deficiencia, exceso. Se obtuvieron 141 artículos y se revisaron 50 aplicando como criterio de inclusión el abordaje de la implementación de la política de yodación.
Resultados Se identificaron siete desafíos: sostenibilidad de la política, eliminar la brecha entre la explotación y la comercialización de la sal, prevenir la fortificación indiscriminada de los alimentos, promover la educación sobre la ingesta de sal yodada, controlar la ingesta excesiva de yodo, equilibrar la ingesta óptima de yodo con la reducción del consumo de cloruro de sodio y producir suficiente información oficial sobre la política.
Conclusión La yodación universal de la sal es una política que requiere mayor sensibilidad a las situaciones locales de cada país para mitigar efectivamente el problema de salud pública de los desórdenes por deficiencia y exceso en la ingesta de yodo alrededor del mundo.
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Urmatova B, Shin H, Shon S, Abdyldayeva Z, Ishaeva E, Knyazeva V. Prevalence of Iodine Deficiency among School Children from New Settlement in Kyrgyzstan. CHILDREN (BASEL, SWITZERLAND) 2021; 8:children8090817. [PMID: 34572249 PMCID: PMC8470210 DOI: 10.3390/children8090817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/06/2021] [Accepted: 09/13/2021] [Indexed: 06/13/2023]
Abstract
This study assesses the status of iodine deficiency among at risk-children and adolescents living in migrant settlements in the Kyrgyz Republic. Children aged 7-15 years from two regional primary schools in the new settlement regions were screened for cognitive and behavioural signs of iodine deficiency using questionnaires. The functional state of the thyroid gland was assessed using ultrasonography and blood tests. Out of 1058 schoolchildren, 15.8% showed signs of iodine deficiency. Female children aged 10-12 years showed a higher prevalence of iodine deficiency. The families of schoolchildren reported limited use of seafood and iodised salt. Children in the migrant regions were at risk of iodine deficiency disorder. Among children, clinical manifestations of iodine deficiency were observed as negative hormonal levels or the presence of goitre. Further investigation on standardised screening instruments for iodine deficiency and the relationship among multilevel analyses are warranted.
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Affiliation(s)
- Begaiym Urmatova
- Department of Faculty Pediatrics, Kyrgyz State Medical Academy, 92 Akhunbayev St, Bishkek 720020, Kyrgyzstan; (B.U.); (Z.A.); (E.I.); (V.K.)
| | - Hyunsook Shin
- College of Nursing Science, Kyung Hee University, Seoul 02447, Korea
| | - Soonyoung Shon
- College of Nursing, Keimyung University, Daegu 42601, Korea;
| | - Zeinep Abdyldayeva
- Department of Faculty Pediatrics, Kyrgyz State Medical Academy, 92 Akhunbayev St, Bishkek 720020, Kyrgyzstan; (B.U.); (Z.A.); (E.I.); (V.K.)
| | - Elmira Ishaeva
- Department of Faculty Pediatrics, Kyrgyz State Medical Academy, 92 Akhunbayev St, Bishkek 720020, Kyrgyzstan; (B.U.); (Z.A.); (E.I.); (V.K.)
| | - Valeriya Knyazeva
- Department of Faculty Pediatrics, Kyrgyz State Medical Academy, 92 Akhunbayev St, Bishkek 720020, Kyrgyzstan; (B.U.); (Z.A.); (E.I.); (V.K.)
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