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Nazeri P, Pearce EN, Farrokhzad N, Baghalha F, Shariat M, Azizi F. Do Postpartum Maternal Iodine Status or Supplementation Affect Thyroid Function After Delivery? A Systematic Review and Meta-Analysis. Biol Trace Elem Res 2024; 202:3425-3441. [PMID: 37966688 DOI: 10.1007/s12011-023-03934-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/24/2023] [Indexed: 11/16/2023]
Abstract
The aim of this systematic review and meta-analysis was, for the first time, to explore whether postpartum maternal iodine status or supplementation is associated with thyroid function after delivery. The MEDLINE/PubMed, Web of Science, Embase, and Scopus were searched up to December 2021 to identify relevant studies. The pooled mean thyroid stimulating hormone (TSH), free thyroxine (fT4), and thyroxine (T4) concentrations and 95% confidence intervals (CIs) were estimated based on maternal urinary iodine concentration (UIC) (< 50, 50-100, 100-200, and > 200 µg/L) or breast milk iodine concentration (BMIC) (< 100 µg/L vs. ≥ 100 µg/L) during postpartum. A fixed/random effects model was used based on the absence/presence of heterogeneity, respectively. The study is registered with PROSPERO, number CRD42022336145. A total of 2175 studies were identified, of which 18 were eligible for the meta-analysis. The pooled values for TSH, fT4, and T4 concentrations in all subgroups were within the normal range; however, except for TSH, comparing the 95% CI showed no statistically significant difference among different subgroups. The pooled mean for TSH concentration in women with UIC > 200 µg/L was 2.23 mIU/L, whereas the corresponding values in women with UIC < 50, 50-100 and 100-200 µg/L were 0.56, 0.56 and 0.95 mIU/L, respectively. Thyroid hormones in women with BMIC < 100 µg/L and ≥ 100 µg/L were within the normal range. Iodine supplementation during postpartum was not associated with any differences in thyroid parameters, compared to non-supplemented women. In conclusion, iodine status or supplementation had no effect on thyroid hormones in postpartum women.
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Affiliation(s)
- Pantea Nazeri
- Breastfeeding Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Maternal, Fetal and Neonatal Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Elizabeth N Pearce
- Section of Endocrinology, Diabetes and Nutrition, Boston University Chobanian & Avedisian School of Medicine, Boston, USA.
| | - Nahid Farrokhzad
- Maternal, Fetal and Neonatal Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Baghalha
- Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mamak Shariat
- Maternal, Fetal and Neonatal Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Wu Y, Long HH, Zhang SJ, Li MM, Chen CG, Wang C, Sheng ZY, Ye YB, Zuo SY, Pan WJ, Liu ZM. Reference Intervals of Serum Iodine Concentration in Chinese Pregnant Women. Biol Trace Elem Res 2024; 202:2457-2465. [PMID: 37713053 DOI: 10.1007/s12011-023-03859-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 09/11/2023] [Indexed: 09/16/2023]
Abstract
The study aims to establish trimester-specific reference ranges for serum iodine (SI) in Chinese pregnant women and explore its associations with maternal and infantile thyroid function. Apparently healthy pregnant women were enrolled during their first antenatal visit. Fasting venous and spot urine samples were collected for determining serum and urinary iodine (UI) levels by a validated inductively coupled plasma mass spectrometry. Serum free triiodothyronine (FT3), free thyroxine (FT4), thyrotropin (TSH), and neonatal TSH levels were tested by electro-chemiluminescent assay. The reference ranges of SI were established by percentile method and reported as 2.5-97.5%. ROC analysis was applied to compare the discriminative ability of SI, UI, and UI to urinary creatine ratio (UI /UCr) in early pregnancy for various thyroid conditions. The trimester-specific reference ranges of SI for Chinese pregnant women were 60.91-114.53 μg/L for the first trimester (T1, n = 1029), 54.57-103.42 μg/L for the second trimester (T2, n = 379), and 52.03-110.40 μg/L for the third trimester (T3, n = 455). Maternal SI at T1 but not UI and UI/UCr was significantly correlated with FT3 (r = 0.393, P < 0.001), FT4 (r = 0.637, P < 0.001), and TSH (r = -0.299, P<0.001). Maternal SI change% from T1 to T2 (but not SI change% from T1 to T3) had marginal correlation with neonatal TSH (r=-0.106, P=0.046). ROC analysis showed that maternal SI at T1 had better predictability for several thyroid conditions than UIC and UI/UCr.
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Affiliation(s)
- Yi Wu
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University (North Campus), Guangzhou, 510080, People's Republic of China
| | - Huan-Huan Long
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University (North Campus), Guangzhou, 510080, People's Republic of China
| | - Su-Juan Zhang
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University (North Campus), Guangzhou, 510080, People's Republic of China
| | - Min-Min Li
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University (North Campus), Guangzhou, 510080, People's Republic of China
| | - Chao-Gang Chen
- Department of Clinical Nutrition, The Second Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510235, People's Republic of China
| | - Cheng Wang
- Department of Clinical Nutrition, The Second Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510235, People's Republic of China
| | - Zheng-Yu Sheng
- Department of Paediatrics, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Yan-Bin Ye
- Department of Clinical Nutrition, The First Affiliated Hospital, Jinan University, Guangzhou, 510632, People's Republic of China
| | - Shu-Yu Zuo
- Department of Clinical Nutrition, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Wen-Jing Pan
- Huizhou First Maternal and Child Health Care Hospital, Guangdong Province, Huizhou, 516001, People's Republic of China.
| | - Zhao-Min Liu
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University (North Campus), Guangzhou, 510080, People's Republic of China.
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Evidence-Based Recommendations for an Optimal Prenatal Supplement for Women in the U.S., Part Two: Minerals. Nutrients 2021; 13:nu13061849. [PMID: 34071548 PMCID: PMC8229801 DOI: 10.3390/nu13061849] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/18/2021] [Accepted: 05/22/2021] [Indexed: 02/08/2023] Open
Abstract
The levels of many essential minerals decrease during pregnancy if un-supplemented, including calcium, iron, magnesium, selenium, zinc, and possibly chromium and iodine. Sub-optimal intake of minerals from preconception through pregnancy increases the risk of many pregnancy complications and infant health problems. In the U.S., dietary intake of minerals is often below the Recommended Dietary Allowance (RDA), especially for iodine and magnesium, and 28% of women develop iron deficiency anemia during their third trimester. The goal of this paper is to propose evidence-based recommendations for the optimal level of prenatal supplementation for each mineral for most women in the United States. Overall, the evidence suggests that optimal mineral supplementation can significantly reduce a wide range of pregnancy complications (including anemia, gestational hypertension, gestational diabetes, hyperthyroidism, miscarriage, and pre-eclampsia) and infant health problems (including anemia, asthma/wheeze, autism, cerebral palsy, hypothyroidism, intellectual disability, low birth weight, neural tube defects, preterm birth, rickets, and wheeze). An evaluation of 180 commercial prenatal supplements found that they varied widely in mineral content, often contained only a subset of essential minerals, and the levels were often below our recommendations. Therefore, there is a need to establish recommendations on the optimal level of mineral supplementation during pregnancy.
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Neven KY, Cox B, Cosemans C, Gyselaers W, Penders J, Plusquin M, Roels HA, Vrijens K, Ruttens A, Nawrot TS. Lower iodine storage in the placenta is associated with gestational diabetes mellitus. BMC Med 2021; 19:47. [PMID: 33602219 PMCID: PMC7893873 DOI: 10.1186/s12916-021-01919-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 01/19/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The micronutrient iodine is essential for a healthy intrauterine environment and is required for optimal fetal growth and neurodevelopment. Evidence linking urinary iodine concentrations, which mainly reflects short-term iodine intake, to gestational diabetes mellitus (GDM) is inconclusive. Although the placental concentrations would better reflect the long-term gestational iodine status, no studies to date have investigated the association between the placental iodine load and the risk at GDM. Moreover, evidence is lacking whether placental iodine could play a role in biomarkers of insulin resistance and β-cell activity. METHODS We assessed the incidence of GDM between weeks 24 and 28 of gestation for 471 mother-neonate pairs from the ENVIRONAGE birth cohort. In placentas, we determined the iodine concentrations. In maternal and cord blood, we measured the insulin concentrations, the Homeostasis Model Assessment (HOMA) for insulin resistance (IR) index, and β-cell activity. Logistic regression was used to estimate the odds ratios (OR) of GDM, and the population attributable factor (PAF) was calculated. Generalized linear models estimated the changes in insulin, HOMA-IR, and β-cell activity for a 5 μg/kg increase in placental iodine. RESULTS Higher placental iodine concentrations decreased the risk at GDM (OR = 0.82; 95%CI 0.72 to 0.93; p = 0.003). According to the PAF, 54.2% (95%CI 11.4 to 82.3%; p = 0.0006) of the GDM cases could be prevented if the mothers of the lowest tertile of placental iodine would have placental iodine levels as those belonging to the highest tertile. In cord blood, the plasma insulin concentration was inversely associated with the placental iodine load (β = - 4.8%; 95%CI - 8.9 to - 0.6%; p = 0.026). CONCLUSIONS Higher concentrations of placental iodine are linked with a lower incidence of GDM. Moreover, a lower placental iodine load is associated with an altered plasma insulin concentration, HOMA-IR index, and β-cell activity. These findings postulate that a mild-to-moderate iodine deficiency could be linked with subclinical and early-onset alterations in the normal insulin homeostasis in healthy pregnant women. Nevertheless, the functional link between gestational iodine status and GDM warrants further research.
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Affiliation(s)
- Kristof Y Neven
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Bianca Cox
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Charlotte Cosemans
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | | | - Joris Penders
- Laboratory of Clinical Biology, East-Limburg Hospital, Genk, Belgium
| | - Michelle Plusquin
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Harry A Roels
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium.,Louvain Centre for Toxicology and Applied Pharmacology, Université catholique de Louvain, Brussels, Belgium
| | - Karen Vrijens
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Ann Ruttens
- Sciensano, SD Chemical and Physical Health Risks, Tervuren, Belgium
| | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium. .,Department of Public Health & Primary Care, Leuven University, Leuven, Belgium.
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Kabthymer RH, Shaka MF, Ayele GM, Malako BG. Systematic review and meta-analysis of iodine deficiency and its associated factors among pregnant women in Ethiopia. BMC Pregnancy Childbirth 2021; 21:106. [PMID: 33541277 PMCID: PMC7863485 DOI: 10.1186/s12884-021-03584-0] [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: 08/13/2020] [Accepted: 01/22/2021] [Indexed: 11/24/2022] Open
Abstract
Background Iodine deficiency (ID) is a global public health problem and its impact is more pronounced in low-income countries. During pregnancy, iodine requirement is known to elevate sharply, making pregnant women, especially those living in low-income countries highly vulnerable to iodine deficiency. This study aims to assess the prevalence of iodine deficiency and its associated factors among pregnant women in Ethiopia. Methods A systematic literature search was performed by using PubMed, CINAHL, Web of science, global health, and Google scholar electronic databases. Two authors independently extracted all the necessary data using a structured data extraction format. Data analysis was done using STATA Version 14. The heterogeneity of the studies was assessed by using I2 test. A random-effects model was used to estimate the pooled prevalence and pooled odds ratio. The presence of publication bias was checked using Funnel plot and Egger’s test. Results One thousand one hundred and sixteen studies were reviewed and seven studies fulfilling the inclusion criteria were included in the meta-analysis. The meta-analysis of seven studies that included 2190 pregnant women showed a pooled prevalence of iodine deficiency during pregnancy to be 68.76% (95% CI: 55.21–82.31). In a subgroup analysis, the prevalence in Oromia region is 71.93% (95% CI: 54.87–88.99) and in Amhara region is 60.93% (95% CI: 57.39–64.48). Iodized salt use (AOR = 0.18; 95% CI: 0.08–0.44) and 1st trimester pregnancy (AOR = 0.68; 95% CI: 0.47–0.99) were found to have a significant association with iodine deficiency. Conclusions The prevalence of iodine deficiency during pregnancy using urine iodine is considerably high in Ethiopia. Using iodized salt is found to reduce the burden. Hence, there is a need to strengthen iodization programs to tackle the problem. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-03584-0.
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Affiliation(s)
- Robel Hussen Kabthymer
- College of Health sciences and Medicine, School of Public Health, Dilla University, P.O. Box 419, Dilla, Ethiopia.
| | - Mohammed Feyisso Shaka
- College of Health sciences and Medicine, School of Public Health, Dilla University, P.O. Box 419, Dilla, Ethiopia
| | - Getnet Melaku Ayele
- College of Health sciences and Medicine, Department of Midwifery, Dilla University, P.O. Box 419, Dilla, Ethiopia
| | - Bereket Geze Malako
- World Vision Ethiopia, Sodo Program coordination office, Wolaita Sodo, Ethiopia
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Zhou H, Ma ZF, Lu Y, Pan B, Shao J, Wang L, Du Y, Zhao Q. Assessment of Iodine Status among Pregnant Women and Neonates Using Neonatal Thyrotropin (TSH) in Mainland China after the Introduction of New Revised Universal Salt Iodisation (USI) in 2012: A Re-Emergence of Iodine Deficiency? Int J Endocrinol 2019; 2019:3618169. [PMID: 31687019 PMCID: PMC6800896 DOI: 10.1155/2019/3618169] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 09/02/2019] [Accepted: 09/11/2019] [Indexed: 12/11/2022] Open
Abstract
Iodine deficiency during pregnancy can cause iodine deficiency disorders (IDD). However, it is unclear about iodine and thyroid status of Chinese pregnant women and neonates after the implementation of the revised universal salt iodisation (USI) level in 2012. Therefore, the aim of the cross-sectional study was to determine iodine nutrition and thyroid status among pregnant women and their neonates in China after the implementation of USI. Medical records of pregnant women and neonates in Northern Jiangsu People's Hospital between January 2016 and December 2017 were reviewed and included. We included 3060 mother-and-newborn pairs in the study. Mean age of participants was 28.2 ± 4.1 years. TSH, FT3, and FT4 of participants were within normal reference range. The overall mean neonatal TSH, birth weight, and prevalence of low birth weight (LBW) were 4.86 ± 2.06 mIU/L, 3358 ± 455 g, and 3.2%, respectively. The prevalence of neonatal TSH values >5 mIU/L was 29.3%, suggesting iodine deficiency in the region. In conclusion, our results indicated iodine deficiency in the region, according to the neonatal TSH cutoff recommended by WHO/UNICEF/IGD. More efforts are urgently required to improve iodine status of pregnant women in the region in order to prevent a re-emergence of iodine deficiency.
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Affiliation(s)
- Hang Zhou
- Clinical Medical College, Yangzhou University, Yangzhou 225009, Jiangsu Province, China
- Department of Clinical Nutrition, Northern Jiangsu People's Hospital, Yangzhou 225001, Jiangsu Province, China
| | - Zheng Feei Ma
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou 215123, Jiangsu Province, China
| | - Yiming Lu
- Clinical Medical College, Yangzhou University, Yangzhou 225009, Jiangsu Province, China
- Department of Orthopedics, Northern Jiangsu People's Hospital, Yangzhou 225001, Jiangsu Province, China
| | - Binyu Pan
- Department of Clinical Nutrition, The First People's Hospital of Wujiang District, Suzhou 215200, Jiangsu Province, China
| | - Jian Shao
- Clinical Medical College, Yangzhou University, Yangzhou 225009, Jiangsu Province, China
- Department of Clinical Nutrition, Northern Jiangsu People's Hospital, Yangzhou 225001, Jiangsu Province, China
| | - Liya Wang
- Clinical Medical College, Yangzhou University, Yangzhou 225009, Jiangsu Province, China
- Department of Clinical Nutrition, Northern Jiangsu People's Hospital, Yangzhou 225001, Jiangsu Province, China
| | - Yanyan Du
- Clinical Medical College, Yangzhou University, Yangzhou 225009, Jiangsu Province, China
- Department of Clinical Nutrition, Northern Jiangsu People's Hospital, Yangzhou 225001, Jiangsu Province, China
| | - Qihua Zhao
- Clinical Medical College, Yangzhou University, Yangzhou 225009, Jiangsu Province, China
- Department of Clinical Nutrition, Northern Jiangsu People's Hospital, Yangzhou 225001, Jiangsu Province, China
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Repeated KI Prophylaxis in Case of Prolonged Exposure to Iodine Radioisotopes: Pharmacokinetic Studies in Adult Rats. Pharm Res 2018; 35:227. [PMID: 30298383 DOI: 10.1007/s11095-018-2515-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 10/02/2018] [Indexed: 02/07/2023]
Abstract
PURPOSE To propose a new and effective dose regimen for stable potassium iodide (KI) repeated prophylaxis in case of prolonged exposure to radioactive iodine. METHODS The pharmacokinetics of iodine was determined in rats by compartmental analyses after intravenous and oral administrations of the optimal dose of 1 mg/kg KI, which was previously selected in a dose-effect study. The thyroid protection against iodine-125 incorporation was followed during 24 h after a single oral dosing of KI. A repeated KI prophylaxis was modeled using initial estimates of iodine pharmacokinetic parameters. RESULTS A dose regimen consisting in administrations of 1 mg/kg daily for 8 days was selected and studied. Plasma iodine concentrations predicted by simulation were verified by experimental data and varied after the third dose of KI between 174 and 1190 μg/l. The inhibition study of iodine-125 binding in the thyroid as a function of the time showed that the protection effect of KI could be correlated to stable iodine plasma concentrations. Hence, a theoretical decrease in iodine-125 thyroid uptake from 63 to 88% could be achieved in a 24 h-interval between two KI doses. CONCLUSION Given the satisfactory levels of thyroid protection, this dose regimen could be envisaged in order to extent KI indications for repeated prophylaxis.
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Chong W, Shi X, Shan Z, Teng X, Teng D, Guan H, Li Y, Jin Y, Yu X, Fan C, Yang F, Dai H, Yu Y, Li J, Chen Y, Zhao D, Hu F, Mao J, Gu X, Yang R, Tong Y, Wang W, Gao T, Li C, Teng W. Tg in Adults as a Sensitive Biomarker of Iodine Status: A 5-Year Follow up Population Study in Different Levels of Iodine Intake Regions. PLoS One 2015; 10:e0135553. [PMID: 26266530 PMCID: PMC4534098 DOI: 10.1371/journal.pone.0135553] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Accepted: 07/24/2015] [Indexed: 11/18/2022] Open
Abstract
This study was to evaluate the usefulness of serum thymoglobulin (Tg) in adults to assess iodine status through a 5-year cohort study which was conducted in three regions with different levels of iodine intake: mild deficiency, more than adequate, and excess, from 1999 to 2004 in China. A total of 3099 subjects over 14 years old with normal serum levels of Tg in 1999 were eligible, of whom 2448 were followed in 2004. Serum levels of thyroid hormones and thyroid autoantibodies as well as urine iodine were measured, and B-mode ultrasonography of the thyroid was performed. A general linear model was performed to determine the determinant factors of serum Tg. Among subjects with mildly deficient iodine intake, those with more than adequate intake, and those with excessive intake, the baseline levels of serum Tg were substantially different (7.5μg/L, 5.9μg/L, and 6.8μg/L respectively, P<0.01), which were associated with age, sex, the rate of positive TgAb, abnormal thyroid volume, abnormal TSH, and positive personal history of thyroid diseases. The data from 1856 subjects with normal range of thyroid parameters but no personal history of thyroid diseases were analyzed to clarify the effect of iodine intake on Tg. Among these three regions, the serum Tg levels were substantially different in both 1999 and 2004, with a similar pattern for increased Tg (ΔTg) (3.1μg/L, 2.5μg/L and 3.5μg/L respectively, P<0.01). The general linear model analysis revealed that age, Tg, and baseline TSH levels were the determinants of ΔTg besides iodine intake. In conclusion, serum Tg in adults, resulting from a time-accumulative effect of iodine exposure, is a useful biomarker of regional iodine intake.
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Affiliation(s)
- Wei Chong
- Department of Emergency, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China
| | - Xiaoguang Shi
- Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China
| | - Zhongyan Shan
- Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China
| | - Xiaochun Teng
- Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China
| | - Di Teng
- Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China
| | - Haixia Guan
- Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China
| | - Yushu Li
- Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China
| | - Ying Jin
- Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China
| | - Xiaohui Yu
- Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China
| | - Chenling Fan
- Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China
| | - Fan Yang
- Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China
| | - Hong Dai
- Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China
| | - Yang Yu
- Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China
| | - Jia Li
- Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China
| | - Yanyan Chen
- Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China
| | - Dong Zhao
- Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China
| | - Fengnan Hu
- Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China
| | - Jinyuan Mao
- Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China
| | - Xiaolan Gu
- Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China
| | - Rong Yang
- Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China
| | - Yajie Tong
- Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China
| | - Weibo Wang
- Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China
| | - Tianshu Gao
- Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China
| | - Chenyang Li
- Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China
| | - Weiping Teng
- Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, People’s Republic of China
- * E-mail:
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Physiological sodium concentrations enhance the iodide affinity of the Na+/I- symporter. Nat Commun 2014; 5:3948. [PMID: 24888603 PMCID: PMC4248369 DOI: 10.1038/ncomms4948] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Accepted: 04/24/2014] [Indexed: 01/23/2023] Open
Abstract
The Na(+)/I(-) symporter (NIS) mediates active I(-) transport--the first step in thyroid hormonogenesis--with a 2Na(+):1I(-) stoichiometry. NIS-mediated (131)I(-) treatment of thyroid cancer post-thyroidectomy is the most effective targeted internal radiation cancer treatment available. Here to uncover mechanistic information on NIS, we use statistical thermodynamics to obtain Kds and estimate the relative populations of the different NIS species during Na(+)/anion binding and transport. We show that, although the affinity of NIS for I(-) is low (Kd=224 μM), it increases when Na(+) is bound (Kd=22.4 μM). However, this Kd is still much higher than the submicromolar physiological I(-) concentration. To overcome this, NIS takes advantage of the extracellular Na(+) concentration and the pronounced increase in its own affinity for I(-) and for the second Na(+) elicited by binding of the first. Thus, at physiological Na(+) concentrations, ~79% of NIS molecules are occupied by two Na(+) ions and ready to bind and transport I(-).
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Stagnaro-Green A, Abalovich M, Alexander E, Azizi F, Mestman J, Negro R, Nixon A, Pearce EN, Soldin OP, Sullivan S, Wiersinga W. Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and postpartum. Thyroid 2011; 21:1081-125. [PMID: 21787128 PMCID: PMC3472679 DOI: 10.1089/thy.2011.0087] [Citation(s) in RCA: 951] [Impact Index Per Article: 73.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Alex Stagnaro-Green
- Department of Medicine, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia 20037, USA.
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Kahric-Janicic N, Soldin SJ, Soldin OP, West T, Gu J, Jonklaas J. Tandem mass spectrometry improves the accuracy of free thyroxine measurements during pregnancy. Thyroid 2007; 17:303-11. [PMID: 17465859 PMCID: PMC3641793 DOI: 10.1089/thy.2006.0303] [Citation(s) in RCA: 121] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Pregnancy is a time of rapidly changing demands on the thyroid axis, and knowledge of thyroid hormone levels, especially during the first trimester, is important for ensuring maternal and fetal health. The thyroid hormone assays currently in use become more inaccurate at extremes of binding protein concentrations and when heterophilic antibodies are present. Pregnancy is characterized by both these conditions, making accurate determination of free thyroid hormone levels by conventional direct analog immunoassay methods difficult. The objective of this study was to characterize the performance of a novel tandem mass spectrometric assay for free thyroxine during the physiologic conditions of pregnancy. DESIGN Healthy women without a history of thyroid abnormalities were recruited from the obstetrics and gynecology and endocrinology clinics of a university medical center and their thyroid status was monitored. Free thyroxine levels were assessed by both immunoassay and tandem mass spectrometry during the course of their pregnancy. Serum thyrotropin levels were also measured. The distributions of free thyroid concentrations obtained by the two assays were compared. MAIN OUTCOME The tandem mass spectrometry and immunoassay values did not correlate well with each other. However, tandem mass spectrometry values correlated well with the current gold standard equilibrium dialysis values. Moreover, the good agreement between equilibrium dialysis and tandem mass spectrometry was maintained across all weeks of gestation. CONCLUSIONS We conclude that tandem mass spectrometry has a superior performance to immunoassay for the measurement of free thyroxine during pregnancy. Furthermore, it is ideally suited to generating trimester-specific reference intervals for free thyroxine levels. Future studies will determine if it is a better assay to use in most clinical circumstances.
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Affiliation(s)
| | - Steven J. Soldin
- Division of Endocrinology, Georgetown University Medical Center, Washington, DC
- Bioanalytic Core Laboratory, General Clinical Research Center, Georgetown University Medical Center, Washington, DC, and Department of Laboratory Medicine, Children’s National Medical Center, Washington, DC
| | - Offie P. Soldin
- Division of Endocrinology, Georgetown University Medical Center, Washington, DC
- Departments of Oncology and Medicine, Georgetown University Medical Center, Washington, DC
| | - Threvia West
- Department of Obstetrics and Gynecology, Georgetown University Medical Center, Washington, DC
| | - Jianghong Gu
- Bioanalytic Core Laboratory, General Clinical Research Center, Georgetown University Medical Center, Washington, DC, and Department of Laboratory Medicine, Children’s National Medical Center, Washington, DC
| | - Jacqueline Jonklaas
- Division of Endocrinology, Georgetown University Medical Center, Washington, DC
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Abstract
BACKGROUND The status of iodine nutrition of a population can be determined by measurement of urinary iodine concentrations since it is thought to indicate dietary iodine intake. Normally, these results are compared to population-based criteria, since there are no reference ranges for urinary iodine. OBJECTIVE To determine the percentile ranges for urinary iodide (UI) concentrations in normal individuals in the United States. MATERIALS AND METHODS The third National Health and Nutrition Examination Survey (NHANES III) (1988-1994) database of the civilian, non-institutionalized, iodine-sufficient US population was used. The 2.5th to 97.5th percentile ranges for urinary iodine and for urinary iodine per gram creatinine ratio (UI/Cr) (microg/g) were calculated for females and males, 6-89 years of age, each stratified by age groups. RESULTS AND CONCLUSIONS We calculated the percentile ranges for urinary iodine. After exclusions of subjects with goiter or thyroid disease, the study sample included 21,530 subjects; 10,439 males and 11,091 females. For women of childbearing age (14-44 years), urinary iodine concentration 2.5th to 97.5th percentiles are 1.8-65 microg/dl or 36-539 microg/g creatinine. For pregnant women, the ranges are 4.2-55 microg/dl or 33-535 microg/g creatinine.
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Affiliation(s)
- Offie Porat Soldin
- Soldin Research and Consultants, Incorporated, 6308 Walhonding Road, Bethesda, MD 20816, USA.
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