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Ali J, Mohiuddin M, Wang X, Hussain Z, Irshad M, Zia M, Pervez R, Okla MK, Ahmad S. Spatial variation in iodine content with relation to soil physicochemical properties in lower Himalayan region. ENVIRONMENTAL RESEARCH 2024; 251:118569. [PMID: 38431069 DOI: 10.1016/j.envres.2024.118569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 02/12/2024] [Accepted: 02/26/2024] [Indexed: 03/05/2024]
Abstract
Topography of a place has a significant impact on soil characteristics that ultimately influence soil iodine levels. Lower Himalayan region (LHR) in Pakistan has a wide range of climatic and geological variations. Hence, an investigation was conducted to analyze the iodine concentration and other physicochemical properties of soils in two LHR districts, Haripur and Mansehra. Spatial analysis indicated a decrease in iodine levels in the mountainous regions in comparison to the flat portions of LHR. Soil samples obtained from different locations across Haripur had a stronger affinity for iodine due to variations in solubility and adsorption of iodine to soil clay components, which can be attributed to lower pH, higher organic matter, and a higher cation exchange capacity (CEC). In contrast to the plains of Haripur, elevated locations in the Mansehra district had decreased levels of iodine, along with a higher soil pH and reduced soil organic matter. The soil erosion and depletion of soil micronutrients in the hilly region of Mansehra may be attributed to the unfavorable soil conditions and excessive precipitation. Presence of clay, iron (Fe), and aluminum (Al) in the soil led to a rise in iodine levels. Iodine concentrations exhibited an inverse relationship with soil acidity. Study revealed a direct correlation between soil iodine levels and their cation exchange capacity (CEC) and clay content. This study aims to gather fundamental data for the chosen regions of LHR to address illnesses caused by iodine deficiency.
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Affiliation(s)
- Jawad Ali
- Environment Research Institute, Shandong University, Qingdao, 266237, China.
| | - Muhammad Mohiuddin
- Department of Environmental Sciences, Kohsar University Murree, Murree 47150, Pakistan
| | - Xinfeng Wang
- Environment Research Institute, Shandong University, Qingdao, 266237, China.
| | - Zahid Hussain
- Department of Development Studies, COMSATS University Islamabad, Abbottabad Campus, Abbottabad, Pakistan
| | - Muhammad Irshad
- Department of Environmental Sciences, COMSATS University Islamabad, Abbottabad Campus, Abbottabad, Pakistan
| | - Munir Zia
- Research and Development Coordinator, Fauji Fertilizer Company Ltd., Rawalpindi, Punjab, Pakistan
| | - Rashid Pervez
- College of Marine Sciences, Shantou University, China
| | - Mohammad K Okla
- Department of Botany and Microbiology, College of Science, King Saud University, P.O. Box 2455, Riyadh, 11451, Saudi Arabia
| | - Shakeel Ahmad
- School of Environment, Tsinghua University, Beijing, 100084, China
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Wei R, Wang Z, Zhang X, Wang X, Xu Y, Li Q. Burden and trends of iodine deficiency in Asia from 1990 to 2019. Public Health 2023; 222:75-84. [PMID: 37531713 DOI: 10.1016/j.puhe.2023.06.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 06/19/2023] [Accepted: 06/26/2023] [Indexed: 08/04/2023]
Abstract
OBJECTIVES Understanding iodine deficiency (ID) burdens and trends in Asia can help guide effective intervention strategies. This study aims to report the incidence, prevalence, and disability-adjusted life years (DALYs) of ID in 48 Asian countries during the period 1990-2019. STUDY DESIGN Data on ID were retrieved from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 and estimated by age, sex, geographical region, and sociodemographic index (SDI). METHODS The estimated annual percentage change (EAPC) was calculated to evaluate the changing trend of age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), and age-standardized DALYs rate (ASDR) related to ID during the period 1990-2019. RESULTS In Asia, there were 126,983,965.8 cases with 5,466,213.1 new incidence and 1,765,995.5 DALYs of ID in 2019. Between 1999 and 2019, the EAPC in ASIR, ASPR and ASDR were -0.6 (95% confidence interval [CI], -0.8 to -0.4), -0.9 (95% CI, -1.2 to -0.7), and -1.6 (95% CI, -1.8 to -1.5), respectively. Malaysia charted the largest decrease in ASIR, ASPR, and ASDR (82.4%, 85.3%, and 80.9% separately), whereas the Philippines and Pakistan were the only two countries that witnessed an increase in ASIR and ASPR. ID burdens were more pronounced in women, countries located to the south of the Himalayas, and low-middle SDI regions. CONCLUSIONS The incidence, prevalence, and DALYs of ID in Asia substantially decreased from 1990 to 2019. Women and low-middle SDI countries have relatively high ID burdens. Governments need to pay constant attention to the implementation and monitoring of universal salt iodization.
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Affiliation(s)
- R Wei
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China; Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Z Wang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China; China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - X Zhang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China; China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - X Wang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China; China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Y Xu
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China.
| | - Q Li
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China.
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Bhattacharya S, Bera OP, Saleem SM, Hossain MM, Varshney DS, Kaur R, Rana RK, Tripathi S, Gokdemir O, Bacorro M, Mehta K, Singh A. Dietary salt consumption pattern as an antecedent risk factor for hypertension: Status, vision, and future recommendations. Clin Nutr ESPEN 2022; 47:422-430. [PMID: 35063238 DOI: 10.1016/j.clnesp.2021.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 11/15/2021] [Accepted: 12/04/2021] [Indexed: 12/26/2022]
Abstract
Multiple salt reduction strategies have been devised from time to time, addressing the issues of hypertension without considering the other essential factors, like the variability of salt sensitivity from the person to person. In this paper, we discuss how high salt consumption is one modifiable risk factor associated with hypertension among Indians, and there needs to be updated cut-off values. A thorough literature search on salt consumption articles on well-known search engines like Cochrane Library, PubMed, Google Scholar and Embase electronic database revealed a paucity of data in this field for India. Several studies revealed that the mean salt intake among the Indian populations ranges between 5.22 and 42.30 g/day. Moreover, among other risk factors analysed, salt intake (≥ 5 gm/day) was significantly associated with the development of hypertension. Although the need to address reduced salt intake for primordial prevention of hypertension and related cardiovascular diseases (CVDs) in India is well acknowledged by the key stakeholders, social and cultural beliefs, unorganized food retail sector and lack of existing food policing are some of the potential barriers that affect the progress and employment of such effective strategies. Some multinational food companies have already research is warranted to evaluate the contextual barriers and facilitators and to adopt effective strategies to improve awareness among consumers, to encourage the endorsement of salt reduction by the food industry, and to facilitate the adoption of countrywide consumer-friendly food labelling. We concluded that salt consumption is high in India, although this assessment has been done primarily by subjective methods in India. People all across are recommended the same cut-off value of dietary salt consumption regardless of the diversity in dietary patterns and environmental conditions across the country. There is an urgent need to address these issues through evidence-based population research.
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Affiliation(s)
| | - Om Prakash Bera
- National Consultant, Global Health Advocacy Incubator, India
| | | | - Md Mahbub Hossain
- Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A & M University, Texas, USA
| | | | - Ravneet Kaur
- Associate Professor of All India Institute of Medical Sciences, New Delhi, India
| | - Rishabh Kumar Rana
- Department of PSM, Patliputra Medical College and Hospital PMCH, Dhanbad, Jharkhand, India
| | | | - Ozden Gokdemir
- PhD Izmir University of Economics, Faculty of Medicine, Izmir, Turkey
| | - Madonna Bacorro
- Department of Family Medicine, University of Sto. Tomas Hospital, Espana, Manila, Philippines
| | - Kedar Mehta
- GMERS Medical College, Community Medicine, Gotri, Vadodara, India
| | - Amarjeet Singh
- Department of Community Medicine and School of Public Health, PGIMER, Chandigarh, India
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Al Ghali R, El-Mallah C, Obeid O, El-Saleh O, Smail L, Haroun D. Urinary minerals excretion among primary schoolchildren in Dubai-United Arab Emirates. PLoS One 2021; 16:e0255195. [PMID: 34351961 PMCID: PMC8341483 DOI: 10.1371/journal.pone.0255195] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 07/10/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction Urinary excretion of calcium (Ca), magnesium (Mg), phosphorus (P), iodine and fluoride is used to assess their statuses and/or the existence of metabolic abnormalities. In the United Arab Emirates (UAE), the urinary concentration of these minerals among children have not been documented. Materials and methods A cross-sectional study, including 593 subjects (232 boys and 361 girls), was conducted among healthy 6 to 11-year-old Emirati children living in Dubai. Non-fasting morning urine samples and anthropometrical measurements were collected and analyzed. Results were expressed as per mg of creatinine (Cr). Results On average, estimated Cr excretion was 17.88±3.12 mg/kg/d. Mean urinary Ca/Cr, Mg/Cr and P/Cr excretions were 0.08±0.07 mg/mg, 0.09±0.04 mg/mg, and 0.57±0.26 mg/mg respectively. Urinary excretion of Ca, Mg and P were found to decrease as age increased. Urinary excretion and predicted intake of fluoride were lower than 0.05 mg/kg body weight per day. Surprisingly, more than 50% of the children were found to have urinary iodine excretion level above adequate. Conclusion The Emirati schoolchildren had comparable levels of urinary Ca, Mg and P excretion to other countries. The 95% percentile allows the use of the current data as a reference value for the detection of mineral abnormalities. Fluoride excretion implies that Emirati children are at low risk of fluorosis. The level of urinary iodine excretion is slightly higher than recommended and requires close monitoring of the process of salt iodization to avoid the harmful impact of iodine overconsumption.
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Affiliation(s)
- Rola Al Ghali
- Department of Public Health and Nutrition, College of Natural and Health Sciences, Zayed University, Dubai, United Arab Emirates
| | - Carla El-Mallah
- Department of Nutrition and Food Science. Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Omar Obeid
- Department of Nutrition and Food Science. Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Ola El-Saleh
- Department of Medicine, School of Public Health, Imperial College London, London, United Kingdom
| | - Linda Smail
- Department of Mathematics and Statistics, College of Natural and Health Sciences, Zayed University, Dubai, United Arab Emirates
| | - Dalia Haroun
- Department of Public Health and Nutrition, College of Natural and Health Sciences, Zayed University, Dubai, United Arab Emirates
- * E-mail:
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BOLU S, İŞLEYEN F, TURĞUT M. Adıyaman ilinde guatrla başvuran çocuk hastalarda etiyolojik dağılım ile klinik ve laboratuvar özellikler. EGE TIP DERGISI 2020. [DOI: 10.19161/etd.756171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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McLean R. Dietary salt reduction for primary prevention of cardiovascular disease in Nepal. J Clin Hypertens (Greenwich) 2020; 22:280-282. [DOI: 10.1111/jch.13805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 12/24/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Rachael McLean
- Department of Preventive and Social Medicine Dunedin School of Medicine University of Otago Dunedin New Zealand
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Tamang B, Khatiwada S, Gelal B, Shrestha S, Mehta KD, Baral N, Shah GS, Lamsal M. Association of antithyroglobulin antibody with iodine nutrition and thyroid dysfunction in Nepalese children. Thyroid Res 2019; 12:6. [PMID: 31320934 PMCID: PMC6615089 DOI: 10.1186/s13044-019-0067-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 07/01/2019] [Indexed: 11/10/2022] Open
Abstract
Background Aberrant iodine intake and thyroid autoimmunity affect thyroid function. Deficiencies of iodine including thyroid disorders have serious impact on child physical and mental development. This study was conducted to investigate iodine nutrition, thyroid function and thyroid autoimmunity in the Nepalese children, and explore the association of thyroidal autoimmunity with iodine nutrition and thyroid dysfunction. Methods Five schools from Udayapur district of eastern Nepal were selected for the study. A total of 213 school children aged 6–12 years were enrolled, and anthropometric data, urine samples and blood samples were collected. Urinary iodine concentration (UIC), free triiodothyronine (fT3), free thyroxine (fT4), thyroid stimulating hormone (TSH), and antithyroglobulin antibody (TgAb) was measured. Independent T test, Man-Whitney test, Chi-square test and Fisher’s Exact test were used for testing statistical significance. Spearman’s correlation analysis was done to find association between variables. Results The median UIC with IQR, mean ± SD fT3, mean ± SD fT4, median TSH and TgAb with IQR was 150.0 μg/L (102.8; 204.0), 2.49 ± 0.83 pg/ml, 1.33 ± 0.42 ng/dl, 2.49 mIU/L (1.58; 4.29), and 21.40 IU/ml (15.54; 31.20) respectively. Elvated TgAb (≥30 IU/ml, thyroid autoimmune condition) was seen in 25.8% (n = 55) children. UIC was less than 100 μg/L in 17.4% (n = 37) of the children. Subclinical hypothyroidism, overt hypothyroidism and sublinical hyperthyroidism was seen in 1.4% (n = 3), 3.3% (n = 7) and 3.8% (n = 8) children respectively. A strong association of TgAb with UIC (r = − 0.210, p = 0.002) and thyroid hormones; fT3 (r = − 0.160, p = 0.019), fT4 (r = − 0.275, p < 0.001), and TSH (r = 0.296, p < 0.001) was seen. The relative risk for thyroid autoimmunity in children with UIC less than 100 μg/L was 1.784 (95% CI: 1.108–2.871, p = 0.024). Similarly, children with thyroid autoimmunity had higher relative risk [7.469 (95% CI: 2.790–19.995, p < 0.001)] for thyroid dysfunction. Conclusions School children of eastern Nepal have adequate iodine nutrition. Thyroid autoimmunity is very common, while thyroid dysfunction is sparse in children. An association of thyroid autoimmunity with iodine nutrition and thyroid dysfunction was seen in children.
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Affiliation(s)
- Binaya Tamang
- 1Department of Biochemistry, Universal College of Medical Sciences, Bhairahawa, Nepal
| | | | - Basanta Gelal
- 3Department of Biochemistry, B P Koirala Institute of Health Sciences, Ghopa, Dharan, Nepal
| | - Shrijana Shrestha
- 3Department of Biochemistry, B P Koirala Institute of Health Sciences, Ghopa, Dharan, Nepal
| | - Kishun Deo Mehta
- 3Department of Biochemistry, B P Koirala Institute of Health Sciences, Ghopa, Dharan, Nepal
| | - Nirmal Baral
- 3Department of Biochemistry, B P Koirala Institute of Health Sciences, Ghopa, Dharan, Nepal
| | - Gauri Shankar Shah
- 4Department of Paediatrics and Adolescent medicine, B P Koirala Institute of Health Sciences, Dharan, Nepal
| | - Madhab Lamsal
- 3Department of Biochemistry, B P Koirala Institute of Health Sciences, Ghopa, Dharan, Nepal
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8
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Tamang MK, Gelal B, Tamang B, Lamsal M, Brodie D, Baral N. Excess urinary iodine concentration and thyroid dysfunction among school age children of eastern Nepal: a matter of concern. BMC Res Notes 2019; 12:294. [PMID: 31133065 PMCID: PMC6537302 DOI: 10.1186/s13104-019-4332-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 05/22/2019] [Indexed: 11/17/2022] Open
Abstract
Objectives Deficiency as well as excess dietary iodine is associated with several thyroid disorders including Grave’s disease and goitre. Previously, cross sectional studies conducted among school children in Nepal showed high prevalence of iodine deficiency. In contrast, recently, few studies have revealed emerging trends of excess urinary iodine concentration in children. This paper, reports excess urinary iodine excretion and thyroid dysfunction among school age children from eastern Nepal. Results It was a community based cross sectional study in which we measured urinary iodine excretion levels among school age children at baseline and after educational program. The educational program consisted of audio-visual and pamphlets on thyroid health. We also screened them for thyroid function status by physical examination and measuring serum thyroid hormones. Our results show that 34.4% of the children had excess urinary iodine concentration above the WHO recommended levels. Overall, 3.2% of the children were identified to have thyroid dysfunction. Urinary iodine concentration was significantly different between types of salt used and between salt iodine content categories.
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Affiliation(s)
- Man Kumar Tamang
- Rotary Club of Dharan Ghopa, B. P. Koirala Institute of Health Sciences, Dharan, Nepal.
| | - Basanta Gelal
- Department of Biochemistry, B. P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Binaya Tamang
- Department of Biochemistry, B. P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Madhab Lamsal
- Department of Biochemistry, B. P. Koirala Institute of Health Sciences, Dharan, Nepal
| | | | - Nirmal Baral
- Department of Biochemistry, B. P. Koirala Institute of Health Sciences, Dharan, Nepal
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Assessment of thyroid function in children, adults and pregnant and lactating women after long-term salt iodisation measurements. Br J Nutr 2018; 119:1245-1253. [PMID: 29580306 DOI: 10.1017/s0007114518000570] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Universal salt iodisation (USI) has been successfully implemented in China for more than 15 years. Recent evidence suggests that the definition of 'adequate iodine' (100-199 µg/l) be revised to 'sufficient iodine' (100-299 µg/l) based on the median urinary iodine concentration (MUI) in school-age children. The objective of this study was to determine the prevalence of thyroid dysfunction in populations after long-term salt iodisation and examine whether the definition of adequate iodine can be broadened to sufficient iodine based on the thyroid function in four population groups. A cross-sectional survey was conducted in six provinces in the northern, central and southern regions of China. Four population groups consisting of 657 children, 755 adults, 347 pregnant women and 348 lactating women were recruited. Three spot urinary samples were collected over a 10-d period and blood samples were collected on the 1st day. In the study, among the adults, pregnant women and lactating women, the prevalence rates of elevated thyroglobulin antibody and thyroid microsomal antibody levels were 12·4, 8·5 and 7·8 %, and 12·1, 9·1 and 9·1 %, respectively. Abnormally high thyroid dysfunction prevalence was not observed after more than 15 years of USI in China because the thyroid dysfunction rates were all <5 %. The recommended range should be cautiously broadened from adequate iodine to sufficient iodine according to the MUI of school-age children considering the high levels of hormones and antibodies in the other populations. Adults, particularly pregnant women positive for thyroid antibodies, should be closely monitored.
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Huang H, Shi Y, Liang B, Cai H, Cai Q. Low Iodine in the Follicular Lumen Caused by Cytoplasm Mis-localization of Sodium Iodide Symporter may Induce Nodular Goiter. Biol Trace Elem Res 2017; 179:165-171. [PMID: 28190186 DOI: 10.1007/s12011-017-0960-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Accepted: 02/06/2017] [Indexed: 01/10/2023]
Abstract
Iodine is a key ingredient in the synthesis of thyroid hormones and also a major factor in the regulation of thyroid function. A local reduction of iodine content in follicular lumen leads to overexpression of local thyroid-stimulating hormone receptor (TSHr), which in turn excessively stimulates the regional thyroid tissue, and result in the formation of nodular goiter. In this study, we investigated the relationship between iodine content and sodium iodide symporter (NIS) expression by using the clinical specimens from patients with nodular goiter and explored the pathogenesis triggered by iodine deficiency in nodular goiter. In total, 28 patients were clinically histopathologically confirmed to have nodular goiter and the corresponding adjacent normal thyroid specimens were harvested simultaneously. Western blot and immunohistochemistry were performed to assay NIS expression and localization in thyrocytes of both nodular goiter and adjacent normal thyroid tissues. NIS expression mediated by iodine in follicular lumen was confirmed by follicular model in vitro. Meanwhile, radioscan with iodine-131were conducted on both nodular goiter and adjacent normal thyroid. Our data showed that NIS expression in nodular goiter was significantly higher than that in adjacent normal tissues, which was associated with low iodine in the follicular lumen. Abnormal localization of NIS and lower amount of radioactive iodine-131 were also found in nodular goiter. Our data implied that low iodine in the follicular lumen caused by cytoplasm mis-localization of NIS may induce nodular goiter.
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Affiliation(s)
- Huibin Huang
- Department of Endocrinology, The Second Affiliated Hospital of Fujian Medical University, No. 34 North Zhongshan Road, Quanzhou, Fujian, 362000, People's Republic of China.
| | - Yaxiong Shi
- Department of Endocrinology, The Second Affiliated Hospital of Fujian Medical University, No. 34 North Zhongshan Road, Quanzhou, Fujian, 362000, People's Republic of China
| | - Bo Liang
- Department of Endocrinology, The Second Affiliated Hospital of Fujian Medical University, No. 34 North Zhongshan Road, Quanzhou, Fujian, 362000, People's Republic of China
| | - Huiyao Cai
- Department of Endocrinology, The Second Affiliated Hospital of Fujian Medical University, No. 34 North Zhongshan Road, Quanzhou, Fujian, 362000, People's Republic of China
| | - Qingyan Cai
- Department of Endocrinology, The Second Affiliated Hospital of Fujian Medical University, No. 34 North Zhongshan Road, Quanzhou, Fujian, 362000, People's Republic of China
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Katagiri R, Yuan X, Kobayashi S, Sasaki S. Effect of excess iodine intake on thyroid diseases in different populations: A systematic review and meta-analyses including observational studies. PLoS One 2017; 12:e0173722. [PMID: 28282437 PMCID: PMC5345857 DOI: 10.1371/journal.pone.0173722] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 02/24/2017] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Although several reports concerning the association of iodine excess and thyroid disease have appeared, no systematic review of the association between iodine excess intake and thyroid diseases, especially hyperthyroidism and hypothyroidism, has yet been reported. METHOD We conducted a systematic search of Ovid MEDLINE, PubMed, Cochrane Central Register of Controlled Trials databases, Ichushi-Web and CiNii database for intervention trials and observational studies. Search terms were constructed from related words for excess AND iodine intake or excretion AND thyroid hormones or diseases AND study designs. After considering the qualitative heterogeneity among studies, a meta-analysis was conducted and odds ratios and 95% confidence intervals (CI) were estimated in random-effects models. A protocol was registered with PROSPERO (No. CRD42015028081). RESULTS 50 articles were included, including three intervention trials, six case-control studies, six follow-up studies and 35 cross-sectional studies. Three cross-sectional studies in adults included in meta-analysis. Odds ratio of overt and subclinical hypothyroidism between excess and adequate populations were 2.78 (CI:1.47 to 5.27) and 2.03 (CI:1.58 to 2.62) in adults, respectively. Source of excess iodine status was mainly iodized salt or water in included studies. CONCLUSION Although universal salt iodization has improved goiter rates, chronic exposure to excess iodine from water or poorly monitored salt are risk factors for hypothyroidism in free-living populations. Monitoring of both iodine concentration in salt as well as the iodine concentration in local drinking water are essential to preventing thyroid diseases. Hypothyroidism should be also carefully monitored in areas with excess iodine. Because of the low quality and limited number of included studies, further evidence and review are required.
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Affiliation(s)
- Ryoko Katagiri
- Department of Social and Preventive Epidemiology, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Xiaoyi Yuan
- Department of Social and Preventive Epidemiology, School of Public Health, the University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Satomi Kobayashi
- Department of Social and Preventive Epidemiology, School of Public Health, the University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo, Japan
- Department of Social and Preventive Epidemiology, School of Public Health, the University of Tokyo, Bunkyo-ku, Tokyo, Japan
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Henjum S, Kjellevold M, Ulak M, Chandyo RK, Shrestha PS, Frøyland L, Strydom EE, Dhansay MA, Strand TA. Iodine Concentration in Breastmilk and Urine among Lactating Women of Bhaktapur, Nepal. Nutrients 2016; 8:E255. [PMID: 27136582 PMCID: PMC4882668 DOI: 10.3390/nu8050255] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 04/15/2016] [Accepted: 04/21/2016] [Indexed: 11/24/2022] Open
Abstract
Adequate iodine concentration in breastmilk (BMIC) is essential for optimal neonatal thyroid hormone synthesis and neurological development in breastfed infants. For many decades, iodine deficiency has been a public health problem in Nepal. However, recently, excessive iodine intakes among Nepali infants have been reported. This study aimed to measure BMIC and urinary iodine concentration (UIC) among lactating women in a peri-urban area of Nepal. Iodine concentration was measured in spot urine (n = 485) and breastmilk samples (n = 291) of 500 randomly selected lactating women. The median (p25, p75) BMIC and median UIC were 250 (130, 370) µg/L and 230 (135-377) µg/L, respectively. Around 82% had BMIC > 100 µg/L, 61% had BMIC > 200 µg/L and 81% had UIC > 100 µg/L, 37% had >300 µg/L and 20% had >500 µg/L. In multiple linear regression models, time since birth (β 3.0, 95% CI (0.2, 5.0)) and UIC (β 1.0, 95% CI (0.1, 2.0)) were associated with BMIC, explaining 26% of the variance. A large proportion of the women had adequate BMIC and UIC; however, a subset had high iodine concentrations. These findings emphasize the importance of carefully monitoring iodine intake to minimize the risk of iodine excess and subsequently preventing transient iodine-induced hypothyroidism in breastfed infants.
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Affiliation(s)
- Sigrun Henjum
- Oslo and Akershus University College of Applied Sciences, P.O. Box 4, St. Olavs plass, Oslo 0130, Norway.
| | - Marian Kjellevold
- National Institute of Nutrition and Seafood Research (NIFES), Bergen 5817, Norway.
| | - Manjeswori Ulak
- Department of Child Health, Institute of Medicine, Tribhuvan University ,Maharajgunj, P.O. Box 1524, Kathmandu 44600, Nepal.
| | - Ram K Chandyo
- Centre for International Health, University of Bergen, P.O. Box 7800, Bergen 5020, Norway.
| | - Prakash S Shrestha
- Department of Child Health, Institute of Medicine, Tribhuvan University ,Maharajgunj, P.O. Box 1524, Kathmandu 44600, Nepal.
| | - Livar Frøyland
- National Institute of Nutrition and Seafood Research (NIFES), Bergen 5817, Norway.
| | - Emmerentia E Strydom
- Burden of Disease Research Unit, South African Medical Research Council, P.O. Box 19070, Tygerberg 7505, South Africa.
| | - Muhammad A Dhansay
- Burden of Disease Research Unit, South African Medical Research Council, P.O. Box 19070, Tygerberg 7505, South Africa.
- Division of Human Nutrition and Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg Hospital, Tygerberg 7505, South Africa.
| | - Tor A Strand
- Department of Research, Innlandet Hospital Trust, Lillehammer 2629, Norway.
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Huang H, Chen L, Liang B, Cai H, Cai Q, Shi Y. Upregulation of TSHR, TTF-1, and PAX8 in Nodular Goiter Is Associated with Iodine Deficiency in the Follicular Lumen. Int J Endocrinol 2016; 2016:2492450. [PMID: 27525008 PMCID: PMC4976194 DOI: 10.1155/2016/2492450] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 06/26/2016] [Indexed: 01/08/2023] Open
Abstract
Objective. It has been testified that iodine regulates thyroid function by controlling thyroid-restricted genes expression and is closely related to diffuse goiter and thyroid dysfunction. However, the effects of follicular lumen iodine, the main form of iodine reserve in the body, on thyroid-restricted genes in nodular goiter are poorly understood. In this study, correlations between follicular lumen iodine and the expressions of thyroid stimulating hormone receptor (TSHR), its transcription factors TTF-1, and PAX8 in nodular goiter were investigated. Patients. In this study, 30 resection specimens clinically histopathologically confirmed to have nodular goiter and 30 normal thyroid specimens from adjacent tissues of nodular goiter are used. Measurement. Western blot immunohistochemistry was performed to assay TSHR, TTF-1, and PAX8 in thyrocytes of nodular goiter as well as in extranodular normal thyroid tissues. Meanwhile, follicular lumen iodine of both nodular goiter and extranodular normal thyroid tissues was detected as well. Results. The TSHR, TTF-1, and PAX8 in nodular goiter were significantly higher than those in the controls. The iodine content in nodular goiter was significantly lower than those in control tissues. Conclusion. Upregulation of TSHR, TTF-1, and PAX8 is associated with low follicular lumen iodine content in nodular goiter.
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Affiliation(s)
- Huibin Huang
- Department of Endocrinology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian 362000, China
- *Huibin Huang:
| | - Lijun Chen
- Postgraduate School, The Second Clinical Medical College of Fujian Medical University, Quanzhou, Fujian 362000, China
| | - Bo Liang
- Department of Endocrinology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian 362000, China
| | - Huiyao Cai
- Department of Endocrinology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian 362000, China
| | - Qingyan Cai
- Department of Endocrinology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian 362000, China
| | - Yaxiong Shi
- Department of Endocrinology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian 362000, China
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