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Kim C, Park K. Association between seaweed intake and risk of type 2 diabetes mellitus: a prospective cohort study. Br J Nutr 2024; 131:1259-1267. [PMID: 38012847 PMCID: PMC10918518 DOI: 10.1017/s0007114523002751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 11/09/2023] [Accepted: 11/21/2023] [Indexed: 11/29/2023]
Abstract
This study aimed to identify the longitudinal association between seaweed and type 2 diabetes mellitus (T2DM) in the Korean population. Data from 148 404 Korean adults aged 40 years and older without a history of T2DM, cardiovascular disease or cancer at baseline were obtained from the Korean Genome and Epidemiology Study data. The participants' seaweed intake was obtained using a validated semi-quantitative food frequency questionnaire, and the diagnosis of T2DM was surveyed through a self-reported questionnaire during follow-up. The hazard ratio (HR) and 95 % confidence interval (CI) for T2DM were calculated using the Cox proportional hazard regression, and the dose-response relationship was analysed using a restricted cubic spline regression. Participants had a mean follow-up period of 5 years. Participants with the highest seaweed intake had a 7 % lower risk of T2DM compared with the group with the lowest intake (95 % CI (0·87, 0·99)). Interestingly, this association was stronger in those with normal weight (HR: 0·88, 95 % CI (0·81, 0·95)), while no association was observed in participants with obesity. Spline regression revealed an inverse linear relationship between seaweed intake and T2DM risk in participants with normal weight, showing a trend where increased seaweed intake is related to lower instances of T2DM (Pfor nonlinearity = 0·48). Seaweed intake is inversely associated with the onset of T2DM in Korean adults with normal weight.
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Affiliation(s)
- Chaehyun Kim
- Department of Food and Nutrition, Yeungnam University, Gyeongbuk, 38541, Republic of Korea
| | - Kyong Park
- Department of Food and Nutrition, Yeungnam University, Gyeongbuk, 38541, Republic of Korea
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Association between urinary iodine concentration and the risk of papillary thyroid cancer by sex and age: a case-control study. Sci Rep 2023; 13:2041. [PMID: 36739467 PMCID: PMC9899236 DOI: 10.1038/s41598-023-29071-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 01/30/2023] [Indexed: 02/05/2023] Open
Abstract
Previous studies on dietary iodine intake and the risk of papillary thyroid cancer (PTC) have demonstrated inconsistent results. We aimed to evaluate the association between urinary iodine concentration (UIC), a surrogate biomarker for dietary iodine intake, and the risk of thyroid cancer stratified by sex and age in an iodine-sufficient area. A hospital-based case-control study was conducted in Seoul, South Korea. A total of 492 cases of newly diagnosed PTC and 595 controls were included. Compared with the lowest quartile of creatine-adjusted UIC (< 159.3 μg/gCr), the highest quartile (≥ 1037.3 μg/gCr) showed an increased risk of PTC (odds ratio [OR] 1.49, 95% confidence interval [CI] 1.04-2.13), especially in those who were < 45 years old (ptrend = 0.01) compared with those who were ≥ 45 years old (ptrend = 0.48). For those who were < 45 years old, a positive association between creatinine-adjusted UIC and the risk of PTC was observed in both men (q4 vs. q1, OR 4.27, 95% CI 1.14-18.08) and women (OR 1.97, 95% CI 1.04-3.78). For those who were ≥ 45 years old, no association was found in any sex. Creatinine-adjusted UIC was positively associated with the risk of PTC, especially in those who were younger than 45 years for both men and women.
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Ju DL, Cho SW, Chung CW, Lee YA, Cheon GJ, Park YJ, Shin CH, Jun JK, Chung JK, Park SK, Song Y. High intakes of iodine among women during pregnancy and the postpartum period has no adverse effect on thyroid function. Eur J Nutr 2023; 62:239-249. [PMID: 35947162 DOI: 10.1007/s00394-022-02960-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 07/08/2022] [Indexed: 02/07/2023]
Abstract
PURPOSE Given the high consumption of seaweed soup by pregnant and lactating Korean women, concerns have been raised about excessive iodine intake. We evaluated the effects of maternal iodine intake on maternal thyroid function and birth outcomes. We also evaluated iodine intake via seaweed soup during late pregnancy and the early postpartum period. METHODS A total of 349 pregnant women of the Ideal Breast Milk cohort were recruited in late pregnancy, of whom 302 revisited after delivery. Three-day dietary records were assessed at each visit. Blood was collected for thyroid function test. Obstetrical and birth outcomes were obtained. RESULTS The median dietary iodine intake was 459 μg/day (interquartile range [IQR] 326.5-647.4 μg/day) during pregnancy. Dietary iodine intake by quartile was not significantly associated with maternal thyroid status, or obstetrical or neonatal outcomes. However, the dietary iodine intake in the early postpartum period was 1759 μg/day (IQR 1026.7-2491.1 μg/day) because of a marked increase in seaweed soup consumption. Of all women, 25.8% consumed seaweed soup more than once over the 3 days of dietary records when pregnant, but the figure rose to 93.4% postpartum. Of postpartum women who consumed seaweed soup daily, the median dietary iodine intakes were 1355, 2394, and 3063 μg/day (soup at one, two, and three-or-four meals). CONCLUSIONS In these iodine-replete pregnant women, dietary iodine intake during pregnancy showed no effect on maternal thyroid function or birth outcomes. However, iodine intake in the early postpartum period was markedly increased by the frequency of seaweed soup consumption.
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Affiliation(s)
- Dal Lae Ju
- Department of Nutrition, SMG-SNU Boramae Medical Center, Seoul, 07061, Korea
| | - Sun Wook Cho
- Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Hospital, Seoul, 03080, Korea
| | - Chae Won Chung
- Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Hospital, Seoul, 03080, Korea
| | - Young Ah Lee
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, 03080, Korea
| | - Gi Jeong Cheon
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, 03080, Korea
| | - Young Joo Park
- Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Hospital, Seoul, 03080, Korea.,Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Sicence and Technology, Seoul National University, Seoul, Korea
| | - Choong Ho Shin
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, 03080, Korea
| | - Jong Kwan Jun
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, 03080, Korea
| | - June-Key Chung
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, 03080, Korea
| | - Sue K Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, 03080, Korea. .,Cancer Research Institute, Seoul National University, Seoul, 03080, Korea. .,Integrated Major in Innovative Medical Science, Seoul National University College of Medicine, Seoul, Korea.
| | - YoonJu Song
- Department of Food Science and Nutrition, Catholic University of Korea, 43 Jibong-ro Wonmi-gu, Bucheon-si, 14662, Republic of Korea.
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Kwon TE, Chung Y, Jin YW. Korean-specific biokinetic model for iodine in radiological protection. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2021; 41:162-178. [PMID: 33395670 DOI: 10.1088/1361-6498/abd842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 01/04/2021] [Indexed: 06/12/2023]
Abstract
The International Commission on Radiological Protection (ICRP) recently adopted a detailed biokinetic model for systemic iodine with reference transfer coefficients based on typical worldwide dietary intakes of stable iodine. The regional data provided demonstrate that the ICRP reference thyroidal biokinetics may differ substantially across regions with atypically low or high dietary intakes of stable iodine. Importantly, the design of the ICRP model facilitates modifications of reference thyroidal kinetics based on regional dietary iodine intake. The present study extended the ICRP model to the South Korean population, whose dietary iodine intake is much higher than the global mean. The following three transfer coefficients were selected as targets for Korean-specific values: thyroidal uptake rate (λ1), hormonal secretion rate (λ4) and leakage rate of thyroidal organic iodine as inorganic iodide (λ5). The Korean-specific values forλ1,λ4andλ5were determined to be 4.48, 0.0086 and 0.0171 d-1, respectively, to yield the measurements of thyroidal iodine and physiological status of Korean adults. The determinedλ1andλ5values differed noticeably from the ICRP values, whereas theλ4value was comparable to that of the ICRP. Compared with the ICRP reference model, the Korean model, in which the Korean-specific transfer coefficients were adopted, predicted noticeably lower thyroidal uptake and faster decrease of thyroidal iodine. In addition, the predicted cumulative activities of radioiodine in the thyroid were substantially lower (40-80%) than those predicted by the ICRP model. The Korean model developed in this study demonstrates that the iodine biokinetics for Koreans (i.e. a population with a high iodine consumption) obviously differ from the prediction of the ICRP model. Hence, the Korean model may serve to improve the accuracy of thyroid dose estimation for Koreans and will lead to practical changes in matters concerned with radiological protection.
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Affiliation(s)
- Tae-Eun Kwon
- National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, 01812 Seoul, Republic of Korea
- Department of Nuclear Engineering, Hanyang University, 04763 Seoul, Republic of Korea
| | - Yoonsun Chung
- Department of Nuclear Engineering, Hanyang University, 04763 Seoul, Republic of Korea
| | - Young Woo Jin
- National Radiation Emergency Medical Center, Korea Institute of Radiological and Medical Sciences, 01812 Seoul, Republic of Korea
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Kim S, Kwon YS, Kim JY, Hong KH, Park YK. Association between Iodine Nutrition Status and Thyroid Disease-Related Hormone in Korean Adults: Korean National Health and Nutrition Examination Survey VI (2013-2015). Nutrients 2019; 11:nu11112757. [PMID: 31766270 PMCID: PMC6893705 DOI: 10.3390/nu11112757] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 11/06/2019] [Accepted: 11/11/2019] [Indexed: 01/21/2023] Open
Abstract
This study aimed to observe the relationship between iodine nutrition status (dietary iodine intake and estimated iodine intake based on urinary iodine concentration (UIC)) and thyroid disease-related hormones. This study involved 6090 subjects >19 years old with valid UIC, assessed between 2013 and 2015 by the Korean National Health and Nutrition Examination Survey, using a stratified, multistage, clustered probability-sampling design. The estimated iodine intake in participants was measured using UIC and urine creatinine. To examine the effect of iodine intake on thyroid disease, the iodine intake was divided into Korean Dietary Reference Intakes groups, and logistic regression analysis was performed via the surveylogistic procedure to obtain odds ratios (ORs) and 95% confidence intervals (CIs). The estimated iodine intake showed a significant positive correlation with dietary iodine intake (r = 0.021, p < 0.001), UIC (r = 0.918, p < 0.001), and thyroid-stimulating hormone (TSH) (r = 0.043, p < 0.001), but a significant negative correlation with free thyroxine (FT4) (r = -0.037, p < 0.001). Additionally, as the estimated iodine intake increased, age, TSH, and UIC increased, but FT4 decreased (p for trend < 0.0001). The risk of thyroid disease was higher in the "≥tolerable upper intake level (UL ≥ 2400 µg/day)" group than in the "<estimated average requirement (EAR < 150 µg/day)" group in females (OR: 2.418; 95% CI: 1.010-5.787). Also, as iodine intake increased, the risk of thyroid disease increased (p for trend < 0.038).
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Affiliation(s)
- Sohye Kim
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Korea;
- Nutrition Care Services, Seoul National University of Bundang Hospital, Seongnam 13620, Korea
| | | | - Ju Young Kim
- Department of Family Medicine, Seoul National University of Bundang Hospital, Seongnam 13620, Korea;
| | - Kyung Hee Hong
- Department of Food Science and Nutrition, Dongseo University, Pusan 47011, Korea;
| | - Yoo Kyoung Park
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Korea;
- Correspondence:
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Kim SY, Park JM, Hwang JP. Analysis of Iodine Content in Salts and Korean Sauces for Low-Iodine Diet Education in Korean Patients with Thyroid Cancer Preparing for Radioiodine Therapy. Nucl Med Mol Imaging 2018; 52:229-233. [PMID: 29942402 PMCID: PMC5995774 DOI: 10.1007/s13139-017-0511-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 12/11/2017] [Accepted: 12/17/2017] [Indexed: 10/18/2022] Open
Abstract
PURPOSE A low-iodine diet is necessary in patients about to undergo radioiodine therapy for thyroid cancer to decrease the competitive absorption of ingested nonradioactive iodine. This study aimed to assess the iodine concentrations in salts and basic Korean sauces, and to provide fundamental data for guidelines on a low-iodine diet before radioiodine therapy. METHODS The iodine contents of refined salts, solar sea salts, fish sauces, and commonly used Korean sauces with added refined salt were determined by ICP-MS. RESULTS The iodine content of refined salts was found to be very low (0.033 ± 0.05 μg/100 g) compared with that of solar sea salts (434 ± 73.6 μg/100 g). The iodine contents of Korean soy sauce, Korean soybean paste, Gochujang seasoned with refined salt were also very low (0.010, 0.044, 0.002 μg/100 g, respectively). However, the mean iodine contents of the shrimp and fish Jeots analyzed in this study were found to be 41.3 ± 4.2 and 24.8 ± 4.5 μg/100 g, respectively. CONCLUSION This study is the first to investigate the iodine contents of the salts and basic sauces used in Korea. The results show that refined salts and Korean traditional sauces seasoned with them can be safely used in low-iodine diets before radioiodine therapy.
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Affiliation(s)
- Soo Young Kim
- Department of Food and Nutrition, Soonchunhyang University Bucheon Hospital, Bucheon, 14584 South Korea
| | - Jung Mi Park
- Department of Nuclear Medicine, Soonchunhyang University Bucheon Hospital, 170 Jomaru-ro, Bucheon, Gyunggi-do 14584 South Korea
| | - Jae Pil Hwang
- Department of Nuclear Medicine, Soonchunhyang University Bucheon Hospital, 170 Jomaru-ro, Bucheon, Gyunggi-do 14584 South Korea
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Ko YM, Kwon YS, Park YK. An iodine database establishment and iodine intake in Korean adults: Based on the 1998~2014 Korea National Health and Nutrition Examination Survey. ACTA ACUST UNITED AC 2017. [DOI: 10.4163/jnh.2017.50.6.624] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Yu Mi Ko
- Department of Medical Nutrition, Kyunghee University, Yongin 17104, Korea
| | | | - Yoo Kyoung Park
- Department of Medical Nutrition, Kyunghee University, Yongin 17104, Korea
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8
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Ju DL, Park YJ, Paik HY, Kim MJ, Park S, Jung KY, Kim TH, Choi HS, Song YJ. Dietary evaluation of a low-iodine diet in Korean thyroid cancer patients preparing for radioactive iodine therapy in an iodine-rich region. Nutr Res Pract 2015; 10:167-74. [PMID: 27087900 PMCID: PMC4819127 DOI: 10.4162/nrp.2016.10.2.167] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 09/30/2015] [Accepted: 10/28/2015] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND/OBJECTIVES Despite the importance of a low-iodine diet (LID) for thyroid cancer patients preparing for radioactive iodine (RAI) therapy, few studies have evaluated dietary intake during LID. This study evaluated the amount of dietary iodine intake and its major food sources during a typical diet and during LID periods for thyroid cancer patients preparing for RAI therapy, and examined how the type of nutrition education of LID affects iodine intake. SUBJECTS/METHODS A total of 92 differentiated thyroid cancer patients with total thyroidectomy were enrolled from Seoul National University Hospital. All subjects completed three days of dietary records during usual and low-iodine diets before 131I administration. RESULTS The median iodine intake was 290 µg/day on the usual diet and 63.2 µg/day on the LID. The major food groups during the usual diet were seaweed, salted vegetables, fish, milk, and dairy products and the consumption of these foods decreased significantly during LID. The mean energy intake on the LID was 1,325 kcal, which was 446 kcal lower than on the usual diet (1,771 kcal). By avoiding iodine, the intake of most other nutrients, including sodium, was significantly reduced during LID (P < 0.005). Regarding nutritional education, intensive education was more effective than a simple education at reducing iodine intake. CONCLUSION Iodine intake for thyroid cancer patients was significantly reduced during LID and was within the recommended amount. However, the intake of most other nutrients and calories was also reduced. Future studies are needed to develop a practical dietary protocol for a LID in Korean patients.
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Affiliation(s)
- Dal Lae Ju
- Department of Food Service and Nutrition Care, Seoul National University Hospital, Seoul, 03080, Korea
| | - Young Joo Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, 03080, Korea
| | - Hee-Young Paik
- Department of Food and Nutrition, Seoul National University, Seoul, 08826, Korea
| | - Min-Ji Kim
- Major of Food and Nutrition, School of Human Ecology, The Catholic University of Korea, 43 Jibong-ro, Wonmi-gu, Bucheon-si, Gyeonggi 14662, Korea
| | - Seonyeong Park
- Department of Internal Medicine, Seoul National University Hospital Biomedical Research Institute, Seoul, 03080, Korea
| | - Kyong Yeun Jung
- Department of Internal Medicine, Eulji University Hospital, Seoul, 01830, Korea
| | - Tae Hyuk Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, 03080, Korea.; Department of Internal Medicine, Thyroid Center, Samsung Medical Center, Seoul, 06351, Korea
| | - Hun Sung Choi
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, 03080, Korea.; Department of Internal Medicine, Kangwon National University Hospital, Chuncheon, 24289, Korea
| | - Yoon Ju Song
- Major of Food and Nutrition, School of Human Ecology, The Catholic University of Korea, 43 Jibong-ro, Wonmi-gu, Bucheon-si, Gyeonggi 14662, Korea
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Kim M, Kim TY, Kim SH, Lee Y, Park SY, Kim HD, Kwon H, Choi YM, Jang EK, Jeon MJ, Kim WG, Shong YK, Kim WB. Reference interval for thyrotropin in a ultrasonography screened Korean population. Korean J Intern Med 2015; 30:335-44. [PMID: 25995664 PMCID: PMC4438288 DOI: 10.3904/kjim.2015.30.3.335] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 09/02/2014] [Accepted: 10/06/2014] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND/AIMS The diagnostic accuracy of thyroid dysfunctions is primarily affected by the validity of the reference interval for serum thyroid-stimulating hormone (TSH). Thus, the present study aimed to establish a reference interval for TSH using a normal Korean population. METHODS This study included 19,465 subjects who were recruited after undergoing routine health check-ups. Subjects with overt thyroid disease, a prior history of thyroid disease, or a family history of thyroid cancer were excluded from the present analyses. The reference range for serum TSH was evaluated in a normal Korean reference population which was defined according to criteria based on the guidelines of the National Academy of Clinical Biochemistry, ultrasound (US) findings, and smoking status. Sex and age were also taken into consideration when evaluating the distribution of serum TSH levels in different groups. RESULTS In the presence of positive anti-thyroid peroxidase antibodies or abnormal US findings, the central 95 percentile interval of the serum TSH levels was widened. Additionally, the distribution of serum TSH levels shifted toward lower values in the current smokers group. The reference interval for TSH obtained using a normal Korean reference population was 0.73 to 7.06 mIU/L. The serum TSH levels were higher in females than in males in all groups, and there were no age-dependent shifts. CONCLUSIONS The present findings demonstrate that the serum TSH reference interval in a normal Korean reference population was higher than that in other countries. This result suggests that the upper and lower limits of the TSH reference interval, which was previously defined by studies from Western countries, should be raised for Korean populations.
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Affiliation(s)
- Mijin Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Tae Yong Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Soo Han Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yunkyoung Lee
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Su-yeon Park
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyung-don Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyemi Kwon
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yun Mi Choi
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eun Kyung Jang
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Min Ji Jeon
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Won Gu Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young Kee Shong
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Won Bae Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Park HJ, Jeong GC, Kwon SY, Min JJ, Bom HS, Park KS, Cho SG, Kang SR, Kim J, Song HC, Chong A, Yoo SW. Stimulated Serum Thyroglobulin Level at the Time of First Dose of Radioactive Iodine Therapy Is the Most Predictive Factor for Therapeutic Failure in Patients With Papillary Thyroid Carcinoma. Nucl Med Mol Imaging 2014; 48:255-61. [PMID: 26396629 DOI: 10.1007/s13139-014-0282-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Revised: 05/19/2014] [Accepted: 05/22/2014] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To investigate the clinical importance of serum thyroglobulin (Tg) levels just before high-dose I-131 ablation therapy (preablation Tg) for predicting therapeutic failure in patients with papillary thyroid carcinoma (PTC). METHODS Patients with PTC (n = 132) undergoing total thyroidectomy followed by the first high-dose I-131 ablation therapy (HI-Rx) were included in this retrospective review. Just before HI-Rx, preablation Tg, anti-Tg antibody, and TSH were measured. The patients were followed up for a mean period of 7 months (range 6-23 months) by I-123 whole-body scans (f/u IWBS) and stimulated Tg (f/u Tg). Therapeutic failure was defined by positive f/u IWBS or f/u Tg >2 ng/ml. We classified patients into three groups according to the value of preablation Tg (group 1, <1 ng/ml; group 2, ≥1 and <10 ng/ml; group 3, ≥10 ng/ml) and compared clinical variables to therapeutic response. RESULTS Therapeutic failure was noted in 39 patients (29.5 %). On univariate analysis, T stage, tumor size, and preablation Tg were the statistically significant factors that could predict therapeutic failure. After multivariate analysis, preablation Tg was the only independent predictor of therapeutic failure (P < 0.001). The therapeutic failure rate was significantly increased as the preablation Tg level increased (11.3 %, 33.3 %, and 87.5 % in groups 1, 2, and 3, respectively; P < 0.001). Individuals with preablation Tg levels ≥10 ng/ml had 25.5 times greater chance of therapeutic failure than those with levels <10 ng/ml (95 % CI = 5.43-119.60; P < 0.001). CONCLUSIONS A high preablation Tg level is the most significant predictor of therapeutic failure at the time of first HI-Rx in patients with PTC.
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Affiliation(s)
- Hee Jeong Park
- Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, 322 Seoyang-ro Hwasun-eup, Hwasun-gun Jeonnam, Korea 519-763
| | - Geum-Cheol Jeong
- Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, 322 Seoyang-ro Hwasun-eup, Hwasun-gun Jeonnam, Korea 519-763
| | - Seong Young Kwon
- Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, 322 Seoyang-ro Hwasun-eup, Hwasun-gun Jeonnam, Korea 519-763
| | - Jung-Joon Min
- Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, 322 Seoyang-ro Hwasun-eup, Hwasun-gun Jeonnam, Korea 519-763
| | - Hee-Seung Bom
- Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, 322 Seoyang-ro Hwasun-eup, Hwasun-gun Jeonnam, Korea 519-763
| | - Ki Seong Park
- Chonnam National University Hospital, Gwangju, Korea
| | - Sang-Geon Cho
- Chonnam National University Hospital, Gwangju, Korea
| | | | - Jahae Kim
- Chonnam National University Hospital, Gwangju, Korea
| | - Ho-Chun Song
- Chonnam National University Hospital, Gwangju, Korea
| | - Ari Chong
- Chosun University Hospital, Gwangju, Korea
| | - Su Woong Yoo
- Gwangju Institute of Science and Technology, Gwangju, Korea
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Abstract
Severe iodine deficiency causes hypothyroidism that results in impaired somatic growth and motor development in children. Mild and moderate iodine deficiencies cause multifocal autonomous growth of thyroid, which results in thyrotoxicosis. On the other hand, iodine excess is associated with the development of hypothyroidism and thyroid autoimmunity. In areas of iodine deficiency, a sudden increase in iodine intake is associated with transient hyperthyroidism. Recent studies demonstrated that long-term thyroid function of subjects who experienced both iodine deficiency and iodine excess during childhood tended to be abnormal despite optimization of their current iodine intake. Iodine status in the Korean Peninsula is very unique because people in the Republic of Korea have been shown to have predominantly excessive iodine levels, whereas the Democratic People's Republic of Korea is known to be an iodine-deficient area. Further research is warranted to verify the optimal ranges of iodine intake and to clarify the effects of iodine intake on thyroid disorders in the Korean Peninsula.
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Affiliation(s)
- Hye Rim Chung
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
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12
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Moon JA, Yoo CH, Kim MH, Lee SM, Oh YJ, Ryu YH, Lee YS, Chang HS, Park CS, Lee KE. Knowledge, Self-Efficacy, and Perceived Barriers on the Low-Iodine Diet among Thyroid Cancer Patients Preparing for Radioactive Iodine Therapy. Clin Nutr Res 2013; 1:13-22. [PMID: 23430156 PMCID: PMC3572801 DOI: 10.7762/cnr.2012.1.1.13] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Revised: 07/12/2012] [Accepted: 07/16/2012] [Indexed: 12/05/2022] Open
Abstract
The purposes of the study were to assess knowledge, self-efficacy, and perceived barriers on a low-iodine diet among thyroid cancer patients and to identify strategies for nutrition education. A self-administered questionnaire was developed based on a review of literature and pilot-tested. A total of 121 female thyroid cancer patients participated in a survey and 117 responses were used for data analysis. An average knowledge score of the thyroid cancer patients was 4.5 point (available score: 0-10 point). Majority of the respondents knew that seaweeds such as lavers, brown seaweeds, and sea tangles contain large amount of iodine. However they mistook the low iodine diet as a low salt diet and were not aware of foods and seasonings that are allowed on the low iodine diet. While self-efficacy related to consuming various fruits and vegetables, to choosing potatoes and sweet potatoes for snacks, and restricting consumption of eggs, milk and milk products, and processed foods was rated highly, self-efficacy for preparing foods without using sea salts was rated low. The self-efficacy score increased as their interest on the dietary life and perceived cooking skills were greater. Most perceived barriers toward practicing the low iodine diet were related to preparation of the low iodine menus. As their interest in the dietary life and cooking and perceived cooking skills were greater, the patients perceived barriers on practicing the low iodine diet less. While the patients showed higher self-efficacy and lower barrier perception on selecting foods low in iodine and restricting food high in iodine, they showed lower self-efficacy and higher barrier perceptions on preparing low iodine meals. Clinical dietitians should recognize the gap between what the patients should know and what they really know and identify strategies on how to improve self-efficacy and reduce perceived barriers on the low iodine diet. Recent literature and the findings of the study reveal that incorporating cooking classes into nutrition education for thyroid patients is effective to enhance self-efficacy and to reduce perceived barriers on the low iodine diet.
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Affiliation(s)
- Jeong-Ah Moon
- Department of Food & Nutrition, Seoul Women's University, Seoul 139-774, Korea
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