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Girschik C, Muchalla P, Kowall B, Zwanziger D, Erbel R, Ittermann T, Meisinger C, Stang A, Jöckel KH, Führer D. [Regional Differences in Thyroid Function Parameters: A Comparison of European Cohort Studies]. DAS GESUNDHEITSWESEN 2023; 85:175-180. [PMID: 36195110 PMCID: PMC11248100 DOI: 10.1055/a-1806-0707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2022]
Abstract
AIM OF THE STUDY The aim of the project was to investigate regional differences in thyroid stimulating hormone (TSH), and free thyroxine (fT4) concentrations and iodine status in comparable German and European cohort studies. METHODS Sex- and age-stratified TSH, fT4, and urine iodine concentrations of thyroid-healthy participants (age group 45-75 years) of the HNR (Heinz Nixdorf Recall) Study in the Ruhr region of Germany, the southern German KORA (Cooperative Health Research in the Augsburg Region) and northeastern German SHIP (Study of Health in Pomerania) studies, as well as the Norwegian HUNT (Nord-Trøndelag Health) study (age group 40-79 years), the English EPIC (European Prospective Investigation of Cancer)-Norfolk study, and the Dutch Rotterdam study were compared. The TSH reference range for the HNR study population was calculated and compared to the KORA and SHIP studies. RESULTS Regional differences showed a stronger influence on TSH and fT4 concentrations than sex and age of the subjects in the 45- to 75-year age group. The estimated difference in medians, as measured by the HNR study, was lowest in the SHIP study, -0.47 (95% CI: -0.53; -0.41) for men and -0.41 (-0.53; -0.41) for women. The Rotterdam study had the highest difference in medians for both men and women (men: 0.56 with 0.44; 0.68 and women: 0.62 with 0.46; 0.78). The lowest median TSH concentrations, across all age categories considered, were seen in the German cohorts. CONCLUSIONS Comparison of thyroid function parameters and iodine in elderly subjects between six comparable cohort studies from Germany and Europe showed a significant influence of region, which exceeded the sex and age dependence of the parameters.
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Affiliation(s)
- Carolin Girschik
- Institut für Medizinische Informatik, Biometrie und Epidemiologie, Universitätsklinikum Essen, Essen, Germany
- Klinik für Endokrinologie, Diabetologie und Stoffwechsel, Universitätsklinikum Essen, Essen, Germany
| | - Philipp Muchalla
- Klinik für Endokrinologie, Diabetologie und Stoffwechsel, Universitätsklinikum Essen, Essen, Germany
| | - Bernd Kowall
- Institut für Medizinische Informatik, Biometrie und Epidemiologie, Universitätsklinikum Essen, Essen, Germany
| | - Denise Zwanziger
- Zentrallabor - Bereich Forschung und Lehre, Klinik für Endokrinologie, Diabetologie und Stoffwechsel, Universitätsklinikum Essen, Essen, Germany
| | - Raimund Erbel
- Institut für Medizinische Informatik, Biometrie und Epidemiologie, Universitätsklinikum Essen, Essen, Germany
| | - Till Ittermann
- Institut für Community Medicine, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Christa Meisinger
- Lehrstuhl für Epidemiologie am UNIKA-T, Ludwig-Maximilians-Universität München, Augsburg, Germany
- Selbstständige Forschungsgruppe Klinische Epidemiologie, Helmholtz Zentrum München - Deutsches Forschungszentrum für Gesundheit und Umwelt, Neuherberg, Germany
| | - Andreas Stang
- Institut für Medizinische Informatik, Biometrie und Epidemiologie, Universitätsklinikum Essen, Essen, Germany
- School of Public Health, Department of Epidemiology, Boston University, Boston, United States
| | - Karl-Heinz Jöckel
- Institut für Medizinische Informatik, Biometrie und Epidemiologie, Universitätsklinikum Essen, Essen, Germany
| | - Dagmar Führer
- Klinik für Endokrinologie, Diabetologie und Stoffwechsel, Universitätsklinikum Essen, Essen, Germany
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Udhani R, Kothari C, Sarvaiya J. A Comprehensive Study: Traditional and Cutting-Edge Analytical Techniques for the Biomarker Based Detection of the Micronutrients & POC Sensing Directions for Next-Generation Diagnostic. Crit Rev Anal Chem 2023:1-20. [PMID: 36720848 DOI: 10.1080/10408347.2023.2169823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Micronutrient deficiency is wide spread and highly affects morbidity, mortality, and well-being of human beings. Micronutrient deficiency gradually manifests into diseases, which effects pathophysiology directly or indirectly. There is an imprecision in the diagnosis of micronutrient deficiency because of two causes; the selection of the standard biomarker and the diagnostic technique used. In appropriate diagnosis could increase the severity of the disorder. Instead of a single a combination of biomarkers can give more stringent results for micronutrient testing. Several traditional analytical techniques are used for diagnosis but HPLC, ELISA & LCMS/MS are most sensitive and reliable methods used by CLSIA-certified labs. However, these techniques require well-equipped, centralized laboratory facilities. The diagnostic era moves toward the Point of Care Testing (POCT), a boon in emerging diagnostics, breaking all paradigms of traditional analytical techniques. POCT led us toward the development of biosensors, which encompasses many techniques like paper-based sensors, microfluidic chip, wearable devices, and smartphone-assisted diagnostics, which become more popular diagnostic tools. This outlook summarizes the micronutrients like vitamins A, B5, B6, B7, B9, B12 C, D, and E and Minerals like iron, calcium, zinc, magnesium, and sodium; along with its biomarkers, analytical techniques, and point of care innovation in micronutrients.
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Affiliation(s)
- Raveena Udhani
- Department of Pharmaceutical Analysis, Institute of Pharmacy, Nirma University, Ahmedabad, Gujarat, India
| | - Charmy Kothari
- Department of Pharmaceutical Analysis, Institute of Pharmacy, Nirma University, Ahmedabad, Gujarat, India
| | - Jayrajsinh Sarvaiya
- School of Engineering and Technology, National Forensic Science University, Gandhinagar, Gujarat, India
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Verkaik-Kloosterman J. Neonatal heel prick screening TSH concentration in the Netherlands as indicator of iodine status. Nutr J 2021; 20:63. [PMID: 34218798 PMCID: PMC8256570 DOI: 10.1186/s12937-021-00722-4] [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: 12/03/2020] [Accepted: 06/19/2021] [Indexed: 12/02/2022] Open
Abstract
Background Neonatal Thyroid Stimulating Hormone (nTSH) is proposed as indicator of iodine deficiency in a population. Population’s iodine sufficiency is indicated by a proportion of the newborns less than 3% having nTSH above 5 mIU/L. The aim of this study was to explore the Dutch neonatal heel prick screening TSH data to assess iodine status in the Netherlands and identify determinants and potential confounders of this assessment. Methods All newborns born in the Netherlands between 2007 and 2015 with a heel prick collection at day 3-7 were included (n = 1,435,600), except preterm neonates and baby’s with a low birth weight. Total T4 was measured for all children, nTSH was measured in the ~ 20% children with lowest total T4. Results The proportion with nTSH > 5mIU/L fluctuated between 0.6-1.3% in 2007-2015. nTSH was significantly associated with laboratory performing the nTSH assay and age of heel prick sampling. The overall increasing trend in proportion nTSH >1mIU/L was confounded by the laboratories with different and changed assays. Conclusions The low proportion neonates with high nTSH suggests a sufficient iodine status in the Netherlands. Whether the increased proportion nTSH>1mIU/L over the years is an early indicator of deterioration of the iodine status remains unclear, due to differences and changes in analytical assays. nTSH might be a valuable and inexpensive way to get crude insight in the (trend in) iodine status, but more research is needed on the validity and potential conditions. Supplementary Information The online version contains supplementary material available at 10.1186/s12937-021-00722-4.
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Affiliation(s)
- Janneke Verkaik-Kloosterman
- National Institute for Public Health and the Environment (RIVM), PO box 1, 3720, Bilthoven, BA, The Netherlands.
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The Impact of Preconceptional Hysterosalpingography with Oil-based Contrast on Maternal and Neonatal Iodine Status. Reprod Sci 2021; 28:2887-2894. [PMID: 34080176 DOI: 10.1007/s43032-021-00640-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 05/25/2021] [Indexed: 10/21/2022]
Abstract
The objective of this study is to investigate the impact of preconceptional exposure to oil-based iodinated contrast in the hysterosalpingography (HSG) on pregnant women and their offspring's iodine status, thyroid function, and the outcomes of pregnancy. A cross-sectional evaluation of iodine status was performed on pregnant women with the preconceptional experience of ethiodized-oil HSG. For those found to have iodine excess (with serum iodine concentration (SIC) > 92 μg/L), a prospective follow-up was conducted until termination of the pregnancy or 1 week postpartum. Among 70 of 425 pregnant women with preconceptional ethiodized-oil HSG, iodine excess was initially confirmed in 38 (54.3%), with an elevated SIC (294.00 μg/L [142.00, 123.20]) and urinary iodine-to-creatinine ratio (UI/Cr) (830.00 μg/g Cr [437.50, 255.30]), both higher than the normative data (P = 0.000, P = 0.000). Subsequent follow-up in pregnancy showed a downward trend in both SIC and UI/Cr. Thirty-four women delivered healthy neonates at full term, though the other 4 cases of premature birth, abnormal fetal karyotype, spontaneous abortion, and neonatal cardiac defect were reported. After delivery, the iodine concentration in maternal breast milk and neonatal urine was 584.50 μg/L [328.50, 1507.50] and 424.00 μg/L [277.00, 657.50], respectively, both higher than normative data (P = 0.001, P = 0.015). For thyroid evaluation, 25 cases (65.79%) of clinical or subclinical hypothyroidism and 2 cases (5.26%) of thyrotoxicosis were confirmed in women with iodine excess. Neither goiter nor thyroid dysfunction was detected in any offspring. Preconceptional exposure to oil-based contrast in HSG might exert a far-reaching impact on maternal and offspring iodine status, and tend to result in increased risk of maternal thyroid dysfunction.
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Ning P, Ren Q, Teng D, Zhang Z, Lv X, Meng S, Shi X, Lou Z, Wu C, Yang P, Zhang W, Zhou L, Luo Y, Zhuoma Z, Yang L, Teng W. Current Iodine Nutrition Status and Prevalence of Thyroid Disorders in Tibetan Adults in an Oxygen-Deficient Plateau, Tibet, China: A Population-Based Study. Thyroid 2020; 30:759-766. [PMID: 31928176 DOI: 10.1089/thy.2019.0669] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background: Iodine deficiency (ID) is a global problem in individuals living in an iodine-deficient environment, specifically in mountainous regions. However, data regarding the iodine nutritional status of Tibetan people in the plateau are limited. Methods: A population-based survey was conducted from July 2016 to July 2017 in Lhasa, Tibet, including 12 communities in Lhasa city and 10 surrounding rural areas. The iodine nutritional status of Tibetan people was evaluated using the traditional iodine nutrition indexes: urinary iodine concentration (UIC), thyroid size, serum thyroxine, thyrotropin, thyroglobulin antibody and thyroid peroxidase antibody (TPOAb). Results: A total of 2295 healthy participants were screened, and 2160 participants who had completed all the required examinations were enrolled in this study (response rate, 94.1%). Urinary iodine showed a skewed distribution, with a median (upper and lower quartiles) of 154 (99-229) μg/L. The percentages of low iodine (UIC <100 μg/L), adequate iodine (UIC, 100-199 μg/L), and high iodine (UIC ≥200 μg/L) were 25.6%, 42.0%, and 32.4%, respectively. The urinary iodine level in the urban region was higher than that in the rural region (p < 0.05). Urinary iodine levels were lower with increasing age (p < 0.05). The prevalence of hyperthyroidism, hypothyroidism, goiter, TPOAb positivity, and thyroglobulin antibody positivity was 1.0%, 21.8%, 4.7%, 6.6%, and 10.4%, respectively. Logistic regression analysis found that urinary iodine was an independent risk factor for TPOAb positivity (odds ratio = 0.997 [95% confidence interval, 0.995-0.999]; p < 0.001). Conclusions: Compared with individuals living in the plains of China, Tibetan adults have a higher rate of ID. UIC was an independent risk factor for TPOAb positivity. This public health issue should be further investigated.
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Affiliation(s)
- Peng Ning
- Department of Endocrinology and Metabolism, People's Hospital of Tibet Autonomous Region, Lhasa, Tibet, China
| | - Qian Ren
- Department of Endocrinology and Metabolism, Peking University of People's Hospital, Beijing, China
| | - Di Teng
- Department of Endocrinology and Metabolism and the Institute of Endocrinology, The First Hospital of China Medical University, Shenyang, Liaoning, P.R. China
| | - Zexin Zhang
- Department of Endocrinology and Metabolism, People's Hospital of Tibet Autonomous Region, Lhasa, Tibet, China
| | - Xuemei Lv
- Department of Endocrinology and Metabolism, People's Hospital of Tibet Autonomous Region, Lhasa, Tibet, China
| | - Shuyou Meng
- Department of Endocrinology and Metabolism, People's Hospital of Tibet Autonomous Region, Lhasa, Tibet, China
| | - Xiaoguang Shi
- Department of Endocrinology and Metabolism and the Institute of Endocrinology, The First Hospital of China Medical University, Shenyang, Liaoning, P.R. China
| | - Zhe Lou
- Department of Endocrinology and Metabolism and the Institute of Endocrinology, The First Hospital of China Medical University, Shenyang, Liaoning, P.R. China
| | - Changhao Wu
- Department of Endocrinology and Metabolism and the Institute of Endocrinology, The First Hospital of China Medical University, Shenyang, Liaoning, P.R. China
| | - Puxu Yang
- Department of Endocrinology and Metabolism and the Institute of Endocrinology, The First Hospital of China Medical University, Shenyang, Liaoning, P.R. China
| | - Wenqian Zhang
- Department of Endocrinology and Metabolism and the Institute of Endocrinology, The First Hospital of China Medical University, Shenyang, Liaoning, P.R. China
| | - Lingli Zhou
- Department of Endocrinology and Metabolism, Peking University of People's Hospital, Beijing, China
| | - Yingying Luo
- Department of Endocrinology and Metabolism, Peking University of People's Hospital, Beijing, China
| | - Zeding Zhuoma
- Department of Endocrinology and Metabolism, People's Hospital of Tibet Autonomous Region, Lhasa, Tibet, China
| | - Lihui Yang
- Department of Endocrinology and Metabolism, People's Hospital of Tibet Autonomous Region, Lhasa, Tibet, China
| | - Weiping Teng
- Department of Endocrinology and Metabolism and the Institute of Endocrinology, The First Hospital of China Medical University, Shenyang, Liaoning, P.R. China
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Medin AC, Carlsen MH, Andersen LF. Iodine intake among children and adolescents in Norway: Estimates from the national dietary survey Ungkost 3 (2015-2016). J Trace Elem Med Biol 2020; 58:126427. [PMID: 31770674 DOI: 10.1016/j.jtemb.2019.126427] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 10/14/2019] [Accepted: 10/29/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Iodine is crucial for normal growth and neurodevelopment. Before 1950, goitre caused by iodine deficiency was widespread in Norway, but decreased significantly after mandatory fortification of animal fodder. Recent dietary changes in milk consumption and fish intake may again have increased the risk of inadequate intakes in some population groups in Norway. The situation for children and adolescents is unclear, and data from nationally representative studies are highly needed. We aimed to describe the iodine intake in Norwegian children and adolescents and estimate the proportion of individuals with an increased risk of suboptimal, adequate and excessive usual iodine intake. In addition, we aimed to investigate whether individuals' characteristics were associated with iodine intake, and to identify the major iodine contributing foods in the diet of this population. METHODS Data from 1722 individuals (4-, 9- and 13-year-olds) from a national dietary survey in Norway from 2015-2016 was used. Both descriptive and inferential statistics were conducted. Usual iodine intakes were estimated, stratified by age group and sex and compared to dietary reference intake cut-offs. Linear regression models were used to assess the association between iodine intake and participants' characteristics. The contribution of iodine from different foods was described for all and across different participant groups. RESULTS We estimated that the proportion of participants with an increased risk of a suboptimal usual intake of iodine varied from 3-36%. A significant increased risk was observed for older children and girls compared to younger children and boys. Excessive usual intakes were not observed in any age group. Iodine intake was associated with sex, maternal educational level and area of residence. A lower intake was observed for girls and those with a mother with a low educational level. Moreover, those living in the western part and Mid-Norway had statistically significantly higher intakes compared to those living in the capital city and surroundings. Milk, milk products, cheese, fish and shellfish were the main contributors to iodine intake. Supplements contributed with very little of the total iodine intake. CONCLUSIONS We have shown that the estimated risk of suboptimal usual iodine intakes among children and adolescents in Norway varies according to age, sex, maternal educational level and area of residence. Those with a limited intake of the main dietary contributors to iodine intake may be at risk, and adolescent girls seem to be especially vulnerable.
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Affiliation(s)
- Anine C Medin
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, P.O. Box 1046 Blindern, 0317 Oslo, Norway; Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, 4630 Kristiansand, Norway.
| | - Monica H Carlsen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, P.O. Box 1046 Blindern, 0317 Oslo, Norway.
| | - Lene F Andersen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, P.O. Box 1046 Blindern, 0317 Oslo, Norway.
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Solovyev N, Vanhaecke F, Michalke B. Selenium and iodine in diabetes mellitus with a focus on the interplay and speciation of the elements. J Trace Elem Med Biol 2019; 56:69-80. [PMID: 31442957 DOI: 10.1016/j.jtemb.2019.07.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 07/07/2019] [Accepted: 07/17/2019] [Indexed: 12/13/2022]
Abstract
Diabetes mellitus is a chronic metabolic disease caused by insulin deficiency (type I) or dysfunction (type II). Diabetes is a threatening public health concern. It is considered as one of the priority non-communicable diseases, due to its high and increasing incidence, the associated healthcare costs, and threatening medical complications. Two trace elements selenium (Se) and iodine (I) were intensively discussed in the context of diabetic pathology and, possibly, etiology. It seems there is a multilayer involvement of these essential nutrients in glucose tolerance, energy metabolism, insulin signaling and resistance, which are mainly related to the antioxidant selenoenzymes and the thyroid hormones. Other factors might be related to (auto)immunity, protection against endoplasmic reticulum stress, and leptin signaling. The aim of the current review is to evaluate the current understanding of the role of selenium and iodine in diabetes with a focus on the biochemical interplay between the elements, their possible role as biomarkers, and their chemical speciation. Possible impacts from novel analytical techniques related to trace element speciation and isotopic analysis are outlined.
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Affiliation(s)
- Nikolay Solovyev
- St. Petersburg State University, Universitetskaya nab. 7/9, 199034, St. Petersburg, Russian Federation; Ghent University, Department of Chemistry, Atomic & Mass Spectrometry - A&MS Research Unit, Campus Sterre, Krijgslaan 281-S12, 9000, Ghent, Belgium.
| | - Frank Vanhaecke
- Ghent University, Department of Chemistry, Atomic & Mass Spectrometry - A&MS Research Unit, Campus Sterre, Krijgslaan 281-S12, 9000, Ghent, Belgium
| | - Bernhard Michalke
- Helmhotz Zentrum München - German Research Center for Environmental Health, Research Unit Analytical BioGeoChemistry, Ingolstaedter Landstr. 1, 85764, Neuherberg, Germany
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Wassie MM, Middleton P, Zhou SJ. Agreement between markers of population iodine status in classifying iodine status of populations: a systematic review. Am J Clin Nutr 2019; 110:949-958. [PMID: 31268129 DOI: 10.1093/ajcn/nqz118] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 05/10/2019] [Accepted: 05/24/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Population iodine deficiency is indicated by >3% of the population with newborn thyroid-stimulating hormone (TSH) concentration >5 mIU/L, median urinary iodine concentration (MUIC) <100 µg/L, or >5% prevalence of goiter in school-age children. However, the agreement between these population markers has not been systematically investigated. OBJECTIVE To assess the agreement between TSH, MUIC, and goiter as markers of population iodine status. METHODS We performed a systematic search for studies published on PubMed, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, and PsycINFO up to 29 October, 2018. Studies assessing iodine status in the population using the TSH marker and either MUIC or goiter prevalence in school-age children were included. The agreement between markers in classifying iodine status of the population was assessed. The sensitivity and specificity of the TSH marker was determined against MUIC and goiter prevalence as the reference markers. RESULTS Of 17,435 records identified by the search strategy, 57 eligible studies were included in the review. The agreement between markers in classifying the iodine status of populations into the same category was 65% for TSH and MUIC, and 83% for TSH and goiter prevalence. The TSH marker had a sensitivity of 0.75 and specificity of 0.53 when compared with MUIC, and 0.86 and 0.50 when compared with goiter prevalence. CONCLUSIONS The TSH marker has a better agreement with goiter prevalence than MUIC when classifying the iodine status of populations. Re-evaluation of the current criteria for classifying the iodine status of populations using the TSH marker is warranted. This systematic review was registered at PROSPERO (http://www.crd.york.ac.uk/prospero/) as CRD42018091247.
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Affiliation(s)
- Molla Mesele Wassie
- School of Agriculture Food and Wine, Faculty of Sciences, The University of Adelaide, Adelaide, Australia.,Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Philippa Middleton
- Robinson Research Institute, School of Paediatrics and Reproductive Health, The University of Adelaide, Adelaide, Australia.,South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Shao Jia Zhou
- School of Agriculture Food and Wine, Faculty of Sciences, The University of Adelaide, Adelaide, Australia.,Robinson Research Institute, School of Paediatrics and Reproductive Health, The University of Adelaide, Adelaide, Australia
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García-Ascaso MT, Ares Segura S, Ros Pérez P, Piñeiro Pérez R, Alfageme Zubillaga M. Thyroid Volume Assessment in 3-14 Year-Old Spanish Children from an Iodine-Replete Area. Eur Thyroid J 2019; 8:196-201. [PMID: 31602362 PMCID: PMC6738148 DOI: 10.1159/000499103] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 02/21/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Few data exist on reference thyroid volumes (Tvols) for Spanish children. The standard tables of the World Health Organization (WHO) are only for children older than 6 years. The present cross-sectional study reports the normal Tvols of 3-14 year-old girls and boys living in Madrid (Spain). METHODS The study subjects were 217 children aged 3-14 years. Urinary iodine was determined, and, on the same day, cervical ultrasound examinations were performed by a single, experienced paediatric radiologist. The sex-specific, upper normal limits for Tvol were then determined, based on age and body surface area (BSA). RESULTS The median urinary iodine concentration was 120 µg/L (interquartile range 80-184); the population was therefore deemed to fall within the optimum range for iodine nutritional status. Eight children with heterogeneous glandular parenchyma were detected, as were 6 with increased vascularity, and 22 with intrathyroid cysts. Tvol increased with age and BSA in both sexes from the age of 3 years. In girls aged 11-12 years, Tvol was significantly larger than that in boys of the same age. When comparing children 6 years old and above, the 97th percentile Tvols with respect to gender/BSA were similar to WHO reference values, but by gender/age they were 30% larger. CONCLUSIONS This work proposes reference ultrasound-determined Tvols for 3-14-year-old children living in Madrid.
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Affiliation(s)
- Marta Taida García-Ascaso
- Servicio de Pediatría, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
- *Marta Taida García-Ascaso, Division of Pediatrics, Mount Sinai Hospital, 600 University Avenue, Toronto, ON M5G 1X5 (Canada), E-Mail
| | | | - Purificación Ros Pérez
- Servicio de Pediatría, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
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Ter Borg S, Koopman N, Verkaik-Kloosterman J. Food Consumption, Nutrient Intake and Status during the First 1000 days of Life in the Netherlands: a Systematic Review. Nutrients 2019; 11:E860. [PMID: 30995816 PMCID: PMC6520769 DOI: 10.3390/nu11040860] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 04/04/2019] [Accepted: 04/11/2019] [Indexed: 12/25/2022] Open
Abstract
Adequate nutrition is essential for growth and development in early life. Nutritional data serves as a basis for national nutritional guidelines and policies. Currently, there is no insight into the availability of such data during the first 1000 days of life. Therefore, a systematic review was performed, following the PRISMA reporting guideline, to identify studies on food consumption, nutrient intake or status in the Netherlands. Potential gaps were identified, and the quality of the studies is discussed. The databases Embase and Medline were used, as well as databases from national institutes. Articles published in 2008-2018 were screened by two independent reviewers. In total 601 articles were identified, of which 173 were included. For pregnant women, 32 studies were available with nutritional data, for young children 40 studies were identified. No studies were available for breastfeeding women. A large variety of foods and nutrients were assessed, however certain nutrients were lacking (e.g., vitamin K). Overall, the studies had methodological limitations, making the data unsuitable to assess nutrient inadequacies. There is a need for recent, high quality nutritional research to strengthen the understanding of the nutritional needs and deficiencies during early life, and is fundamental for national guidelines and policies.
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Affiliation(s)
- Sovianne Ter Borg
- National Institute for Public Health and the Environment, 3721 MA, Bilthoven, The Netherlands.
| | - Nynke Koopman
- National Institute for Public Health and the Environment, 3721 MA, Bilthoven, The Netherlands.
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García Ascaso MT, Pérez PR, Alcol EC, López AL, de Lucas Collantes C, Santos IM, Tessier E, Segura SA. Nutritional status of iodine in children: When appropriateness relies on milk consumption and not adequate coverage of iodized salt in households. Clin Nutr ESPEN 2019; 30:52-58. [PMID: 30904229 DOI: 10.1016/j.clnesp.2019.02.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Revised: 12/05/2018] [Accepted: 02/13/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND & AIMS Iodine deficiency inhibits the normal development of human beings and is the leading cause of preventable mental retardation. Our study aims to update the urinary iodine concentrations and the intake of iodized salt in children in Madrid (Spain). METHODS A cross-sectional study was designed where 217 children aged 3-14 years old were studied. A nutritional survey including the intake of iodized salt and other iodine-rich foods was performed. In addition, the urinary concentration of iodine was determined in each patient. RESULTS Near 60% of the surveyed households routinely used iodized salt. Significant differences in age, sex, country of birth, or country of birth and parents educational levels and iodized salt consumption were not found. The median of the urinary iodine level (120 μg/L; interquartile range 80-184) was significantly higher in boys than girls and more elevated in younger children. Iodized salt and milk consumption significantly increased the concentration of urinary iodine. Children who drank less than two glasses of milk per day and did not consume iodized salt have four times the risk of iodine deficiency compared to children who daily drank at least two glasses of milk and consumed iodized salt (P < 0.001). CONCLUSIONS The nutritional level of iodine in the children studied is appropriate despite the low consumption of iodized salt. This is due to the consumption of dairy products and milk. The younger the child, the better his/her iodine nutritional level. Teenagers studied are at higher risk of iodine deficiency.
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Affiliation(s)
| | - Purificación Ros Pérez
- Servicio de Pediatría, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Esmeralda Colino Alcol
- Servicio de Pediatría, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Agustín López López
- Servicio de Pediatría, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | | | - Isabel Millán Santos
- Servicio de Estadística, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Elise Tessier
- London School of Hygiene and Tropical Medicine, London, UK
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Dida N, Legese A, Aman A, Muhamed B, Damise T, Birhanu T, Hailu S, Darega J, Woldamichael B, Gadisa E. Availability of adequately iodised salt at household level and its associated factors in Robe town, Bale Zone, South East Ethiopia: community-based cross-sectional study. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2018. [DOI: 10.1080/16070658.2018.1551767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Nagasa Dida
- Department of Public Health, Medicine and Health Science College, Ambo University, Ambo, Ethiopia
| | - Abiyot Legese
- Department of Public Health Nursing, Goba Referral Hospital, Madda Walabu University, Bale-Goba, Ethiopia
| | - Abdurhim Aman
- Department of Public Health Nursing, Goba Referral Hospital, Madda Walabu University, Bale-Goba, Ethiopia
| | - Bilkisa Muhamed
- Department of Public Health Nursing, Goba Referral Hospital, Madda Walabu University, Bale-Goba, Ethiopia
| | - Teshome Damise
- Department of Public Health Nursing, Goba Referral Hospital, Madda Walabu University, Bale-Goba, Ethiopia
| | - Tizita Birhanu
- Department of Public Health Nursing, Goba Referral Hospital, Madda Walabu University, Bale-Goba, Ethiopia
| | - Sintayehu Hailu
- Department of Nursing, Goba Referral Hospital, Madda Walabu University, Bale-Goba, Ethiopia
| | - Jiregna Darega
- Department of Public Health, Medicine and Health Science College, Ambo University, Ambo, Ethiopia
| | - Bedasa Woldamichael
- Department of Nursing, Goba Referral Hospital, Madda Walabu University, Bale-Goba, Ethiopia
| | - Eshetu Gadisa
- Department of Microbiology, Goba Referral Hospital, Madda Walabu University, Bale-Goba, Ethiopia
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Wassie MM, Abebe Z, Tariku A, Gebeye E, Awoke T, Gete AA, Yesuf ME, Kebede Y, Biks GA, Zhou SJ. Iodine status five years after the mandatory salt iodization legislation indicates above requirement: a cross sectional study in Northwest Ethiopia. BMC Nutr 2018; 4:52. [PMID: 32153913 PMCID: PMC7050929 DOI: 10.1186/s40795-018-0261-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 12/10/2018] [Indexed: 11/12/2022] Open
Abstract
Background Iodine deficiency is one of a major nutritional problem. The study aimed to assess the iodine status of populations in Dabat district using median urinary iodine concentration (UIC) in school-age children (6–12 years) and compared the results with goiter prevalence. Methods The study used a cross-sectional study design. The study was conducted in Dabat district, northwest Ethiopia in May 2016. Spot urine samples were used for the determination of UIC. Manual examination of the thyroid gland was performed to assess presence of goiter. The MBI international Rapid Test Kits (RTK) were used to determine the level of salt iodine content. Children aged 6–12 years were recruited from schools using a multistage stratified sampling. One-way Analysis of Variance (ANOVA) was used to compare mean of log-transformed UIC values among key variables. Significant was determined at P-value less than 0.05. Results A total of 358 school age children enrolled to the study. The mean age of children was 10.8((Standard Deviation (SD) = 1.45) years and 56.7% were males. The median UIC was 235 μg/l ((Inter Quartile Range (IQR): 161, 320]. Excessive iodine intake and inadequate iodine intake was observed on 29.1 and 8.7% of school aged children, respectfully. The coverage of iodized salt use in school-age children were 66.8%. The UIC was higher in urban children than rural counterparts and in those used adequately iodised salt than inadequately iodized salt (P < 0.05). Thirty-four percent of school-age children had a goiter. The prevalence of grade 1 and grade 2 goiter was 26.5 and 7.5%, respectively. There was a poor agreement between UIC and goiter (k = 0.1) in classifying iodine status of populations. Conclusions The study population is classified as above requirements by median UIC in school-age children but severe iodine deficiency by goiter prevalence. Further research investigating the agreement between UIC and goiter prevalence in classifying iodine status of populations with various iodine status is warranted.
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Affiliation(s)
- Molla Mesele Wassie
- 1Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Po Box: 196, Gondar, Ethiopia.,2School of Agriculture Food and Wine, Faculty of sciences, The University of Adelaide, Adelaide, Australia
| | - Zegeye Abebe
- 1Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Po Box: 196, Gondar, Ethiopia
| | - Amare Tariku
- 1Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Po Box: 196, Gondar, Ethiopia
| | - Ejigu Gebeye
- 3Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadese Awoke
- 3Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Azeb Atenafu Gete
- 1Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Po Box: 196, Gondar, Ethiopia
| | - Melkie Edris Yesuf
- 1Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Po Box: 196, Gondar, Ethiopia
| | - Yigzaw Kebede
- 3Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Gashaw Andargie Biks
- 4Department of Health Service Management and Heath Economics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Shao Jia Zhou
- 2School of Agriculture Food and Wine, Faculty of sciences, The University of Adelaide, Adelaide, Australia
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Randremanana RV, Bastaraud A, Rabarijaona LP, Piola P, Rakotonirina D, Razafinimanana JO, Ramangakoto MH, Andriantsarafara L, Randriamasiarijaona H, Tucker-Brown A, Harimanana A, Namana S. First national iodine survey in Madagascar demonstrates iodine deficiency. MATERNAL AND CHILD NUTRITION 2018; 15:e12717. [PMID: 30315611 DOI: 10.1111/mcn.12717] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 09/27/2018] [Accepted: 10/02/2018] [Indexed: 11/28/2022]
Abstract
Universal salt iodization (USI) was adopted in Madagascar in 1995 within the framework of a worldwide policy to eliminate iodine deficiency disorders. Despite early USI adoption, there are no representative data on the iodine status of the Malagasy population. The aims of this study were to determine the iodine status of the Malagasy population and to assess the use of adequately iodized salt among households. We randomly sampled women of reproductive age (WRA) using a national, two-stage, stratified cross-sectional survey in 2014. Casual urine from WRA and salt samples from the household containing WRA were collected to measure urinary iodine concentration (UIC) and to assess household salt iodine content. Data from 1,721 WRA in 1,128 households were collected and analysed. The national median UIC was 46 μg L-1 (interquartile range [IQR]: 13-98 μg L-1 ), indicating a moderate iodine deficiency. The median UIC was 53 μg L-1 (IQR: 9-89 μg L-1 ) in pregnant women and 46 μg L-1 (IQR: 13-98 μg L-1 ) in non-pregnant women. The national median iodine concentration of household salt was 10 mg kg-1 (IQR: 6.3-15.8 mg kg-1 ) and 26.2% (95% CI [22.1, 31.0]) of households containing WRA used adequately iodized salt (≥15 mg kg-1 ). Women living in households with adequately iodized salt had higher median UIC (72 vs. 50 μg L-1 ). Iodine status was significantly lower among women from low socio-economic households. Madagascar's USI program needs to be revitalized. Implementing strategies to provide adequately iodized salt and enhancing iodized salt legislation to prevent severe complications resulting from iodine deficiency in the Malagasy population are essential.
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Affiliation(s)
| | - Alexandra Bastaraud
- Laboratoire d'Hygiène des Aliments et de l'Environnement, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | | | - Patrice Piola
- Unité épidémiologie, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | | | | | | | | | | | | | - Aina Harimanana
- Unité épidémiologie, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Simeon Namana
- Maison Commune des Nations Unies, UNICEF, Antananarivo, Madagascar
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Is iodine nutrition in the Spanish pediatric population adequate? Historical review and current situation. ACTA ACUST UNITED AC 2018; 65:458-467. [PMID: 30030155 DOI: 10.1016/j.endinu.2018.05.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 05/16/2018] [Accepted: 05/16/2018] [Indexed: 11/21/2022]
Abstract
Iodine is an essential component of thyroid hormones, and iodine deficit is the leading cause of preventable mental retardation worldwide. Spain was considered iodine-deficient until 2003. Although iodine urinary levels have been in the optimal range in Spain since 2004, the WHO recognizes that our country does not meet the necessary requirements to ensure that the whole population is not at risk of an iodine deficiency disorder. The aim of this article is to review the current iodine status in Spain. Data from several studies emphasize the low consumption of iodized salt at home. Despite the progress made in recent decades, Spanish children are not exempt from suffering an iodine deficiency disorder. Policies that allow for controlling iodine nutrition and promote universal consumption of iodized salt should therefore be implemented.
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Kim UJ, Kannan K. Method for the Determination of Iodide in Dried Blood Spots from Newborns by High Performance Liquid Chromatography Tandem Mass Spectrometry. Anal Chem 2018; 90:3291-3298. [PMID: 29412637 DOI: 10.1021/acs.analchem.7b04827] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Dried blood spots (DBS), collected for newborn screening programs in the United States, have been used to screen for congenital metabolic diseases in newborns for over 50 years. DBS provide an easy and inexpensive way to collect and store peripheral blood specimens and present an excellent resource for studies on the assessment of chemical exposures in newborns. In this study, a selective and sensitive method was developed for the analysis of iodide in DBS by high performance liquid chromatography electrospray tandem mass spectrometry. Accuracy, inter- and intraday precision, matrix effects, and detection limits of the method were determined. Further validation of the method was accomplished by concurrent analysis of whole blood and fortified blood spotted on a Whatman 903 filter card. A significant positive correlation was found between measured concentrations of iodide in venous whole blood and the same blood spotted as DBS. The method limit of detection was 0.15 ng/mL iodide. The method was further validated by the analysis of a whole blood sample certified for iodide levels (proficiency testing sample) by spotting on a filter card. Twenty DBS samples collected from newborns in New York State were analyzed to demonstrate the applicability of the method. The measured concentrations of iodide in whole blood of newborns from New York State ranged between <LOD and 16.4 ng/mL. The developed method is applicable for the analysis of DBS collected for epidemiological studies that investigate the importance of iodide on the health of newborns.
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Affiliation(s)
- Un-Jung Kim
- Wadsworth Center, New York State Department of Health, and Department of Environmental Health Sciences, School of Public Health , State University of New York at Albany , Empire State Plaza, P.O. Box 509 , Albany , New York 12201-0509 , United States
| | - Kurunthachalam Kannan
- Wadsworth Center, New York State Department of Health, and Department of Environmental Health Sciences, School of Public Health , State University of New York at Albany , Empire State Plaza, P.O. Box 509 , Albany , New York 12201-0509 , United States.,Biochemistry Department, Faculty of Science and Experimental Biochemistry Unit, King Fahd Medical Research Center , King Abdulaziz University , Jeddah 21589 , Saudi Arabia
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Derivatives of Cucurbitacin-E-glucoside produced by Curvularia lunata NRRL 2178: Anti-inflammatory, antipyretic, antitumor activities, and effect on biochemical parameters. FUTURE JOURNAL OF PHARMACEUTICAL SCIENCES 2017. [DOI: 10.1016/j.fjps.2017.04.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
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Koukkou EG, Ilias I, Mamalis I, Markou KB. Pregnant Greek Women May Have a Higher Prevalence of Iodine Deficiency than the General Greek Population. Eur Thyroid J 2017; 6:26-30. [PMID: 28611945 PMCID: PMC5465751 DOI: 10.1159/000449285] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 08/18/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Adequate dietary iodine consumption, predicted via the urinary iodine concentration (UIC), is necessary for normal thyroid function and for the neurodevelopment of fetuses and neonates. The general population of Greece is considered to be iodine sufficient, but our preliminary findings suggest that Greek pregnant women are at risk of iodine deficiency. OBJECTIVE Our aim was to estimate the thyroid function and UIC in a representative population of pregnant Greek women. METHODS UIC and thyroid function were assessed in 1,118 women from 19 representative areas of the country. RESULTS The median UIC was found to be 127.1 µg/l (range 7.8-2,296), which is indicative of insufficient iodine intake according to the standard of the World Health Organization (WHO) for pregnant women. The median UIC was below the minimal recommended value of 150 µg/l in 61% of the women, and below 100 or 50 µg/l in 32 and 7%, respectively. An optimal iodine intake (150-250 µg/l) was observed in 26%, and was over the cut-off of 500 µg/l in 2% of the subjects. Serum thyrotropin significantly increased between trimesters, from 1.57 ± 1.2, to 1.68 ± 1.0 and to 2.02 ± 1.2 mU/l (p < 0.001). Serum-free thyroxine decreased significantly between trimesters, from 1.22 ± 0.34, to 1.01 ± 0.21 and 0.96 ± 0.2 ng/ml (p < 0.05). Serum thyroglobulin levels remained unchanged over the trimesters and were not correlated with UIC. CONCLUSIONS While the general population of Greece is iodine sufficient, these findings suggest that, according to the WHO, the majority of pregnant Greek women are iodine deficient. These data strongly suggest that a proactive policy should be developed to lower iodine deficiency risk in this population of women.
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Affiliation(s)
- Eftychia G. Koukkou
- Division of Endocrinology, Endocrine Unit, E Venizelou Hospital, Athens, Greece
| | - Ioannis Ilias
- Division of Endocrinology, Endocrine Unit, E Venizelou Hospital, Athens, Greece
| | - Irene Mamalis
- Division of Endocrinology, University Medical School, University Hospital, Rion-Patras, Greece
| | - Kostas B. Markou
- Division of Endocrinology, University Medical School, University Hospital, Rion-Patras, Greece
- *Kostas B. Markou, 6 Thisseos Street, GR−26500 Ovria Patras (Greece), E-Mail
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Tsubokura M, Nomura S, Watanobe H, Nishikawa Y, Suzuki C, Ochi S, Leppold C, Kinoshita H, Kato S, Saito Y. Assessment of Nutritional Status of Iodine Through Urinary Iodine Screening Among Local Children and Adolescents After the Fukushima Daiichi Nuclear Power Plant Accident. Thyroid 2016; 26:1778-1785. [PMID: 27758131 DOI: 10.1089/thy.2016.0313] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Iodine deficiency is an important modifier of the risk of thyroid cancer following irradiation. However, little information is available on the prevalence of iodine deficiency in Fukushima and its surroundings after the Fukushima Daiichi nuclear power plant accident that occurred in March 2011. METHODS In order to assess urinary iodine concentrations (UIC) and the prevalence of iodine deficiency and to elucidate any associations between demographic characteristics and UIC levels among children and adolescents aged ≤18 years at the time of the accident in Fukushima Prefecture and its surroundings, the data on voluntary UIC testing conducted by Hirata Central Hospital, Fukushima, were evaluated. RESULTS A total of 4410 children and adolescents with a median age of 10 years at examination underwent UIC testing between October 2012 and October 2015. Calculated for all the participants, the median UIC level was 204 μg/L (range 25-21,100 μg/L). There were 133 (3.0%), 732 (16.6%), and 1472 (33.4%) participants with UIC levels of <50, <100, or ≥300 μg/L, respectively. Based on the World Health Organization criteria for nutritional iodine status, no participants were severely iodine deficient (<20 μg/L), but 16.6% of the population were mildly (50-100 μg/L) or moderately (20-50 μg/L) iodine deficient. While no significant difference in UIC was noted between those who did and did not increase dietary iodine intake after the accident (p = 0.93), there were significant differences by year (p < 0.01), school level (p < 0.001), and residential area at the time of the accident (p < 0.001). CONCLUSIONS This study demonstrates that the children and adolescents examined had a sufficient amount of iodine during the period 1.5-4.5 years after the nuclear accident. In addition to the differences in the scale and the countermeasures undertaken between the Fukushima and Chernobyl accidents, differences in dietary iodine intake might have played an additional role in resulting in the reportedly different radiation doses to the thyroid between the two nuclear accidents.
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Affiliation(s)
- Masaharu Tsubokura
- 1 Department of Internal Medicine, Hirata Central Hospital , Hirata, Fukushima, Japan
| | - Shuhei Nomura
- 2 Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London , London, United Kingdom
| | | | - Yoshitaka Nishikawa
- 4 Department of Health Informatics, School of Public Health, Kyoto University , Kyoto, Japan
| | - Chiaki Suzuki
- 5 Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University , Kyoto, Japan
| | - Sae Ochi
- 6 Department of Internal Medicine, Soma Central Hospital , Soma, Fukushima, Japan
| | - Claire Leppold
- 7 Department of Research, Minamisoma Municipal General Hospital , Minamisoma, Fukushima, Japan
| | - Hirokatsu Kinoshita
- 8 The Institute for Humanistic Studies, Kamakura Women's University, Kamakura, Kanagawa, Japan
| | - Shigeaki Kato
- 9 Research Institute of Innovative Medicine, Tokiwa Foundation, Iwaki, Fukushima, Japan
| | - Yasutoshi Saito
- 1 Department of Internal Medicine, Hirata Central Hospital , Hirata, Fukushima, Japan
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Campos RDO, Reboucas SCL, Beck R, de Jesus LRM, Ramos YR, Barreto IDS, Marques TX, Cerqueira TLO, Santos WA, Oliveira CA, Teixeira LSG, Souza VCDO, Barbosa F, Ramos HE. Iodine Nutritional Status in Schoolchildren from Public Schools in Brazil: A Cross-Sectional Study Exposes Association with Socioeconomic Factors and Food Insecurity. Thyroid 2016; 26:972-9. [PMID: 27184190 DOI: 10.1089/thy.2015.0448] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
INTRODUCTION National programs of salt iodization were implemented in Brazil to combat iodine deficiency (ID) in children of school age. Currently, there are limited data in Brazil on those still vulnerable to this deficiency and the state of nutritional iodine status in the northeast region of Brazil, where children are vulnerable to malnutrition. OBJECTIVE The aim of this study was to analyze the iodine nutritional status, household food insecurity, socioeconomic and demographic characteristics among schoolchildren from the public school system living in state the state of Bahia, Brazil. METHODS A cross-sectional study was conducted on 1419 schoolchildren in Bahia between the ages of 6 and 14 years old. Anthropometric parameters, urinary iodine concentrations (UIC), and thyrotropin (TSH) measurements were evaluated from blood spots on filter paper. RESULTS The mean UIC was 206.4 ± 80.5 μg/L, with a median of 221.6 μg/L, indicating sufficient iodine intake in the region. Low urinary iodide concentration (<100 μg/L) was detected in 12.3% of the schoolchildren (n = 174), with 6.2% with mild (<100 μg/L), 3.0% with moderate (20-49 μg/L), and 3.1% with severe ID (<20 μg/L). Moreover, 9.4% (n = 134) had a urinary iodide concentration of >300 μg/L, indicating the coexistence of excessive iodine intake (EII). The mean TSH was 1.0 ± 0.6 mIU/L. The body mass index category "overweight/obesity" was a protective factor against EII (odds ratio [OR] = 0.64 [confidence interval (CI) 0.4-1.0]; p = 0.07). Urban areas (73%) had a mean UIC of 213.1 ± 80 μg/L compared with 176.8 ± 76.1 μg/L in rural areas. The risk for EII increased in children living in a house with more than six people (OR = 1.62 [CI 0.9-2.6]; p < 0.05) and water consumption from shallow wells (OR = 1.70 [CI 0.9-3.1]; p = 0.09). The risk of ID was increased by 70% in schoolchildren who had moderate or severe food insecurity (OR = 1.70 [CI 0.9-3.0]; p > 0.05). CONCLUSION A significant proportion of schoolchildren still have ID or EII in the northeast region of Brazil, emphasizing the importance of committed public policies to address this problem. Socioeconomic factors and the lack of education about nutritional importance of iodine were important influencing factors in the presence of ID in schoolchildren.
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Affiliation(s)
- Renata de Oliveira Campos
- 1 Department of Bioregulation, Health and Science Institute, Federal University of Bahia , Salvador, Brazil
- 2 Postgraduate Program in Interactive Processes of Organs and Systems, Health and Science Institute, Federal University of Bahia , Salvador, Brazil
| | | | - Rebeca Beck
- 1 Department of Bioregulation, Health and Science Institute, Federal University of Bahia , Salvador, Brazil
| | | | - Yanne Rocha Ramos
- 1 Department of Bioregulation, Health and Science Institute, Federal University of Bahia , Salvador, Brazil
| | - Iasmin Dos Santos Barreto
- 1 Department of Bioregulation, Health and Science Institute, Federal University of Bahia , Salvador, Brazil
| | - Tamires Xavier Marques
- 1 Department of Bioregulation, Health and Science Institute, Federal University of Bahia , Salvador, Brazil
| | | | - William Alves Santos
- 1 Department of Bioregulation, Health and Science Institute, Federal University of Bahia , Salvador, Brazil
- 2 Postgraduate Program in Interactive Processes of Organs and Systems, Health and Science Institute, Federal University of Bahia , Salvador, Brazil
| | - Clotilde Assis Oliveira
- 3 Health and Science Center, Federal University Reconcavo of Bahia , Santo Antonio de Jesus, Brazil
| | | | - Vanessa Cristina de Oliveira Souza
- 5 Laboratory of Toxicology and Essentiality of Metals, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo , Ribeirão Preto, SP, Brazil
| | - Fernando Barbosa
- 5 Laboratory of Toxicology and Essentiality of Metals, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo , Ribeirão Preto, SP, Brazil
| | - Helton Estrela Ramos
- 1 Department of Bioregulation, Health and Science Institute, Federal University of Bahia , Salvador, Brazil
- 2 Postgraduate Program in Interactive Processes of Organs and Systems, Health and Science Institute, Federal University of Bahia , Salvador, Brazil
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Zhao X, Dong H, Zhang J, Sun Y, Yao M, Zhu G, Xu G. Iodine nutrition and thyroid nodules among children and adolescents in a coastal area of China. J Public Health (Oxf) 2016. [DOI: 10.1007/s10389-016-0711-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Biomarkers for nutrient intake with focus on alternative sampling techniques. GENES AND NUTRITION 2016; 11:12. [PMID: 27551313 PMCID: PMC4968438 DOI: 10.1186/s12263-016-0527-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 03/31/2016] [Indexed: 01/06/2023]
Abstract
Biomarkers of nutrient intake or nutrient status are important objective measures of foods/nutrients as one of the most important environmental factors people are exposed to. It is very difficult to obtain accurate data on individual food intake, and there is a large variation of nutrient composition of foods consumed in a population. Thus, it is difficult to obtain precise measures of exposure to different nutrients and thereby be able to understand the relationship between diet, health, and disease. This is the background for investing considerable resources in studying biomarkers of nutrients believed to be important in our foods. Modern technology with high sensitivity and specificity concerning many nutrient biomarkers has allowed an interesting development with analyses of very small amounts of blood or tissue material. In combination with non-professional collection of blood by finger-pricking and collection on filters or sticks, this may make collection of samples and analyses of biomarkers much more available for scientists as well as health professionals and even lay people in particular in relation to the marked trend of self-monitoring of body functions linked to mobile phone technology. Assuming standard operating procedures are used for collection, drying, transport, extraction, and analysis of samples, it turns out that many analytes of nutritional interest can be measured like metabolites, drugs, lipids, vitamins, minerals, and many types of peptides and proteins. The advantage of this alternative sampling technology is that non-professionals can collect, dry, and mail the samples; the samples can often be stored under room temperature in a dry atmosphere, requiring small amounts of blood. Another promising area is the potential relation between the microbiome and biomarkers that may be measured in feces as well as in blood.
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Shakya PR, Gelal B, Lal Das BK, Lamsal M, Pokharel PK, Nepal AK, Brodie DA, Sah GS, Baral N. Urinary iodine excretion and thyroid function status in school age children of hilly and plain regions of Eastern Nepal. BMC Res Notes 2015; 8:374. [PMID: 26306673 PMCID: PMC4548539 DOI: 10.1186/s13104-015-1359-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 08/17/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Iodine deficiency is a major public health problem in many developing countries including Nepal. The present study was designed to investigate the urinary iodine excretion (UIE), thyroid function status and household salt iodine content (SIC) in school-aged children (SAC) and to establish the relationships between these factors. METHODS A community-based cross sectional study was conducted in selected schools of two districts, Tehrathum and Morang, lying in the hill and plain region of eastern Nepal respectively. A total of 640 SAC, (Tehrathum n = 274 and Morang n = 366) aged 6-11 years, were assessed for UIE and household SIC. Among the 640 children, 155 consented to blood samples (Tehrathum n = 78 and Morang n = 77) to test for serum thyroglobulin (Tg), thyroid stimulating hormone (TSH), free triiodothyronine (fT3) and free thyroxine (fT4). UIE was measured by ammonium persulfate digestion method. SIC was measured by iodometric titration method and Tg, TSH, fT4 and fT3 were measured by immunoassay based kit method. RESULTS In Tehrathum and Morang, 9.5 and 7.7% of SAC had UIE values of UIE <100 µg/L while 59.5 and 41% had iodine nutrition values of >299 µg/L, with median UIE of 345.65 and 270.36 µg/L respectively. The overall medians were as follows, Tg 14.29 µg/L, fT3 3.94 pmol/L, fT4 16.25 pmol/L and TSH 3.61 mIU/L. There was a negative correlation between UIE and Tg (r = -0.236, p = 0.003) and a positive correlation between UIE and SIC (r = 0.349, p < 0.0001). We found 19.5%, n = 15 and 16.7%, n = 13 subclinical hypothyroid cases in Morang and Tehrathum respectively. Iodometric titration showed only 6.4% (n = 41) of the samples had household SIC <15 ppm. Multivariate analysis revealed that use of packaged salt by SAC of Tehrathum district correlated with higher UIE values. CONCLUSIONS Our focused data suggests that collaborative universal salt iodization (USI) programs are improving the health of children in the Tehrathum and Morang districts of Nepal. We also found that excessive iodine in a large portion of the study groups is a substantial concern and iodine intervention programs need to deal with both deficient and excessive iodine scenarios that can both be present simultaneously in study populations.
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Affiliation(s)
- Prem Raj Shakya
- Department of Biochemistry, School of Medicine, Patan Academy of Health Sciences, Lagankhel-5, PO Box: 26500, Lalitpur, Nepal.
| | - Basanta Gelal
- Department of Biochemistry, B.P. Koirala Institute of Health Sciences, Dharan, Nepal.
| | - Binod Kumar Lal Das
- 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.
| | - Paras Kumar Pokharel
- Department of Community Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal.
| | - Ashwini Kumar Nepal
- Department of Biochemistry, B.P. Koirala Institute of Health Sciences, Dharan, Nepal.
| | - David A Brodie
- Department of Biochemistry, Faculty of Society and Health, Bucks New University, High Wycombe, Buckinghamshire, UK.
| | - Gauri Shankar Sah
- Department of Paediatrics and Adolescent Medicine, 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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BÍLEK R, ČEŘOVSKÁ J, ZAMRAZIL V. The Relationship Between Iodine Intake and Serum Thyroglobulin in the General Population. Physiol Res 2015; 64:345-53. [DOI: 10.33549/physiolres.932840] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The relationship is shown between a concentration of urinary iodine and serum thyroglobulin in population studies carried out on a general population that was randomly selected from the registry of the General Health Insurance Company (individuals aged 6-98 years, 1751 males, 2420 females). The individuals were divided into subgroups with a urinary iodine concentration of <50, 50-99, 100-199, 200-299 and ≥300 μg/l. The mean and median of thyroglobulin were calculated in these subgroups. Tg concentrations were dependent on gender (males<females), age (thyroglobulin increased with age) and statistically significant negative relationship was observed between thyroglobulin and urinary iodine in individuals with urinary iodine <300 μg/l and the age under 65 years. Upper nonparametric tolerance limits of thyroglobulin in relation to iodine intake were calculated in subgroup of normal individuals (n=1858, thyroglobulin, urinary iodine, thyrotropin and free thyroxine were within the normal reference range). Upper limits were dependent on gender and age. The total value of upper limits is 44 μg/l; for individuals aged 6-17 years it is 39.1 μg/l; 18-65 years = 51.4 μg/l and 66-98 years = 60.6 μg/l. In general, thyroglobulin serum concentrations higher than 40 μg/l should be an indicator for determining urinary iodine.
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Affiliation(s)
- R. BÍLEK
- Institute of Endocrinology, Prague, Czech Republic
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Ristić-Medić D, Dullemeijer C, Tepsić J, Petrović-Oggiano G, Popović T, Arsić A, Glibetić M, Souverein OW, Collings R, Cavelaars A, de Groot L, van't Veer P, Gurinović M. Systematic review using meta-analyses to estimate dose-response relationships between iodine intake and biomarkers of iodine status in different population groups. Nutr Rev 2014; 72:143-61. [PMID: 24697303 DOI: 10.1111/nure.12092] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The objective of this systematic review was to identify studies investigating iodine intake and biomarkers of iodine status, to assess the data of the selected studies, and to estimate dose-response relationships using meta-analysis. All randomized controlled trials, prospective cohort studies, nested case-control studies, and cross-sectional studies that supplied or measured dietary iodine and measured iodine biomarkers were included. The overall pooled regression coefficient (β) and the standard error of β were calculated by random-effects meta-analysis on a double-log scale, using the calculated intake-status regression coefficient (β) for each individual study. The results of pooled randomized controlled trials indicated that the doubling of dietary iodine intake increased urinary iodine concentrations by 14% in children and adolescents, by 57% in adults and the elderly, and by 81% in pregnant women. The dose-response relationship between iodine intake and biomarkers of iodine status indicated a 12% decrease in thyroid-stimulating hormone and a 31% decrease in thyroglobulin in pregnant women. The model of dose-response quantification used to describe the relationship between iodine intake and biomarkers of iodine status may be useful for providing complementary evidence to support recommendations for iodine intake in different population groups.
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A study on the influencing factors of urinary iodine concentration and the relationship between iodised salt concentration and urinary iodine concentration. Br J Nutr 2014; 113:142-6. [PMID: 25400041 DOI: 10.1017/s0007114514003377] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The aim of the present study was to explore the influencing factors of urinary iodine concentration (UIC) and the relationship between iodised salt concentration and UIC in order to give suggestions for the surveillance of iodine nutrition status. For this purpose, a multi-stage cluster sampling technique was employed in the present cross-sectional study. Correlations between UIC and salt iodine concentration were evaluated by Spearmen's correlation analysis. Risk factors of having a lower UIC were identified by logistic regression analysis, and the equations of UIC and salt iodine concentration were fitted by curve regression analysis. The median UIC was found to be 162·0 (25th-75th percentile 98·2-248·6) μg/l. The UIC was correlated with salt iodine concentration (Spearman's ρ = 0·144, P< 0·05). The multiple logistic regression analysis found the following influencing factors for having a lower UIC: age (OR 0·98, 95% CI 0·98, 0·98, P< 0·05); sex (OR 0·81, 95% CI 0·71, 0·92, P< 0·05); education level (OR 0·87, 95% CI 0·83, 0·90, P< 0·05); status of occupation (OR 0·91, 95% CI 0·86, 0·96, P< 0·05); occupation (OR 1·03, 95% CI 1·00, 1·05, P< 0·05); pickled food (OR 1·24, 95% CI 1·08, 1·42, P< 0·05); salt iodine concentration (OR 1·03, 95% CI 1·02, 1·03, P< 0·05). The curve regression analysis found that UIC (y) and salt iodine concentration (x) could be expressed by the following equation: y= 1·5772x 1·4845. In conclusion, the median UIC of individuals in Zhejiang Province falls within optimal status as recommended by the WHO/UNICEF/International Council for Control of IDD. To maintain optimal iodine nutrition status, salt iodine concentration should be in the range of 16·4 to 34·3 mg/kg.
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Novaković R, Cavelaars A, Geelen A, Nikolić M, Altaba II, Viñas BR, Ngo J, Golsorkhi M, Medina MW, Brzozowska A, Szczecinska A, de Cock D, Vansant G, Renkema M, Majem LS, Moreno LA, Glibetić M, Gurinović M, van't Veer P, de Groot LCPGM. Socio-economic determinants of micronutrient intake and status in Europe: a systematic review. Public Health Nutr 2014; 17:1031-45. [PMID: 23750829 PMCID: PMC10282449 DOI: 10.1017/s1368980013001341] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Revised: 03/06/2013] [Accepted: 03/12/2013] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To provide the evidence base for targeted nutrition policies to reduce the risk of micronutrient/diet-related diseases among disadvantaged populations in Europe, by focusing on: folate, vitamin B12, Fe, Zn and iodine for intake and status; and vitamin C, vitamin D, Ca, Se and Cu for intake. DESIGN MEDLINE and Embase databases were searched to collect original studies that: (i) were published from 1990 to 2011; (ii) involved >100 subjects; (iii) had assessed dietary intake at the individual level; and/or (iv) included best practice biomarkers reflecting micronutrient status. We estimated relative differences in mean micronutrient intake and/or status between the lowest and highest socio-economic groups to: (i) evaluate variation in intake and status between socio-economic groups; and (ii) report on data availability. SETTING Europe. SUBJECTS Children, adults and elderly. RESULTS Data from eighteen publications originating primarily from Western Europe showed that there is a positive association between indicators of socio-economic status and micronutrient intake and/or status. The largest differences were observed for intake of vitamin C in eleven out of twelve studies (5-47 %) and for vitamin D in total of four studies (4-31 %). CONCLUSIONS The positive association observed between micronutrient intake and socio-economic status should complement existing evidence on socio-economic inequalities in diet-related diseases among disadvantaged populations in Europe. These findings could provide clues for further research and have implications for public health policy aimed at improving the intake of micronutrients and diet-related diseases.
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Affiliation(s)
- Romana Novaković
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, Tadeuska Koscuska 1, 11000 Belgrade, Serbia
- Division of Human Nutrition, Wageningen University and Research Centre, Wageningen, The Netherlands
| | - Adriënne Cavelaars
- Division of Human Nutrition, Wageningen University and Research Centre, Wageningen, The Netherlands
| | - Anouk Geelen
- Division of Human Nutrition, Wageningen University and Research Centre, Wageningen, The Netherlands
| | - Marina Nikolić
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, Tadeuska Koscuska 1, 11000 Belgrade, Serbia
| | - Iris Iglesia Altaba
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, School of Health Science (EUCS), University of Zaragoza, Zaragoza, Spain
| | - Blanca Roman Viñas
- Community Nutrition Research Centre of the Nutrition Research Foundation, University of Barcelona, Barcelona, Spain
| | - Joy Ngo
- Community Nutrition Research Centre of the Nutrition Research Foundation, University of Barcelona, Barcelona, Spain
| | - Mana Golsorkhi
- Department of Sport and Health Sciences, Oxford Brookes University, Oxford, UK
| | - Marisol Warthon Medina
- Centre for Applied Sport and Exercise Sciences, University of Central Lancashire, Preston, UK
| | - Anna Brzozowska
- Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences (WULS-SGGW), Warsaw, Poland
| | - Anna Szczecinska
- Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences (WULS-SGGW), Warsaw, Poland
| | - Diederik de Cock
- Department of Nutrition–Public Health Medicine, LFoRCe (Leuven Food Science and Nutrition Research Centre), Catholic University, Leuven, Belgium
| | - Greet Vansant
- Department of Nutrition–Public Health Medicine, LFoRCe (Leuven Food Science and Nutrition Research Centre), Catholic University, Leuven, Belgium
| | - Marianne Renkema
- Division of Human Nutrition, Wageningen University and Research Centre, Wageningen, The Netherlands
| | - Lluís Serra Majem
- Community Nutrition Research Centre of the Nutrition Research Foundation, University of Barcelona, Barcelona, Spain
- Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Luis Aznar Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, School of Health Science (EUCS), University of Zaragoza, Zaragoza, Spain
| | - Maria Glibetić
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, Tadeuska Koscuska 1, 11000 Belgrade, Serbia
| | - Mirjana Gurinović
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, Tadeuska Koscuska 1, 11000 Belgrade, Serbia
| | - Pieter van't Veer
- Division of Human Nutrition, Wageningen University and Research Centre, Wageningen, The Netherlands
| | - Lisette CPGM de Groot
- Division of Human Nutrition, Wageningen University and Research Centre, Wageningen, The Netherlands
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Bénéfices et risques d’une supplémentation en iode des femmes enceintes : une revue des études observationnelles et expérimentales en régions de carence iodée légère à modérée. Rev Epidemiol Sante Publique 2014; 62:65-74. [DOI: 10.1016/j.respe.2013.08.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2013] [Revised: 07/26/2013] [Accepted: 08/19/2013] [Indexed: 11/19/2022] Open
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Bliddal S, Feldt-Rasmussen U, Boas M, Faber J, Juul A, Larsen T, Precht DH. Gestational age-specific reference ranges from different laboratories misclassify pregnant women's thyroid status: comparison of two longitudinal prospective cohort studies. Eur J Endocrinol 2014; 170:329-39. [PMID: 24277773 DOI: 10.1530/eje-13-0672] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES Correct interpretation of thyroid status during pregnancy is vital to secure fetal development. Pregnancy-related changes in maternal thyroid status necessitate the use of gestational age-specific reference ranges. In this study, we investigated between-laboratory reproducibility of thyroid reference ranges in pregnant women. DESIGN Comparison of two longitudinal prospective cohort studies including 255 (cohort 1) and 101 (cohort 2) healthy antibody-negative Danish pregnant women attending prenatal care at Copenhagen University Hospital. METHODS Different immunoassays were used to measure thyroid hormone levels in the two cohorts. Thyroid hormone reference ranges were established for every 5 weeks of gestation. Differences between cohorts were explored through mixed-model repeated measures regression analyses. By applying reference ranges from one cohort to the other, the proportion of women who would be misclassified by doing so was investigated. RESULTS TSH increased and free thyroxine (FT4) decreased as pregnancy progressed. Results indicated highly significant differences between cohorts in free triiodothyronine (F=21.3, P<0.001) and FT4 (F=941, P<0.001). TSH levels were comparable (P=0.09). Up to 90.3% of the women had FT4 levels outside their laboratory's nonpregnant reference range, and up to 100% outside the other cohort's gestational-age-specific reference ranges. Z-score-based reference ranges markedly improved comparison between cohorts. CONCLUSION Even in the same region, the use of gestational-age-specific reference ranges from different laboratories led to misclassification. Up to 100% of maternal FT4 levels fell outside the other cohort's reference range despite similar TSH levels. In clinical practice, thyroid testing of pregnant women without adding method specificity to gestational age-dependent reference ranges will compromise patient safety.
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Affiliation(s)
- Sofie Bliddal
- Department of Endocrinology, Section 2132, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
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Charlton KE, Batterham MJ, Buchanan LM, Mackerras D. Intraindividual variation in urinary iodine concentrations: effect of adjustment on population distribution using two and three repeated spot urine collections. BMJ Open 2014; 4:e003799. [PMID: 24401724 PMCID: PMC3902374 DOI: 10.1136/bmjopen-2013-003799] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To determine the effect of adjustment for intraindividual variation on estimations of urinary iodine concentrations (UIC), prevalence of iodine deficiency and population distribution of iodine status. SETTING Community-dwelling older adults from New South Wales, Australia. PARTICIPANTS 84 healthy men and women aged 60-95 years were recruited prior to introduction of the mandatory iodine fortification programme. PRIMARY AND SECONDARY OUTCOME MEASURES UIC data were collected from three spot urine samples, each 1 week apart. Repeated measures analysis of variance were determined between-person (sb) and total (sobs) SDs. Adjusted UIC values were calculated as ((person's UIC-group mean)×(sb/sobs))+group mean, and a corrected UIC distribution was calculated. RESULTS The sb/sobs for using three samples and two samples were 0.83 and 0.79, respectively. Following adjustment for intraindividual variation, the proportion with UIC <50 μg/L reduced from 33% to 19%, while the proportion with UIC ≥100 μg/L changed from 21% to 17%. The 95th centile for UIC decreased from 176 to 136 μg/L. Adjustment by taking averages yielded a lesser degree of contraction in the distribution than the analysis of variance method. CONCLUSIONS The addition of information about intraindividual variability has potential for increasing the interpretability of UIC data collected to monitor the iodine status of a population.
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Affiliation(s)
- Karen E Charlton
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
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Ristić-Medić D, Novaković R, Glibetić M, Gurinović M. EURRECA—Estimating Iodine Requirements for Deriving Dietary Reference Values. Crit Rev Food Sci Nutr 2013; 53:1051-63. [PMID: 23952087 DOI: 10.1080/10408398.2012.742859] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Micronutrient intake and status in Central and Eastern Europe compared with other European countries, results from the EURRECA network. Public Health Nutr 2012; 16:824-40. [DOI: 10.1017/s1368980012004077] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectiveTo compare micronutrient intakes and status in Central and Eastern Europe (CEE) with those in other European countries and with reference values.DesignReview of the micronutrient intake/status data from open access and grey literature sources from CEE.SettingMicronutrients studied were folate, iodine, Fe, vitamin B12 and Zn (for intake and status) and Ca, Cu, Se, vitamin C and vitamin D (for intake). Intake data were based on validated dietary assessment methods; mean intakes were compared with average nutrient requirements set by the Nordic countries or the US Institute of Medicine. Nutritional status was assessed using the status biomarkers and cut-off levels recommended primarily by the WHO.SubjectsFor all population groups in CEE, the mean intake and mean/median status levels were compared between countries and regions: CEE, Scandinavia, Western Europe and Mediterranean.ResultsMean micronutrient intakes of adults in the CEE region were in the same range as those from other European regions, with exception of Ca (lower in CEE). CEE children and adolescents had poorer iodine status, and intakes of Ca, folate and vitamin D were below the reference values.ConclusionsCEE countries are lacking comparable studies on micronutrient intake/status across all age ranges, especially in children. Available evidence showed no differences in micronutrient intake/status in CEE populations in comparison with other European regions, except for Ca intake in adults and iodine and Fe status in children. The identified knowledge gaps urge further research on micronutrient intake/status of CEE populations to make a basis for evidence-based nutrition policy.
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Souverein OW, Dullemeijer C, van't Veer P, van der Voet H. Transformations of summary statistics as input in meta-analysis for linear dose-response models on a logarithmic scale: a methodology developed within EURRECA. BMC Med Res Methodol 2012; 12:57. [PMID: 22533574 PMCID: PMC3780718 DOI: 10.1186/1471-2288-12-57] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2012] [Accepted: 04/12/2012] [Indexed: 11/30/2022] Open
Abstract
Background To derive micronutrient recommendations in a scientifically sound way, it is important to obtain and analyse all published information on the association between micronutrient intake and biochemical proxies for micronutrient status using a systematic approach. Therefore, it is important to incorporate information from randomized controlled trials as well as observational studies as both of these provide information on the association. However, original research papers present their data in various ways. Methods This paper presents a methodology to obtain an estimate of the dose–response curve, assuming a bivariate normal linear model on the logarithmic scale, incorporating a range of transformations of the original reported data. Results The simulation study, conducted to validate the methodology, shows that there is no bias in the transformations. Furthermore, it is shown that when the original studies report the mean and standard deviation or the geometric mean and confidence interval the results are less variable compared to when the median with IQR or range is reported in the original study. Conclusions The presented methodology with transformations for various reported data provides a valid way to estimate the dose–response curve for micronutrient intake and status using both randomized controlled trials and observational studies.
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Affiliation(s)
- Olga W Souverein
- Division of Human Nutrition, Wageningen University and Research Centre, PO Box 8129, 6700 EV Wageningen, the Netherlands.
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Yoshida M, Fukuwatari T, Sakai J, Tsuji T, Shibata K. Correlation between Mineral Intake and Urinary Excretion in Free-Living Japanese Young Women. ACTA ACUST UNITED AC 2012. [DOI: 10.4236/fns.2012.31018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Dietary intake of energy and nutrients in relation to resting energy expenditure and anthropometric parameters of Czech pregnant women. Eur J Nutr 2011; 52:117-25. [DOI: 10.1007/s00394-011-0293-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2011] [Accepted: 12/11/2011] [Indexed: 10/14/2022]
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Iodine-induced psychic instability during two consecutive euthyreotic pregnancies. Eur J Integr Med 2011. [DOI: 10.1016/j.eujim.2011.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Current trends of 24-h urinary iodine excretion in German schoolchildren and the importance of iodised salt in processed foods. Br J Nutr 2011; 106:1749-56. [PMID: 22017962 DOI: 10.1017/s0007114511005502] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Worldwide, the iodisation of salt has clearly improved iodine status. In industrialised countries, iodised salt added to processed food contributes most to iodine supply. Yet it is unclear as to what extent changes in the latter may affect the iodine status of populations. Between 2004 and 2009, 24-h urinary iodine excretions (UIE) were repeatedly measured in 278 German children (6 to 12 years old) of the Dortmund Nutritional and Anthropometric Longitudinally Designed Study (n 707). Na excretion measurements and simultaneously collected 3-d weighed dietary records provided data on intakes of the most important dietary sources of iodine in the children's diet. Actual trends of UIE (2004-9) and contributions of relevant food groups were analysed by mixed linear regression models. Longitudinal regression analysis showed a plateau of UIE in 2004-6; afterwards, UIE significantly decreased till 2009 (P = 0·01; median 24-h UIE in 2004-6: 85·6 μg/d; 2009: 80·4 μg/d). Median urinary iodine concentration fell below the WHO criteria for iodine sufficiency of 100 μg/l in 2007-9. Salt, milk, fish and egg intake (g/d) were significant predictors of UIE (P < 0·005); and the main sources of iodine were salt and milk (48 and 38 %, respectively). The present data hint at a beginning deterioration in the iodine status of German schoolchildren. A decreased use of iodised salt in industrially produced foods may be one possible reason for this development. Because of the generally known risks for cognitive impairment due to even mild iodine deficits in children, a more widespread use of iodised salt, especially in industrially processed foods, has to be promoted.
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Hedayati M, Khazan M, Yaghmaee P, Yeghaneh MZ, Behdadfar L, Daneshpour MS. Rapid microwave digestion and microplate reading format method for urinary iodine determination. Clin Chem Lab Med 2011; 49:281-4. [DOI: 10.1515/cclm.2011.053] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Berti C, Decsi T, Dykes F, Hermoso M, Koletzko B, Massari M, Moreno LA, Serra‐Majem L, Cetin I. Critical issues in setting micronutrient recommendations for pregnant women: an insight. MATERNAL & CHILD NUTRITION 2010; 6 Suppl 2:5-22. [PMID: 22296248 PMCID: PMC6860719 DOI: 10.1111/j.1740-8709.2010.00269.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The European Micronutrient Recommendations Aligned (EURRECA) Network aims to provide standardized approaches to reveal and beneficially influence variability within the European Union in micronutrient recommendations for vulnerable population groups. Characterization of the 'vulnerability' together with the 'variability' of micronutrient needs represents the first step to creating guidelines for setting micronutrient recommendations within target populations. This paper describes some of the key factors and characteristics relevant to assess micronutrient requirements and formulate recommendations of micronutrients in pregnancy. Nutritional requirements during pregnancy increase to support fetal growth and development as well as maternal metabolism and tissue accretion. Micronutrients are involved in both embryonal and fetal organ development and overall pregnancy outcomes. Several factors may affect directly or indirectly fetal nourishment and the overall pregnancy outcomes, such as the quality of diet including intakes and bioavailability of micronutrients, maternal age, and the overall environment. The bioavailability of micronutrients during pregnancy varies depending on specific metabolic mechanisms because pregnancy is an anabolic and dynamic state orchestrated via hormones acting for both redirection of nutrients to highly specialized maternal tissues and transfer of nutrients to the developing fetus. The timing of prenatal intakes or supplementations of specific micronutrients is also crucial as pregnancy is characterized by different stages that represent a continuum, up to lactation and beyond. Consequently, nutrition during pregnancy might have long-lasting effects on the well-being of the mother and the fetus, and may further influence the health of the baby at a later age.
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Affiliation(s)
- Cristiana Berti
- Unit of Obstetrics and Gynecology, Department of Clinical Sciences Hospital ‘L. Sacco’ and Center for Fetal Research Giorgio Pardi, University of Milan, 20157 Milano, Italy
| | | | - Fiona Dykes
- Maternal and Infant Nutrition and Nurture Unit (MAINN), University of Central Lancashire, PR1 2HE Preston, UK
| | - Maria Hermoso
- Division of Metabolic Diseases and Nutritional Medicine, Dr von Hauner Children's Hospital, Ludwig‐Maximilians‐University of Munich, 80337 Munich, Germany
| | - Berthold Koletzko
- Division of Metabolic Diseases and Nutritional Medicine, Dr von Hauner Children's Hospital, Ludwig‐Maximilians‐University of Munich, 80337 Munich, Germany
| | - Maddalena Massari
- Unit of Obstetrics and Gynecology, Department of Clinical Sciences Hospital ‘L. Sacco’ and Center for Fetal Research Giorgio Pardi, University of Milan, 20157 Milano, Italy
| | - Luis A. Moreno
- ‘Growth, Exercise, Nutrition and Development’ (GENUD) Research Group, Escuela Universitaria de Ciencias de la Salud, Universidad de Zaragoza, 50009 Zaragoza, Spain, and
| | - Luis Serra‐Majem
- Departamento de Ciencias Clínicas, Universidad de Las Palmas de Gran Canaria, 35080 Las Palmas de Gran Canaria, Spain
| | - Irene Cetin
- Unit of Obstetrics and Gynecology, Department of Clinical Sciences Hospital ‘L. Sacco’ and Center for Fetal Research Giorgio Pardi, University of Milan, 20157 Milano, Italy
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Lee JH, Ji OJ, Song MJ, Park HD, Kim HK, Kim SW, Chung JH, Lee SY. Determination of Urinary Iodine Concentration by Inductively Coupled Plasma-mass Spectrometry in Thyroid Cancer Patients on Low-iodine Diet. Ann Lab Med 2010; 30:351-6. [DOI: 10.3343/kjlm.2010.30.4.351] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Ji Hyun Lee
- Department of Laboratory Medicine & Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ok-Ja Ji
- Department of Laboratory Medicine & Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Min-Jung Song
- Department of Laboratory Medicine & Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyung-Doo Park
- Department of Laboratory Medicine & Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hee Kyung Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sun Wook Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Hoon Chung
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Soo-Youn Lee
- Department of Laboratory Medicine & Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Developing micronutrient reference values: prioritization of tool development by the EURRECA Network of Excellence. Eur J Clin Nutr 2010; 64 Suppl 2:S11-8. [DOI: 10.1038/ejcn.2010.56] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Melse-Boonstra A, Jaiswal N. Iodine deficiency in pregnancy, infancy and childhood and its consequences for brain development. Best Pract Res Clin Endocrinol Metab 2010; 24:29-38. [PMID: 20172468 DOI: 10.1016/j.beem.2009.09.002] [Citation(s) in RCA: 111] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Iodine deficiency during foetal development and early childhood is associated with cognitive impairment. Randomised clinical studies in school-aged children encountered in the literature indicate that cognitive performance can be improved by iodine supplementation, but most studies suffer from methodological constraints. Tests to assess cognitive performance in the domains that are potentially affected by iodine deficiency need to be refined. Maternal iodine supplementation in areas of mild-to-moderate iodine deficiency may improve cognitive performance of the offspring, but randomised controlled studies with long-term outcomes are lacking. Studies in infants or young children have not been conducted. The best indicators for iodine deficiency in children are thyroid-stimulating hormone (TSH) in newborns and thyroglobulin (Tg) in older children. Urinary iodine may also be useful but only at the population level. Adequate salt iodisation will cover the requirements of infants and children as well as pregnant women. However, close monitoring remains essential.
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Affiliation(s)
- Alida Melse-Boonstra
- Division of Human Nutrition, Wageningen University, 6700 EV Wageningen, the Netherlands.
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Abstract
The management of the child with intestinal failure is complex, and it is developing into a multispecialty field of its own led by expert teams of both transplant and nontransplant surgeons, gastroenterologists, and dieticians. Patients are at risk for medical, surgical, and nutritional complications that should be anticipated so that they can be prevented or managed appropriately. Catheter associated infections and intestinal failure associated liver diseases are important complications that impact the likelihood of bowel adaptation and long-term survival. The clinical assessment of a pediatric intestinal failure patient should include evaluation of the child within the context of recognized prognostic factors.
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Affiliation(s)
- Jason S Soden
- Section of Pediatric Gastroenterology, Hepatology, and Nutrition, University of Colorado Denver School of Medicine and The Children's Hospital, Aurora, Colorado 80045, USA.
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Andersson M, de Benoist B, Rogers L. Epidemiology of iodine deficiency: Salt iodisation and iodine status. Best Pract Res Clin Endocrinol Metab 2010; 24:1-11. [PMID: 20172466 DOI: 10.1016/j.beem.2009.08.005] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Universal salt iodisation (USI) and iodine supplementation are highly effective strategies for preventing and controlling iodine deficiency. USI is now implemented in nearly all countries worldwide, and two-thirds of the world's population is covered by iodised salt. The number of countries with iodine deficiency as a national public health problem has decreased from 110 in 1993 to 47 in 2007. Still one-third of households lack access to adequately iodised salt. Iodine deficiency remains a major threat to the health and development of populations around the world, particularly in children and pregnant women in low-income countries. Data on iodine status are available from 130 countries and approximately one-third of the global population is estimated to have a low iodine intake based on urinary iodine (UI) concentrations. Insufficient control of iodine fortification levels has led to excessive iodine intakes in 34 countries. The challenges ahead lie in ensuring higher coverage of adequately iodised salt, strengthening regular monitoring of salt iodisation and iodine status in the population, together with targeted interventions for vulnerable population groups.
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Affiliation(s)
- Maria Andersson
- Human Nutrition Laboratory, Institute of Food Science and Nutrition, Swiss Federal Institute of Technology Zurich, CH 8092 Zurich, Switzerland.
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Charlton KE, Gemming L, Yeatman H, Ma G. Suboptimal iodine status of Australian pregnant women reflects poor knowledge and practices related to iodine nutrition. Nutrition 2010; 26:963-8. [PMID: 20080029 DOI: 10.1016/j.nut.2009.08.016] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2009] [Revised: 07/22/2009] [Accepted: 08/15/2009] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess the iodine status and knowledge and practices related to iodine nutrition of Australian women during pregnancy. METHODS A cross-sectional study was conducted at a public antenatal clinic in the Illawarra region of New South Wales. One hundred thirty-nine pregnant women across all trimesters provided a spot urine sample (n = 110) and completed a short questionnaire (n = 139) in English. Iodine status was based on World Health Organization/International Committee for the Control of Iodine Deficiency Disorders urine iodine concentration (UIC) categories. RESULTS Median UIC was 87.5 μg/L (interquartile range 62); only 14.5% of participants had an adequate UIC value ≥150 μg/L. Fifteen percent of women had very low UIC values (<50 μg/L), whereas 45.5% had values in the 50- to 99-μg/L range. Knowledge of the adverse health effects of an inadequate iodine intake was poor. Approximately half the participants were able to indicate good dietary sources of iodine, such as fish (58%) and iodized salt (51%). However, a high level of confusion regarding other foods was evident. Only a small number of participants (11%) reported that they had intentionally changed their diet to increase iodine intake during pregnancy, but 59% indicated supplement use, of which 35% contained iodine. Those who were taking supplements that contained iodine had significantly higher UIC levels (139.1 μg/L) than those who were not (90.8 μg/L, P < 0.05). CONCLUSION Public health strategies, including nutritional education and supplementation, are urgently required to improve the iodine status of pregnant women. Currently, no readily accessible information on iodine is available to women attending antenatal clinics in Australia.
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Affiliation(s)
- Karen E Charlton
- Smart Foods Centre, School of Health Sciences, University of Wollongong, Wollongong, New South Wales, Australia.
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Seamans KM, Cashman KD. Existing and potentially novel functional markers of vitamin D status: a systematic review. Am J Clin Nutr 2009; 89:1997S-2008S. [PMID: 19403634 DOI: 10.3945/ajcn.2009.27230d] [Citation(s) in RCA: 192] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Although serum 25-hydroxyvitamin D [25(OH)D] is the currently accepted vitamin D status marker of choice, use of other biomarkers or functional endpoints have been suggested. OBJECTIVE The objective was to systematically review the effectiveness of 25(OH)D, parathyroid hormone (PTH), bone turnover markers, bone mineral density (BMD), and calcium absorption as biomarkers of vitamin D status. DESIGN Methods included a structured search on Ovid MEDLINE, EMBASE (Ovid), and Cochrane CENTRAL; rigorous inclusion/exclusion criteria; data extraction; quality assessment; meta-analysis; and meta-regression. RESULTS Thirty-six vitamin D supplementation randomized controlled trials (RCTs) and 4 before-after studies were included. Vitamin D supplementation significantly raised circulating 25(OH)D in all but one RCT, but the response was highly heterogeneous [weighted mean difference (WMD): 34.1 nmol/L; 95% CI: 28.9, 39.2; 32 RCTs; I2 = 97%). Vitamin D supplementation (without calcium) significantly lowered circulating PTH (WMD: -0.29 pmol/L; 95% CI: -0.56, -0.02; 11 RCTs; I2 = 29%), but this was not apparent in the presence of calcium supplementation. There was a suggestion that whole-body or lumbar spine BMD may be a useful biomarker in older people but not in adolescents. Bone turnover markers were not useful biomarkers of vitamin D status, but 4 before-after studies suggested that intestinal calcium absorption may respond to vitamin D status. CONCLUSIONS This systematic review confirmed that circulating 25(OH)D is a robust and reliable marker of vitamin D status. Further research is needed to clarify which population subgroups show responses of PTH, BMD, and/or calcium absorption in response to changes in vitamin D status.
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Affiliation(s)
- Kelly M Seamans
- Department of Food and Nutritional Sciences, University College Cork, Cork, Ireland
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Hoey L, McNulty H, Strain JJ. Studies of biomarker responses to intervention with riboflavin: a systematic review. Am J Clin Nutr 2009; 89:1960S-1980S. [PMID: 19403631 DOI: 10.3945/ajcn.2009.27230b] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND National survey data of erythrocyte glutathione reductase activation coefficient (EGRac) indicate that suboptimal riboflavin status may be a problem in all population age groups, but the cutoff for deficiency is controversial. In addition, the effectiveness of different biomarkers of riboflavin status has not been critically evaluated. OBJECTIVE We aimed to assess the effectiveness of different biomarkers of riboflavin status through a systematic review of published riboflavin supplementation trials. DESIGN We structured our search strategy on Ovid MEDLINE, EMBASE (Ovid), and Cochrane databases; formal inclusion and exclusion criteria; data extraction; validity assessment; and meta-analysis. RESULTS Eighteen supplementation studies reporting up to 14 biomarkers were included. Sufficient data were available to show that EGRac (14 studies) and basal glutathione reductase activity (5 studies) were effective biomarkers of altered riboflavin intake (P < 0.00001), although substantial heterogeneity (I2 > 66%) that could not be explained by the subgroup analysis was observed. Plasma total homocysteine was not an effective biomarker of riboflavin status in the general population, but some evidence identified its potential usefulness specifically in those homozygous for a common polymorphism in the MTHFR gene. CONCLUSIONS The evidence suggests that EGRac is an effective biomarker of a change in riboflavin intake in populations with severe-to-normal baseline status. Studies of healthy populations that compare the response to low-dose supplementation among different age, sex, and MTHFR genotype groups are required to provide evidence for generating dietary riboflavin recommendations specific to different population subgroups. Further research into alternative biomarkers to EGRac is also required.
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Affiliation(s)
- Leane Hoey
- Northern Ireland Centre for Food and Health, School of Biomedical Sciences, University of Ulster, Coleraine, Northern Ireland, United Kingdom.
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Ashton K, Hooper L, Harvey LJ, Hurst R, Casgrain A, Fairweather-Tait SJ. Methods of assessment of selenium status in humans: a systematic review. Am J Clin Nutr 2009; 89:2025S-2039S. [PMID: 19420095 DOI: 10.3945/ajcn.2009.27230f] [Citation(s) in RCA: 205] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND To understand the effect of selenium intake on health, it is important to identify sensitive and population-specific biomarkers of selenium status. OBJECTIVE The objective of this systematic review was to assess the usefulness of biomarkers of selenium status in humans. DESIGN The methods included a structured search strategy on Ovid MEDLINE, EMBASE (Ovid), and Cochrane databases; formal inclusion and exclusion criteria; data extraction into an Access database; validity assessment; and meta-analysis. RESULTS The data from 18 selenium supplementation studies (of which 9 were randomized controlled trials and 1 was considered to be at low risk of bias) indicate that plasma, erythrocyte, and whole-blood selenium, plasma selenoprotein P, and plasma, platelet, and whole-blood glutathione peroxidase activity respond to changes in selenium intake. Although there is a substantial body of data for plasma selenium, more large, high-quality, randomized controlled trials are needed for this biomarker, as well as for the other biomarkers, to explore the reasons for heterogeneity in response to selenium supplementation. There was insufficient evidence to assess the usefulness of other potential biomarkers of selenium status, including urinary selenium, plasma triiodothyroxine:thyroxine ratio, plasma thyroxine, plasma total homocysteine, hair and toenail selenium, erythrocyte, and muscle glutathione peroxidase activity. CONCLUSIONS For all potentially useful biomarkers, more information is needed to evaluate their strengths and limitations in different population groups, including the effects of varying intakes, the duration of intervention, baseline selenium status, and possible confounding effects of genotype.
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Affiliation(s)
- Kate Ashton
- School of Medicine, Health Policy and Practice, the University of East Anglia, Norwich, United Kingdom
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Hoey L, Strain JJ, McNulty H. Studies of biomarker responses to intervention with vitamin B-12: a systematic review of randomized controlled trials. Am J Clin Nutr 2009; 89:1981S-1996S. [PMID: 19403638 DOI: 10.3945/ajcn.2009.27230c] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Mild vitamin B-12 deficiency is common among older adults, but evidence for setting dietary recommendations is limited because most studies have administered vitamin B-12 via nonoral routes or at doses several hundred times higher than current recommendations. Furthermore, different biomarkers of vitamin B-12 status have not been systematically reviewed. OBJECTIVE The aim was to assess the effectiveness of biomarkers of vitamin B-12 status through a systematic review of published randomized controlled trials of oral vitamin B-12 supplementation. DESIGN Methods included a structured search strategy on Ovid MEDLINE, EMBASE (Ovid), and Cochrane databases; formal inclusion and exclusion criteria; data extraction; validity assessment; and meta-analysis. RESULTS Eight randomized controlled trials were included, and all studies measured serum and plasma total vitamin B-12, 3 studies measured methylmalonic acid, and 6 studies measured total homocysteine response. All 3 biomarkers were found to be effective measures of altered vitamin B-12 intake in populations with low and borderline baseline vitamin B-12 status (P < 0.00001); however, in the case of total vitamin B-12, substantial heterogeneity that could not be fully explained by subgroup analysis was observed. Insufficient data were available to determine the effectiveness of plasma holotranscobalamin, which was measured in only one randomized controlled trial. CONCLUSIONS The available evidence suggests that plasma and serum concentrations of total vitamin B-12, methylmalonic acid, and total homocysteine are all effective biomarkers of a change in vitamin B-12 intake; however, because the available data were limited, it was not possible to examine fully the factors that could explain the substantial heterogeneity in total vitamin B-12. Future trials should include low-dose vitamin B-12 in adults across the entire age spectrum and measure the holotranscobalamin response to supplementation.
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Affiliation(s)
- Leane Hoey
- Northern Ireland Centre for Food and Health, School of Biomedical Sciences, University of Ulster, Coleraine, Northern Ireland, United Kingdom.
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