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Deng Y, Che Q, Li Y, Luo J, Gao X, He Y, Liu Y, Liu T, Zhao X, Hu X, Zhao W. Non-radical activation of persulfate with Bi 2O 3/BiO 1.3I 0.4 for efficient degradation of propranolol under visible light. J Environ Sci (China) 2024; 142:57-68. [PMID: 38527896 DOI: 10.1016/j.jes.2023.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 05/11/2023] [Accepted: 05/12/2023] [Indexed: 03/27/2024]
Abstract
Non-radical activation of persulfate (PS) by photocatalysts is an effective approach for removing organic pollutants from aqueous environments. In this study, a novel Bi2O3/BiO1.3I0.4 heterojunction was synthesized using a facile solvothermal approach and used for the first time for non-radical activation of PS to degrade propranolol (PRO) in the presence of visible light. The findings found that the degradation rate of PRO in the Bi2O3/BiO1.3I0.4/PS system was significantly increased from 19% to more than 90% within 90 min compared to the Bi2O3/BiO1.3I0.4 system. This indicated that the composite system exerted an excellent synergistic effect between the photocatalyst and the persulfate-based oxygenation. Quenching tests and electron paramagnetic resonance demonstrated that the non-radical pathway with singlet oxygen as the active species played a major role in the photocatalytic process. The existence of photo-generated holes during the reaction could also be directly involved in the oxidation of pollutants. Meanwhile, a possible PRO degradation pathway was also proposed. Furthermore, the impacts of pH, humic acid and common anions on the PRO degradation by the Bi2O3/BiO1.3I0.4/PS were explored, and the system's stability and reusability were also studied. This study exhibits a highly productive catalyst for PS activation via a non-radical pathway and provides a new idea for the degradation of PRO.
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Affiliation(s)
- Yuehua Deng
- College of Geology and Environment, Xi'an University of Science and Technology, Xi'an 710054, China; Shaanxi Provincial Key Laboratory of Geological Support for Coal Green Exploitation, Xi'an 710054, China.
| | - Qianqian Che
- College of Geology and Environment, Xi'an University of Science and Technology, Xi'an 710054, China
| | - Yani Li
- College of Geology and Environment, Xi'an University of Science and Technology, Xi'an 710054, China
| | - Jiating Luo
- College of Geology and Environment, Xi'an University of Science and Technology, Xi'an 710054, China
| | - Xiang Gao
- College of Geology and Environment, Xi'an University of Science and Technology, Xi'an 710054, China
| | - Yan He
- College of Geology and Environment, Xi'an University of Science and Technology, Xi'an 710054, China
| | - Yiling Liu
- College of Geology and Environment, Xi'an University of Science and Technology, Xi'an 710054, China
| | - Tong Liu
- College of Geology and Environment, Xi'an University of Science and Technology, Xi'an 710054, China
| | - Xiaolong Zhao
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong 999077, China
| | - Xiaobin Hu
- School of Life Science, Huzhou University, Huzhou 313000, China
| | - Wei Zhao
- School of Materials Engineering, Changshu Institute of Technology, Changshu 215500, China.
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Gong B, Wang C, Yang W, Shan Z. Changing trends in the global, regional, and national burden of iodine deficiency among adolescents and young adults: population-based study. Eur J Pediatr 2024:10.1007/s00431-024-05545-z. [PMID: 38592486 DOI: 10.1007/s00431-024-05545-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 03/23/2024] [Accepted: 03/26/2024] [Indexed: 04/10/2024]
Abstract
Iodine is a micronutrient required for the production of thyroid hormones, which regulate metabolism, growth, and neurodevelopment. Iodine deficiency among adolescents and young adults is a major global health issue. We analyzed data from the Global Burden of Disease 2019 database to calculate the prevalence, incidence, and disability-adjusted life-year (DALY) rates of iodine deficiency among adolescents and young adults. We explored the specific year with the most substantial changes in the trends of iodine deficiency among adolescents with annual percentage change (APC) by Joinpoint Regression analysis. Descriptive analyses were conducted to characterize the iodine deficiency burden according to age, sex, location, and sociodemographic index (SDI) quintiles. All measures are listed with 95% uncertainty intervals (UIs), and all rates are reported per 100,000 individuals. From 1990 to 2019, the iodine deficiency prevalence rate among adolescents decreased from 3082.43 (95% uncertainty interval [UI], 2473.01-3855.86) to 2190.84 (95% [UI], 1729.18-2776.16) per 100,000 population, with an AAPC of -1.15 (95% confidence interval [CI], -1.29 to -1.02). Regarding the SDI in 2019, the highest prevalence and DALY rates of iodine deficiency were reported in low-SDI countries. In 1990, Southeast Asia had the highest prevalence and DALYs rates for iodine deficiency among adolescents, while in 2019, Africa had the highest prevalence rate (3330.12). CONCLUSION Globally, the iodine deficiency burden among adolescents has substantially decreased since 1990; however, low-SDI countries still bear a great burden. Implementation measures and monitoring systems should be strengthened to reduce the iodine deficiency burden, especially among adolescents. WHAT IS KNOWN • Iodine deficiency can cause severe or irreversible developmental disorders, particularly in adolescents and young adults. • Universal Salt Iodization was implemented for ensuring appropriate iodine intake. WHAT IS NEW • We found substantial declines in the prevalence rates of iodine deficiency among adolescents during the past three decades. Globally, the disability-adjusted life-year rate of iodine deficiency among adolescents decreased from 56.17 in 1990 to 35.38 in 2019. • Iodine deficiency among adolescents in low- sociodemographic index countries still bear a great burden.
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Affiliation(s)
- Boshen Gong
- Department of Endocrinology and Metabolism, Institute of Endocrinology, National Health Commission (NHC) Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, P. R. China, 110001
| | - Chuyuan Wang
- Department of Endocrinology and Metabolism, Institute of Endocrinology, National Health Commission (NHC) Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, P. R. China, 110001
| | - Wanyu Yang
- Department of Endocrinology and Metabolism, Institute of Endocrinology, National Health Commission (NHC) Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, P. R. China, 110001
| | - Zhongyan Shan
- Department of Endocrinology and Metabolism, Institute of Endocrinology, National Health Commission (NHC) Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, P. R. China, 110001.
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Fischer L, Andersson M, Braegger C, Herter-Aeberli I. Iodine intake in the Swiss population 100 years after the introduction of iodised salt: a cross-sectional national study in children and pregnant women. Eur J Nutr 2024; 63:573-587. [PMID: 38141138 PMCID: PMC10899291 DOI: 10.1007/s00394-023-03287-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 11/23/2023] [Indexed: 12/24/2023]
Abstract
PURPOSE The Swiss voluntary salt iodisation programme has successfully prevented iodine deficiency for 100 years, but dietary habits are changing and today only one-third of processed foods contain iodised salt. We aimed to monitor the current iodine status in children and pregnant women. METHODS We conducted a nationwide cross-sectional study in children (6-12 years) and pregnant women and measured the urinary iodine concentration (UIC) in spot urine samples. We estimated the iodine intake using UIC and urinary creatinine concentration (UCC) and determined the prevalence of intakes below the average requirement (AR) using the SPADE method. We measured dried blood spot (DBS) thyroglobulin (Tg), TSH and total T4 in pregnant women. RESULTS The median UIC was 127 μg/L (bootstrapped 95% CI 119, 140, n = 362) in children and 97 μg/L (bootstrapped 95% CI 90, 106, n = 473) in pregnant women. The estimated prevalence of inadequate iodine intake (< 65 μg/day) was 5.4% (bootstrapped 95% CI 0.0, 14.6) in children. Half (47%) of the women consumed iodine-containing multivitamin and mineral supplements (≥ 150 μg/day). Compared to non-users, users had higher median UIC (129 vs. 81 μg/L, P < 0.001), lower prevalence of inadequacy (< 160 μg/day; 0.2 vs. 31%) and lower DBS-Tg (23 vs. 29 μg/L, P < 0.001). All women were euthyroid. CONCLUSIONS The Swiss diet and current salt fortification provides adequate iodine intake in children, but not in all pregnant women. Iodine supplements cover the dietary gap in pregnancy but are not universally consumed. Therefore, improved use of iodised salt in processed foods is desired to ensure adequate iodine intake in all population groups. This trial was registered at clinicaltrials.gov as NCT04524013.
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Affiliation(s)
- Lena Fischer
- Nutrition Research Unit, Children's Research Centre, University Children's Hospital Zurich - Eleonore Foundation, Steinwiesstrasse 75, 8032, Zurich, Switzerland.
- Laboratory of Nutrition and Metabolic Epigenetics, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland.
| | - Maria Andersson
- Nutrition Research Unit, Children's Research Centre, University Children's Hospital Zurich - Eleonore Foundation, Steinwiesstrasse 75, 8032, Zurich, Switzerland
| | - Christian Braegger
- Nutrition Research Unit, Children's Research Centre, University Children's Hospital Zurich - Eleonore Foundation, Steinwiesstrasse 75, 8032, Zurich, Switzerland
| | - Isabelle Herter-Aeberli
- Laboratory of Nutrition and Metabolic Epigenetics, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
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Ashrafian H. Goiter in the paintings by Rogier van der Weyden (1399-1464). J Endocrinol Invest 2024; 47:483-484. [PMID: 37171783 PMCID: PMC10859325 DOI: 10.1007/s40618-023-02108-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 05/02/2023] [Indexed: 05/13/2023]
Affiliation(s)
- H Ashrafian
- The Department of Surgery and Cancer, Institute of Global Health Innovation, Imperial College London, St Mary's Hospital, 10th Floor Queen Elizabeth the Queen Mother (QEQM) Building, Praed Street, London, W2 1NY, UK.
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Wei R, Wang Z, Zhang X, Wang X, Xu Y, Li Q. Burden and trends of iodine deficiency in Asia from 1990 to 2019. Public Health 2023; 222:75-84. [PMID: 37531713 DOI: 10.1016/j.puhe.2023.06.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 06/19/2023] [Accepted: 06/26/2023] [Indexed: 08/04/2023]
Abstract
OBJECTIVES Understanding iodine deficiency (ID) burdens and trends in Asia can help guide effective intervention strategies. This study aims to report the incidence, prevalence, and disability-adjusted life years (DALYs) of ID in 48 Asian countries during the period 1990-2019. STUDY DESIGN Data on ID were retrieved from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 and estimated by age, sex, geographical region, and sociodemographic index (SDI). METHODS The estimated annual percentage change (EAPC) was calculated to evaluate the changing trend of age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), and age-standardized DALYs rate (ASDR) related to ID during the period 1990-2019. RESULTS In Asia, there were 126,983,965.8 cases with 5,466,213.1 new incidence and 1,765,995.5 DALYs of ID in 2019. Between 1999 and 2019, the EAPC in ASIR, ASPR and ASDR were -0.6 (95% confidence interval [CI], -0.8 to -0.4), -0.9 (95% CI, -1.2 to -0.7), and -1.6 (95% CI, -1.8 to -1.5), respectively. Malaysia charted the largest decrease in ASIR, ASPR, and ASDR (82.4%, 85.3%, and 80.9% separately), whereas the Philippines and Pakistan were the only two countries that witnessed an increase in ASIR and ASPR. ID burdens were more pronounced in women, countries located to the south of the Himalayas, and low-middle SDI regions. CONCLUSIONS The incidence, prevalence, and DALYs of ID in Asia substantially decreased from 1990 to 2019. Women and low-middle SDI countries have relatively high ID burdens. Governments need to pay constant attention to the implementation and monitoring of universal salt iodization.
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Affiliation(s)
- R Wei
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China; Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Z Wang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China; China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - X Zhang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China; China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - X Wang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China; China Academy of Chinese Medical Sciences, Beijing, 100700, China
| | - Y Xu
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China.
| | - Q Li
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China.
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Asfaw A, Behailu M, Oumer A, Gebremariam T, Asefa K. Factors associated with recent iodine intake level among household food handlers in Southwest Ethiopia: a cross-sectional study. BMC Womens Health 2023; 23:354. [PMID: 37403023 DOI: 10.1186/s12905-023-02516-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 06/29/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND Iodine deficiency is a global public health threat, affecting an estimated two billion people. The median urinary iodine concentration is more reliable in determining recent iodine intakes and the risks of iodine deficiency. Therefore, this study was aimed to identify the factors associated with recent iodine intake level using median urinary iodine concentration as an indicator among household food handlers in southwest Ethiopia. METHODS A community-based survey was conducted with selected households using a pretested interviewer-administered questionnaire in southwest Ethiopia. A 20-gram sample of table salt and a 5 ml causal urine samples were also collected and analyzed using rapid test kit and a Sandell-Kolthoff reaction, respectively. A salt iodine concentration above 15 ppm was classified as adequately iodized and a median urinary iodine concentration between 100 and 200µgl- 1 was considered as adequate iodine intake. A bivariable and multivariable logistic regression model was fitted. Crude and adjusted odds ratios with their 95% confidence levels were reported. Associations with a p-value ≤ 0.05 were used to declare statistical significance. RESULTS A total of 478 women were included, with a mean age of 33.2 (± 8.4 years). Only 268 (56.1%) of the households had adequately iodized salt (> 15 ppm). The median urinary iodine concentration (interquartile range) was 87.5 µg l- 1 (45.6-107.6). In a fitted multivariable logistic regression model (p-value = 0.911), illiterate women (AOR = 4.61; 95% CI: 2.17, 9.81), poorly iodized salt in the household (AOR = 25.0; 95% CI: 13-48), salt purchased from open market (AOR = 1.93; 95% CI: 1.0, 3.73) and women who do not read the label during purchasing the salt (AOR = 3.07; 95% CI: 1.31, 7.17) were important predictors of the risk of Iodine deficiency. CONCLUSION Despite public health efforts to improve iodine intake, its deficiency is still a major public health problem among southwest Ethiopian women.
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Affiliation(s)
- Agize Asfaw
- Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Welkite, P.O. Box: 07, Ethiopia.
| | - Mifta Behailu
- Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Welkite, P.O. Box: 07, Ethiopia
| | - Abdu Oumer
- Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Welkite, P.O. Box: 07, Ethiopia
| | - Tigist Gebremariam
- Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Welkite, P.O. Box: 07, Ethiopia
| | - Kenzudin Asefa
- Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Welkite, P.O. Box: 07, Ethiopia
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Ashrafian H. Differential diagnosis of a thyroid mass, Gottron's papules, Calcinosis Cutis and Ptosis on the Saint Mary Magdalen and two depictions of a Madonna and Baby by Bartolomeo Vivarini (1432-1499). J Endocrinol Invest 2023; 46:1043-1045. [PMID: 36633790 PMCID: PMC10105650 DOI: 10.1007/s40618-023-02004-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 01/03/2023] [Indexed: 01/13/2023]
Affiliation(s)
- H Ashrafian
- Institute of Global Health Innovation, Imperial College London, The Department of Surgery and Cancer, St Mary's Hospital, 10th Floor Queen Elizabeth the Queen Mother (QEQM) Building, Praed Street, London, W2 1NY, UK.
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Berezkin VY, Kolmykova LI, Kulieva GA. A study of iodine concentration in drinking waters of Bryansk and Oryol regions. Environ Geochem Health 2023; 45:299-304. [PMID: 35397730 DOI: 10.1007/s10653-022-01249-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 03/04/2022] [Indexed: 06/14/2023]
Abstract
The aim of the research was to study and compare iodine concentration in natural waters originating from aquifers of different ages, primarily residents use for drinking purposes. The analysis was based on the original data on the samples collected during the fieldwork in the Bryansk region (2013-2017) and in the Oryol region (2016-2017). In addition to iodine concentration, the main geochemical parameters (salinity, etc.) were determined in the selected waters. The results showed a significant variation of iodine in waters from both regions (Bryansk region-from 0.7 to 41.2 µg/l; Oryol region-from 1.12 to 36.8 µg/l), the difference being apparently due to different ages and origins of the sampled aquifers (Quaternary, Upper Devonian and Cretaceous deposits). The overall low provision of surface water with iodine was found both in the Bryansk region (median for shallow wells-5.82 µg/l, median for surface water-6.76 µg/l) and in the Oryol region (median for shallow wells-2.96 µg/l, median for surface water-7.4 µg/l). The data obtained deserve attention during organization of monitoring and implementation of measures preventing thyroid diseases.
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Affiliation(s)
- V Yu Berezkin
- Vernadsky Institute of Geochemistry and Analytical Chemistry, Russian Academy of Sciences, Moscow, Russia.
- Russian People Friendship University, Moscow, Russia.
| | - L I Kolmykova
- Vernadsky Institute of Geochemistry and Analytical Chemistry, Russian Academy of Sciences, Moscow, Russia
| | - G A Kulieva
- Russian People Friendship University, Moscow, Russia
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Cannas A, Rayman MP, Kolokotroni O, Bath SC. Iodine status of pregnant women from the Republic of Cyprus. Br J Nutr 2023; 129:126-134. [PMID: 35236523 PMCID: PMC9816652 DOI: 10.1017/s0007114522000617] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 02/08/2022] [Accepted: 02/18/2022] [Indexed: 01/21/2023]
Abstract
Iodine supply is crucial during pregnancy to ensure that the proper thyroid function of mother and baby support fetal brain development. Little is known about iodine status or its dietary determinants in pregnant women in the Republic of Cyprus. We therefore recruited 128 pregnant women at their first-trimester ultrasound scan to a cross-sectional study. We collected spot-urine samples for the measurement of urinary iodine concentration (UIC, µg/l) and creatinine concentration (Creat, g/l), the latter of which allows us to correct for urine dilution and to compute the iodine-to-creatinine ratio (UI/Creat). Women completed a FFQ and a general questionnaire. We used a General Linear model to explore associations between maternal and dietary characteristics with UI/Creat. The median UIC (105 µg/l) indicated iodine deficiency according to the WHO criterion (threshold for adequacy = 150 µg/l), and the UI/Creat was also low at 107 µg/g. Only 32 % (n 45) of women reported the use of iodine-containing supplements; users had a higher UI/Creat than non-users (131 µg/g v. 118 µg/g), though this difference was NS in the adjusted analysis (P = 0·37). Of the dietary components, only egg intake was significantly associated with a higher UI/Creat in adjusted analyses (P = 0·018); there was no significant association with milk, dairy products or fish intake. Our results suggest that pregnant women in Cyprus have inadequate iodine status and are at risk of mild-to-moderate iodine deficiency. Further research on dietary sources in this population is required.
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Affiliation(s)
- Andrea Cannas
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, GU2 7XH, UK
| | - Margaret P. Rayman
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, GU2 7XH, UK
| | - Ourania Kolokotroni
- Department of Primary Care and Population Health, University of Nicosia, Medical School, Nicosia, 1700, Cyprus
| | - Sarah C. Bath
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, GU2 7XH, UK
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Pérsico RS, Silveira RCDS, Gazal CHA, Viana LV. Prevalence of thyroid dysfunction in neonates receiving parenteral nutrition in the intensive care unit. J Pediatr (Rio J) 2023; 99:79-85. [PMID: 36030816 DOI: 10.1016/j.jped.2022.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 06/13/2022] [Accepted: 06/13/2022] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE The use of parenteral nutrition (PN) formulations that do not contain iodine can contribute to the deficiency of this mineral, potentially leading to hypothyroidism and, ultimately, neurocognitive impairments. This study aimed to evaluate TSH alterations in newborns receiving PN. METHODS Retrospective study of neonatal intensive care unit patients receiving PN for > 15 days. Nutritional, anthropometric, and biochemical variables (TSH, T4, CRP) were analyzed. Hypothyroidism was defined by TSH > 10 mU/L. RESULTS Two hundred newborns were evaluated [156 (78%) preterm, 31±5 weeks of gestational age, 112 (56%) with very or extremely low birth weight]. The median (IQR) hospital stay was 68 (42-110) days, PN duration was 31 (21-47) days, and 188 (94%) patients also received enteral nutrition. Overall, 143 (71.5%) newborns underwent at least one TSH measurement. The prevalence of hypothyroidism was 10.5%. The Median PN duration in this group was 51 (34-109) days. Among those with hypothyroidism, 10 received Lugol's solution and six levothyroxine. Thirteen patients received prophylactic Lugol's solution with a median PN duration of 63 (48-197) days. TSH levels correlated positively with PN duration (r = 0.19, p = .02). CONCLUSIONS The present data suggest that changes in TSH and T4 levels are present in neonates receiving PN for > 15 days, suggesting this population may be at risk for developing hypothyroidism. Therefore, the authors suggest that TSH and T4 measurements should be included as routine in neonatal patients receiving PN for > 15 days if PN formulations are not supplemented with iodine, and that iodine supplementation be provided as necessary.
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Bahadir CT. Iodine status of pregnant women in iodine-sufficient regions: A tertiary care unit experience. Indian J Public Health 2023; 67:41-46. [PMID: 37039204 DOI: 10.4103/ijph.ijph_831_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2023] Open
Abstract
Background The recommended urinary iodine concentration (UIC) levels in the overall adult population is 100-199 μg/L whereas 150-249 μg/L in pregnant women. Objectives The objective is to determine the prevalence and severity of iodine deficiency in pregnant women in Amasya, which is located in the Western Black Sea region in Turkey, where sufficient iodine levels were achieved in the normal population. Methods In this single-center study, we retrospectively searched hospital patient records and identified pregnant women who were assessed for iodine levels between January 2019 and January 2021. A total of 408 pregnant women were found eligible for the study. Thyroid-stimulating hormone (TSH), free triiodothyronine, free thyroxine, antithyroid peroxidase antibodies, and antithyroglobulin antibodies in serum samples and UIC were evaluated and compared between the trimesters. Insufficient iodine intake in pregnancy was defined as UIC <150 μg/L. Results Median UIC and median TSH levels were 129 (range 45-452) μg/L and 2.98 (range 0.01-71.2) μIU/ml, respectively. 81.1% of pregnant women had UIC <150 μg/L. Iodine intake was adequate in 17.4% of pregnant whereas excessive in 1.5%. Prevalence of iodine deficiency during 1st, 2nd, and 3rd trimesters were 82.1%, 82.4%, and 74.5%, respectively. There was no significant difference in UIC levels between trimesters (P = 0.399). 72.9% of pregnant womens had TSH >2.5 mIU/L in the 1st trimester. Conclusion Iodine deficiency in pregnancy may exist in an iodine-sufficient population. Appropriate measures must be taken to ensure sufficient iodine levels in these individuals.
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Affiliation(s)
- Cigdem Tura Bahadir
- Assistant Professor, Department of Endocrinology and Metabolism, Faculty of Medicine, Amasya University, Amasya, Turkey
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Wang X, Liu J, Lu W, Jia W, Li Q, Traoré SS, Lyu Q. Iodine Deficiency of Breastfeeding Mothers and Infants from 2012 to 2019 in Zhengzhou, China. Biol Trace Elem Res 2022:10.1007/s12011-022-03531-w. [PMID: 36538209 PMCID: PMC10350439 DOI: 10.1007/s12011-022-03531-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
To investigate iodine status and characteristics of breastfeeding women and infants in Zhengzhou after the implementation of the new national standard of iodine in edible salt, so as to provide the basis for formulating prevention and control measures. Urine samples from 28,730 infants aged 0-2 years and 17,977 breastfeeding women who received preventive health care in 12 districts/cities of Zhengzhou from 2012 to 2019 were collected to measure urinary iodine concentration (UIC). A total of 350 pairs of unweaned infants and their mothers were included in this study. After the implementation of the new national standard of iodine in edible salt, the iodine deficiency of infants aged 0-2 years showed a trend of decreasing first and then increasing, but generally the iodine nutrition of infants aged 0-2 years was at the appropriate level in 8 years. There was a gradual decrease in iodine deficiency among breastfeeding women over an 8-year period. And the median UIC of breastfeeding women in 8 years was at iodine nutrition appropriate level. In addition, the UIC of breastfeeding mothers was positively associated with that of infants (r = 0.104, P = 0.004). After the implementation of the new national standard of iodine in edible salt, breastfeeding women and infants in Zhengzhou generally were at an appropriate level of iodine nutrition, and there was a significant positive correlation between the UIC of breastfeeding mothers and infants.
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Affiliation(s)
- Xinyi Wang
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, 450001, China
| | - Jianghua Liu
- Zhengzhou Center for Disease Control and Prevention, Zhengzhou, 450006, China
| | - Weixia Lu
- Zhengzhou Center for Disease Control and Prevention, Zhengzhou, 450006, China
| | - Weihua Jia
- Zhengzhou Center for Disease Control and Prevention, Zhengzhou, 450006, China
| | - Qingzhi Li
- Zhengzhou Center for Disease Control and Prevention, Zhengzhou, 450006, China
| | - Stanislav S Traoré
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, 450001, China
| | - Quanjun Lyu
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, 450001, China.
- Department of Nutrition, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
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13
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Zhang L, Fan L, Li F, Sun Q, Chen Y, He Y, Shen H, Liu L. Study on the Effect of Different Iodine Intake on Hippocampal Metabolism in Offspring Rats. Biol Trace Elem Res 2022; 200:4385-4394. [PMID: 34855145 DOI: 10.1007/s12011-021-03032-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 11/13/2021] [Indexed: 12/22/2022]
Abstract
Iodine is an essential trace element in the human body. Severe maternal iodine deficiency during pregnancy leads to obvious intellectual disability in the offspring. The effects of iodine deficiency on brain development have been demonstrated, but there is no clear evidence of the effects of iodine excess on brain development. To clarify the effects of iodine excess on the brain development of offspring and to provide clues to the mechanisms underlying the effects of iodine deficiency and iodine excess on the brain development of offspring. In this study, animal models with different iodine intakes were constructed using potassium iodate (KIO3). The models included four experimental groups (low-iodine group one (LI, 0μg/L iodine), low-iodine group two (LII, 5μg/L iodine), high-iodine group one (HI, 3000μg/L iodine), and high-iodine group two (HII, 10000μg/L iodine)) and one control group (NI, 100μg/L iodine). There were 20 female rats in each group, and 8 offspring were chosen from each group following birth to assess metabolic alterations. The metabolites of subsets of brain hippocampal tissue were profiled by ultra-performance liquid chromatography-linked electrospray ionization quadrupole time-of-flight mass spectrometry (UPLC-ESI-QTOFMS) and the results were subjected to multivariate data analysis. Differential substances were screened by t test (p<0.05), principal component analysis (PCA), and partial least squares analysis (PLS-DA, VIP>1). The thyroid function of the female rats in the experimental group was abnormally changed. Metabolic analysis showed that the five groups were separated which revealed significant differences in hippocampal tissue metabolism among the five groups of offspring. A total of 12 potential metabolites were identified, with the majority of them being related to amino acid and energy metabolism. These metabolites are involved in various metabolic pathways, are interrelated, and may play a function in brain development. Our study highlights changes in metabolites and metabolic pathways in the brain hippocampus of offspring rats with different iodine intakes compared to controls, revealing new insights into hippocampal metabolism in offspring rats and new relevant targets.
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Affiliation(s)
- Li Zhang
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
| | - Lijun Fan
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
| | - Fan Li
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
| | - Qihao Sun
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yao Chen
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yanhong He
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
| | - Hongmei Shen
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
| | - Lixiang Liu
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China.
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14
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Matta Coelho C, Guimarães J, Bracchi I, Xavier Moreira N, Pinheiro C, Ferreira P, Pestana D, Barreiros Mota I, Cortez A, Prucha C, Martins C, Pinto E, Almeida A, Delerue-Matos C, Dias CC, Moreira-Rosário A, Ribeiro de Azevedo LF, Cruz Fernandes V, Ramalho C, Calhau C, Brantsæter AL, Costa Leite J, Keating E. Noncompliance to iodine supplementation recommendation is a risk factor for iodine insufficiency in Portuguese pregnant women: results from the IoMum cohort. J Endocrinol Invest 2022; 45:1865-1874. [PMID: 35635644 DOI: 10.1007/s40618-022-01813-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 04/27/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE After a recommendation for iodine supplementation in pregnancy has been issued in 2013 in Portugal, there were no studies covering iodine status in pregnancy in the country. The aim of this study was to assess iodine status in pregnant women in Porto region and its association with iodine supplementation. METHODS A cross-sectional study was conducted at Centro Hospitalar Universitário São João, Porto, from April 2018 to April 2019. Pregnant women attending the 1st trimester ultrasound scan were invited to participate. Exclusion criteria were levothyroxine use, gestational age < 10 and ≥ 14 weeks, non-evolutive pregnancy at recruitment and non-signing of informed consent. Urinary iodine concentration (UIC) was measured in random spot urine by inductively coupled plasma-mass spectrometry. RESULTS Median UIC was 104 μg/L (IQR 62-189) in the overall population (n = 481) of which 19% had UIC < 50 µg/L. Forty three percent (n = 206) were not taking an iodine-containing supplement (ICS) and median UIC values were 146 µg/L (IQR 81-260) and 74 µg/L (IQR 42-113) in ICS users and non-users, respectively (p < 0.001). Not using an ICS was an independent risk factor for iodine insufficiency [adjusted OR (95% CI) = 6.00 (2.74, 13.16); p < 0.001]. Iodised salt use was associated with increased median iodine-to-creatinine ratio (p < 0.014). CONCLUSIONS A low compliance to iodine supplementation recommendation in pregnancy accounted for a mild-to-moderately iodine deficiency. Our results evidence the need to support iodine supplementation among pregnant women in countries with low household coverage of iodised salt. Trial registration number NCT04010708, registered on the 8th July 2019.
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Affiliation(s)
- C Matta Coelho
- CINTESIS@RISE, Department Biomedicine, Unit of Biochemistry, Faculty of Medicine, University of Porto, 4200-319, Porto, Portugal
| | - J Guimarães
- CINTESIS@RISE, Department Biomedicine, Unit of Biochemistry, Faculty of Medicine, University of Porto, 4200-319, Porto, Portugal
| | - I Bracchi
- CINTESIS@RISE, Department Biomedicine, Unit of Biochemistry, Faculty of Medicine, University of Porto, 4200-319, Porto, Portugal
| | - N Xavier Moreira
- CINTESIS@RISE, Faculty of Medicine, University of Porto, Porto, Portugal
- Fluminense Federal University, Niterói, Rio de Janeiro, Brasil
| | - C Pinheiro
- CINTESIS@RISE, Department Biomedicine, Unit of Biochemistry, Faculty of Medicine, University of Porto, 4200-319, Porto, Portugal
| | - P Ferreira
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
| | - D Pestana
- CINTESIS@RISE, Nutrition and Metabolism, NOVA Medical School│FCM, Universidade Nova de Lisboa, Porto, Portugal
| | - I Barreiros Mota
- CINTESIS@RISE, Nutrition and Metabolism, NOVA Medical School│FCM, Universidade Nova de Lisboa, Porto, Portugal
| | - A Cortez
- Medicina Laboratorial Dr. Carlos Torres, Porto, Portugal
| | - C Prucha
- Department of Obstetrics, Centro Hospitalar Universitário S. João, Porto, Portugal
| | - C Martins
- Department of Obstetrics, Centro Hospitalar Universitário S. João, Porto, Portugal
| | - E Pinto
- REQUIMTE//LAQV, Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
- Department of Environmental Health, School of Health, P.Porto, Porto, Portugal
| | - A Almeida
- REQUIMTE//LAQV, Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - C Delerue-Matos
- REQUIMTE/LAQV, Instituto Superior de Engenharia, Politécnico do Porto, Porto, Portugal
| | - C C Dias
- CINTESIS@RISE, Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
| | - A Moreira-Rosário
- CINTESIS@RISE, Nutrition and Metabolism, NOVA Medical School│FCM, Universidade Nova de Lisboa, Porto, Portugal
| | - L F Ribeiro de Azevedo
- CINTESIS@RISE, Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
| | - V Cruz Fernandes
- REQUIMTE/LAQV, Instituto Superior de Engenharia, Politécnico do Porto, Porto, Portugal
| | - C Ramalho
- Department of Obstetrics, Centro Hospitalar Universitário S. João, Porto, Portugal
- Department of Ginecology-Obstetrics and Pediatrics, Faculty of Medicine, University of Porto, Porto, Portugal
- Instituto de Investigação e Inovação em Saúde, i3S, Universidade Do Porto, Porto, Portugal
| | - C Calhau
- CINTESIS@RISE, Nutrition and Metabolism, NOVA Medical School│FCM, Universidade Nova de Lisboa, Porto, Portugal
| | - A-L Brantsæter
- Division of Climate and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - J Costa Leite
- CINTESIS@RISE, Faculty of Medicine, University of Porto, Porto, Portugal
| | - E Keating
- CINTESIS@RISE, Department Biomedicine, Unit of Biochemistry, Faculty of Medicine, University of Porto, 4200-319, Porto, Portugal.
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15
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Negese K, Tilahun S, Kassie A, Birie B. Knowledge and practices of pregnant women about iodized salt and its availability in their households in Hawassa city. Community-based cross-sectional study. SAGE Open Med 2022; 10:20503121221115490. [PMID: 35966212 PMCID: PMC9373163 DOI: 10.1177/20503121221115490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 07/07/2022] [Indexed: 11/17/2022] Open
Abstract
Objectives: This study was aimed to assess the knowledge and practices of pregnant women
about iodized salt and its availability in their households in Hawassa city,
Ethiopia Methods: A community-based cross-sectional study design was conducted among pregnant
women with a total sample size (N) = 553 in Hawassa city. A
multi-stage sampling technique was employed. First, four sub-cities of
Hawassa city (out of eight sub-cities) were selected using the lottery
method. Households of pregnant women in each selected sub-city were
identified and screened. Finally, representative samples were drawn using
systematic random sampling technique. Results: A total of 537 pregnant women was included, a response rate of 97.1%. This
was due to incomplete data for nine and participation refusal for seven
participants. The mean age of the participants was 26.98 ± 4.75 years. About
52.51% and 52.33% of the respondents had good knowledge and good salt
handling practices, respectively. Regarding availability of iodized salt,
65.55% of pregnant women (31.66% salt with iodine level ⩾15 parts per
million (ppm) and 33.89% salt with iodine level <15 ppm) had iodized salt
and the remaining 34.45% non-iodized salt (0 ppm) respectively. Conclusion: Availability of iodized salt in households of pregnant women was 65.55%
(>0 ppm). More than one-third of pregnant women in Hawassa city are
utilized non-iodized salt (0 ppm). Nearly half of the pregnant women in
Hawassa city had poor knowledge and poor practice about iodized salt.
Hawassa city Health Department along with concerned stakeholders should
invest more effort to increase awareness about iodized salt and how to
handle it safely in households.
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Affiliation(s)
- Ketemaw Negese
- Department of Midwifery, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Semahegn Tilahun
- Department of Midwifery, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Aychew Kassie
- Department of Nursing, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Bamlaku Birie
- Department of Midwifery, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Aman, Ethiopia
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16
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Smoleń S, Kowalska I, Skoczylas Ł, Tabaszewska M, Pitala J, Mrożek J, Kováčik P. Effectiveness of enriching lettuce with iodine using 5-iodosalicylic and 3,5-diiodosalicylic acids and the chemical composition of plants depending on the type of soil in a pot experiment. Food Chem 2022; 382:132347. [PMID: 35151013 DOI: 10.1016/j.foodchem.2022.132347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 01/05/2022] [Accepted: 02/01/2022] [Indexed: 11/27/2022]
Abstract
Iodine is a beneficial element for humans, animals and plants. This study was a comparison of the effectiveness of iodosalicylate uptake by lettuce. The experiment included two sub-blocks: organic soil and mineral soil with the addition of the same fertigation of plants (8 times every 7 days) with 10 µM solutions (100 mL/per one plant/one application) of potassium iodate (KIO3), salicylic acid (SA) alone or together with KIO3, 5-iodosalicylic acid (5-ISA) or 3,5-diiodosalicylic acid (3,5-diISA). None of the tested iodine compounds negatively affected the yield of lettuce. When growing plants on mineral soil, plants accumulated more iodine in the leaves than plants grown on peat substrate. The use of 5-ISA allowed for achieving better efficiency of plant biofortification in iodine than the application of KIO3 and 3,5-diISA. The type of soil significantly modified the chemical composition of lettuce.
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Affiliation(s)
- Sylwester Smoleń
- Department of Plant Biology and Biotechnology, Faculty of Biotechnology and Horticulture, University of Agriculture in Krakow, Al. 29 Listopada 54, 31-425 Krakow, Poland.
| | - Iwona Kowalska
- Department of Plant Biology and Biotechnology, Faculty of Biotechnology and Horticulture, University of Agriculture in Krakow, Al. 29 Listopada 54, 31-425 Krakow, Poland.
| | - Łukasz Skoczylas
- Department of Plant Product Technology and Nutrition Hygiene, Faculty of Food Technology, University of Agriculture in Krakow, ul. Balicka 122, 30-149 Krakow, Poland.
| | - Małgorzata Tabaszewska
- Department of Plant Product Technology and Nutrition Hygiene, Faculty of Food Technology, University of Agriculture in Krakow, ul. Balicka 122, 30-149 Krakow, Poland.
| | - Joanna Pitala
- Laboratory of Mass Spectrometry, Faculty of Biotechnology and Horticulture, University of Agriculture in Krakow, Al. 29 Listopada 54, 31-425 Krakow, Poland.
| | - Joanna Mrożek
- Department of Human Nutrition and Dietetics, Faculty of Food Technology, University of Agriculture in Krakow, ul. Balicka 122, 30-149 Krakow, Poland.
| | - Peter Kováčik
- Department of Agrochemistry and Plant Nutrition, Slovak University of Agriculture in Nitra, Tr. A. Hlinku 2, 949 01 Nitra, Slovakia.
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17
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Nista F, Bagnasco M, Gatto F, Albertelli M, Vera L, Boschetti M, Musso N, Ferone D. The effect of sodium restriction on iodine prophylaxis: a review. J Endocrinol Invest 2022; 45:1121-1138. [PMID: 35079975 DOI: 10.1007/s40618-022-01749-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 01/16/2022] [Indexed: 01/06/2023]
Abstract
PURPOSE Sodium is essential to life. However, its dietary excess is detrimental to the cardiovascular system, and sodium restriction is a crucial step in cardiovascular prevention. Iodine deficiency has been fought worldwide for decades, and substantial success has been achieved introducing the use of iodine-enriched salt. Nevertheless, areas of iodine deficiency persist around the world, both in developing and industrialized countries, and a major concern affecting dietary sodium reduction programs is represented by a possible iodine intake deficiency. There are substantial differences in the source of alimentary iodine among countries, such as iodized salt added, household tap water, seafood, or salt employed in packaged food. It is clear that a sodium-restricted diet can induce differences in terms of iodine intake, depending on the country considered. Moreover, iodine status has undergone relevant changes in many countries in the last years. METHODS Systematic review of literature evidence about the possible effects of sodium restriction on population iodine status. RESULTS To date, the available results are conflicting, depending on country, salt iodization policy, as well as time frame of data collection. However, to ensure an optimal iodine supply by salt fortification, without exceeding the current recommendation by World Health Organization for salt intake, seems to be an achievable goal. CONCLUSION A balanced approach may be obtained by an adequate iodine concentration in fortified salt and by promoting the availability of iodized salt for household consumption and food industry use. In this scenario, updated prospective studies are strongly needed.
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Affiliation(s)
- F Nista
- Endocrinology Unit, Department of Internal Medicine and Center of Excellence for Biomedical Research, University of Genoa, Genoa, Italy
| | - M Bagnasco
- Department of Internal Medicine and Medical Specialties, President-elect of the Italian Thyroid Association, University of Genoa, Genoa, Italy
| | - F Gatto
- Endocrinology Unit, IRCCS Ospedale Policlinico San Martino, 16132, Genoa, Italy.
| | - M Albertelli
- Endocrinology Unit, Department of Internal Medicine and Center of Excellence for Biomedical Research, University of Genoa, Genoa, Italy
| | - L Vera
- Endocrinology Unit, IRCCS Ospedale Policlinico San Martino, 16132, Genoa, Italy
| | - M Boschetti
- Endocrinology Unit, Department of Internal Medicine and Center of Excellence for Biomedical Research, University of Genoa, Genoa, Italy
| | - N Musso
- Endocrinology Unit, IRCCS Ospedale Policlinico San Martino, 16132, Genoa, Italy
| | - D Ferone
- Endocrinology Unit, Department of Internal Medicine and Center of Excellence for Biomedical Research, University of Genoa, Genoa, Italy
- Endocrinology Unit, IRCCS Ospedale Policlinico San Martino, 16132, Genoa, Italy
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18
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Xu J, Liu S, Ma W, Li X, Guo M, Cao X, Gu Y, Wang H, Wang J, Zhang Y, Zhuang G, Liu L. Causes of different goiter rates with the same iodine deficiency among the pastoral and agricultural populations of Tibet: a geographical comparison. Thyroid Res 2022; 15:4. [PMID: 35305683 PMCID: PMC8933984 DOI: 10.1186/s13044-022-00122-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 02/28/2022] [Indexed: 11/10/2022] Open
Abstract
Background The residents of both the agricultural and pastoral areas of Tibet share the same iodine deficiency and iodine nutrition, but the rate of thyroid goiter was significantly higher in the agricultural areas than in the pastoral areas. This project sought to determine why the populations in the iodine-deficient pastoral areas show a lower rate of thyroid goiter. Methods Food frequency questionnaires (FFQs) and 24 h history recalls were adopted to investigate the dietary patterns of the residents of the agricultural and pastoral areas. Meat and milk samples were collected to measure their inorganic iodine, total iodine and thyroid hormone contents using ICP-MS, AsIII-Ce4+ catalytic spectrophotometry and the Siemens’ chemiluminescence method, respectively. The intake of protein, and the microelements, selenium and iron, was calculated according to their content in the food. Results The per capita daily intake of meat, dairy, and cereal in the pastoral areas was 116.7, 216.7, and 433.3 g, respectively, which are significantly higher than those in the agricultural areas (50.0, 72.2, and 375.0 g, respectively) (p < 0.05). The content of thyroid hormone in dried beef and milk in the pastoral areas was 62.6 and 13.5 μg/kg, respectively, which was significantly higher than those in the agricultural areas (25.1 and 4.1 μg/kg, respectively) (p < 0.05). The daily intake of thyroid hormone, protein and microelements, selenium and iron from foods by the residents of the pastoral areas were 10.5 μg, 99.6 g, 30.0 μg and 15.8 mg respectively, which was significantly higher than those in the agricultural areas (1.79 μg, 56.5 g, 23.8 μg and 13.2 mg, respectively) (p < 0.05). Conclusions The significantly high intake of the food-borne thyroid hormone by the residents of the pastoral area could be the main reason the residents in the pastoral areas show a lower rate of thyroid goiter than those in the agricultural area. Moreover, the relatively high intake of protein and trace elements, selenium and iron by residents in the pastoral area could be another important factor for reducing the goiter rates.
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Affiliation(s)
- Jing Xu
- Chinese Center for Disease Control and Prevention, Key Laboratory of Trace Element Nutrition of National Health Commission of China, National Institute for Nutrition and Health, 155 Changbai Road, Changping, Beijing, 102206, China
| | - Shichuan Liu
- Chinese Center for Disease Control and Prevention, Key Laboratory of Trace Element Nutrition of National Health Commission of China, National Institute for Nutrition and Health, 155 Changbai Road, Changping, Beijing, 102206, China.,Hangzhou Center for Disease Control and Prevention, 568 Mingshi Road, Jianqiao Town, Hangzhou, 310021, Jianggan District, China
| | - Wei Ma
- Chinese Center for Disease Control and Prevention, Key Laboratory of Trace Element Nutrition of National Health Commission of China, National Institute for Nutrition and Health, 155 Changbai Road, Changping, Beijing, 102206, China
| | - Xiuwei Li
- Chinese Center for Disease Control and Prevention, Key Laboratory of Trace Element Nutrition of National Health Commission of China, National Institute for Nutrition and Health, 155 Changbai Road, Changping, Beijing, 102206, China
| | - Min Guo
- Tibet Autonomous Region Center for Disease Control and Prevention, 71 Jinzhu Middle Road, Lhasa, 850002, China
| | - Xiaoxiao Cao
- Chinese Center for Disease Control and Prevention, Key Laboratory of Trace Element Nutrition of National Health Commission of China, National Institute for Nutrition and Health, 155 Changbai Road, Changping, Beijing, 102206, China
| | - Yunyou Gu
- Chinese Center for Disease Control and Prevention, Key Laboratory of Trace Element Nutrition of National Health Commission of China, National Institute for Nutrition and Health, 155 Changbai Road, Changping, Beijing, 102206, China
| | - Haiyan Wang
- Chinese Center for Disease Control and Prevention, Key Laboratory of Trace Element Nutrition of National Health Commission of China, National Institute for Nutrition and Health, 155 Changbai Road, Changping, Beijing, 102206, China
| | - Jianqiang Wang
- Chinese Center for Disease Control and Prevention, Key Laboratory of Trace Element Nutrition of National Health Commission of China, National Institute for Nutrition and Health, 155 Changbai Road, Changping, Beijing, 102206, China
| | - Ying Zhang
- Chinese Center for Disease Control and Prevention, Key Laboratory of Trace Element Nutrition of National Health Commission of China, National Institute for Nutrition and Health, 155 Changbai Road, Changping, Beijing, 102206, China
| | - Guangxiu Zhuang
- Chinese Center for Disease Control and Prevention, Key Laboratory of Trace Element Nutrition of National Health Commission of China, National Institute for Nutrition and Health, 155 Changbai Road, Changping, Beijing, 102206, China
| | - Liejun Liu
- Chinese Center for Disease Control and Prevention, Key Laboratory of Trace Element Nutrition of National Health Commission of China, National Institute for Nutrition and Health, 155 Changbai Road, Changping, Beijing, 102206, China.
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19
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Ares S, Saenz-Rico B, Arnaez J, Diez-Sebastian J, Omeñaca F, Bernal J. Effects of oral iodine supplementation in very low birth weight preterm infants for the prevention of thyroid function alterations during the neonatal period: results of a randomised assessor-blinded pilot trial and neurodevelopmental outcomes at 24 months. Eur J Pediatr 2022; 181:959-972. [PMID: 34651206 DOI: 10.1007/s00431-021-04288-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 10/02/2021] [Accepted: 10/04/2021] [Indexed: 12/21/2022]
Abstract
The trace element iodine (I) is essential for the synthesis of thyroid hormones. Parenteral nutrition solutions, formula milk, and human breast milk contain insufficient iodine to meet recommended intake for preterm infants. Iodine deficiency may affect thyroid function and may be associated with morbidity or neurological outcomes. The primary objective is to assess the evidence that dietary supplementation with iodine affects thyroid function during the neonatal period. The design was a randomised controlled pilot trial. Infants who met the inclusion criteria were enrolled through consecutive sampling and assigned to two different groups. The setting was a Spanish university hospital. Ninety-four patients with very low birth weight (under 1500 g) were included. Intervention group: 30 µg I/kg/day of iodine in oral drops given to 47 infants from their first day of life until hospital discharge. Control group: 47 infants without supplements. Formula and maternal milk samples for the determination of iodine content were collected at 1, 7, 15, 21, 30 days, and at discharge. Blood samples were collected for thyroid hormones. Neurological development was assessed at 2 years of age (Bayley III Test). Infants in the supplemented group reached the recommended levels from the first days of life. The researchers detected the effects of iodine balance on the plasma levels of thyroid hormones measured during the first 12 weeks of age. The trial assessed the impact of the intervention on neurodevelopmental morbidity.Conclusion: Thyroid function is related to iodine intake in preterm infants. Therefore, supplements should be added if iodine intake is found to be inadequate. The analyses found no effects of iodine supplementation on the composite scores for Bayley-III assessments in all major domains. The study results indicate potentially important effects on language development related to low iodine excretion during the first 4 weeks of life What is Known: • Thyroid function is related to iodine intake in preterm infants. • Preterm babies on formula preparations and with exclusive parenteral nutrition are at high risk of iodine deficiency. What is New: • Iodine intake should be monitored during the neonatal period. • Iodine supplements should be added if iodine intake is found to be inadequate.
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Affiliation(s)
- S Ares
- Neonatology Unit, University Hospital LA PAZ, Paseo de la Castellana 261, 28046, Madrid, Spain.
| | - B Saenz-Rico
- Facultad de Educacion, Universidad Complutense, Madrid, Spain
| | - J Arnaez
- Neonatology Unit, Hospital Universitario de Burgos, Burgos, Spain
| | - J Diez-Sebastian
- Biostatistics Department, University Hospital LA PAZ, Paseo de la Castellana 261, 28046, Madrid, Spain
| | - F Omeñaca
- Neonatology Unit, University Hospital LA PAZ, Paseo de la Castellana 261, 28046, Madrid, Spain
| | - J Bernal
- Instituto de Investigaciones Biomédicas, Universidad Autónoma de Madrid, Arturo Duperier 4, Madrid, Spain.,Center for Research On Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
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Venkatesh U, Sharma A, Ananthan VA, Subbiah P, Durga R; CSIR Summer Research training team. Micronutrient's deficiency in India: a systematic review and meta-analysis. J Nutr Sci 2021; 10:e110. [PMID: 35059191 DOI: 10.1017/jns.2021.102] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 11/28/2021] [Accepted: 11/29/2021] [Indexed: 02/02/2023] Open
Abstract
India is coming to grips with a stage of nutrition transition. According to the Food Safety and Standards Authority of India (FSSAI), preventable micronutrient deficiency is arising public health precedence in India. However, the foremost public health concern is the lack of national prevalence data. The present study was carried out to estimate the pooled age-wise prevalence of six preventable micronutrient deficiencies (vitamin A, vitamin B12, vitamin D, iron, iodine and folic acid) in India. A systematic review was carried out on PubMed and Global Index Medicus databases using the Boolean search strategy. Statistical analyses were done using R software, version 3.6. 2. PRISMA guidelines were strictly adhered to during the review. A preliminary literature search yielded 4302 articles; however, 270 original research articles were found eligible to be included in quantitative synthesis. The estimated overall prevalence was 17 % [95 % confidence interval (CI) 0⋅07, 0⋅26] for iodine deficiency, 37 % (95 % CI 0⋅27, 0⋅46) for folic acid deficiency, 54 % (95 % CI 0⋅49, 0⋅59) for iron deficiency, 53 % (95 % CI 0⋅41, 0⋅64) for vitamin B12 deficiency, 19 % (95 % CI 0⋅09, 0⋅29) for vitamin A deficiency and 61 % (95 % CI 0⋅07, 0⋅26) for vitamin D with high heterogeneity. We classified the population into infants (0–5 years), adolescents (<18 years), adults (>18 years) and pregnant women. Iron deficiency was most prevalent (61 %) in pregnant women. The results of the present study reinforce the data on micronutrient deficiency in India and warrant the immediate need for further active public health interventions to address these deficiencies. The study is registered with PROSPERO (CRD42020205043).
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Abstract
PURPOSE OF REVIEW Iodine deficiency is a global concern, and in recent years, there has been a significant improvement in the number of countries identified as being iodine-sufficient. This review considers the best strategies to ensure iodine sufficiency among breastfeeding women and their infants. RECENT FINDINGS Fortification strategies to improve iodine intake have been adequate for school-age children (SAC); however, often, iodine deficiency remains for breastfeeding women and their infants. Daily supplementation with iodine is not an ideal strategy to overcome deficiency. Countries defined as iodine-sufficient, but where pregnant and breastfeeding women have inadequate intake, should consider increasing salt iodine concentration, such that the median urinary iodine concentration of SAC can be up to 299 µg/L. This will ensure adequate intake for mothers and infants, without SAC being at risk thyroid dysfunction. Consensus is required for thresholds for iodine adequacy for breastfeeding women and infants.
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de Oliveira Campos R, Lima SCR, de Souza Braga Filho J, de Jesus JS, Anunciação SM, Martins GF, de Jesus LM, Dos Anjos Santana A, de Oliveira Souza VC, Júnior FB, Ramos HE. Association of Salt Iodization and Urine Iodine Concentration in Schoolchildren from Public Schools in Northeast of Brazil. Biol Trace Elem Res 2021; 199:4423-4429. [PMID: 33595754 DOI: 10.1007/s12011-020-02571-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 12/28/2020] [Indexed: 10/22/2022]
Abstract
Iodine deficiency (ID) is recognized as a leading risk factor for child development. Universal salt iodization (USI) is an effective and well-established intervention strategy for the prevention of iodine deficiency disorders (IDD). To evaluate the levels of iodine in household salt samples and the urinary iodine concentration (UIC) in schoolchildren aged 6 to 14 years in public schools in Bahia, Brazil. A cross-sectional study was conducted with 1231 students (6 to 14 years old) from 17 public schools in Bahia. The iodine concentration was evaluated in salt and UIC samples. The adapted Sandell-Kolthoff reaction was used to determine urinary iodine levels. A spectrophotometer (UV-Vis) was used to examine the reduction of ceric ammonium sulfate. A standard iodine solution using a potassium iodate was used to extrapolate the iodine concentrations. The total of 665 salt samples had a median iodine concentration of 24 mg/kg (25th-75th percentile 17.0 to 28.5 mg/kg). The largest proportion (79.6%) of salt samples had iodine concentration in the recommended range, 17.6% of the samples presented iodine at a salt concentration below the established level (<15 mg/kg) and a small proportion was above it (2.8%). The general mean urinary iodine concentration (MUIC) was 217.53 ± 28.30 μg/L and median was 205.50 μg/L. The students evaluated and the salt samples analyzed showed satisfactory results, as recommended by Brazilian legislation and nutritional recommendations of the World Health Organization (WHO).
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Affiliation(s)
- Renata de Oliveira Campos
- Health and Science Center, Federal University of Bahia Reconcavo, BA, Santo Antonio de Jesus, Brazil
- Postgraduate Program in Interactive Processes of Organs and Systems, Health & Science Institute, Federal University of Bahia, Salvador, BA, Brazil
- Bioregulation Department, Health and Science Institute, Federal University of Bahia, Avenida Reitor Miguel Calmon, S/N. Vale do Canela. Room 301, Salvador, BA, Brazil
| | - Sara Cristina Rebouças Lima
- Bioregulation Department, Health and Science Institute, Federal University of Bahia, Avenida Reitor Miguel Calmon, S/N. Vale do Canela. Room 301, Salvador, BA, Brazil
| | - Jair de Souza Braga Filho
- Bioregulation Department, Health and Science Institute, Federal University of Bahia, Avenida Reitor Miguel Calmon, S/N. Vale do Canela. Room 301, Salvador, BA, Brazil
| | - Joice Santos de Jesus
- Bioregulation Department, Health and Science Institute, Federal University of Bahia, Avenida Reitor Miguel Calmon, S/N. Vale do Canela. Room 301, Salvador, BA, Brazil
| | - Sara Moreira Anunciação
- Bioregulation Department, Health and Science Institute, Federal University of Bahia, Avenida Reitor Miguel Calmon, S/N. Vale do Canela. Room 301, Salvador, BA, Brazil
- Health & Science Center, Federal University Recôncavo da Bahia, Santo Antonio de Jesus, Bahia, Brazil
| | - Gabriela Flor Martins
- Bioregulation Department, Health and Science Institute, Federal University of Bahia, Avenida Reitor Miguel Calmon, S/N. Vale do Canela. Room 301, Salvador, BA, Brazil
| | - Lorena Maia de Jesus
- Bioregulation Department, Health and Science Institute, Federal University of Bahia, Avenida Reitor Miguel Calmon, S/N. Vale do Canela. Room 301, Salvador, BA, Brazil
| | - Aline Dos Anjos Santana
- Bioregulation Department, Health and Science Institute, Federal University of Bahia, Avenida Reitor Miguel Calmon, S/N. Vale do Canela. Room 301, Salvador, BA, Brazil
| | - Vanessa Cristina de Oliveira Souza
- Department of Veterinary Medicine, Faculty of Animal Science and Food Engineering of University of São Paulo, Pirassununga, São Paulo, Brazil
| | - Fernando Barbosa Júnior
- Department of Clinical Analyses, Toxicology and Food Sciences, School of Pharmaceutical Sciences of Ribeirão Preto of University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Helton Estrela Ramos
- Postgraduate Program in Interactive Processes of Organs and Systems, Health & Science Institute, Federal University of Bahia, Salvador, BA, Brazil.
- Bioregulation Department, Health and Science Institute, Federal University of Bahia, Avenida Reitor Miguel Calmon, S/N. Vale do Canela. Room 301, Salvador, BA, Brazil.
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Delshad H, Raeisi A, Abdollahi Z, Tohidi M, Hedayati M, Mirmiran P, Nobakht F, Azizi F. Iodine supplementation for pregnant women: a cross-sectional national interventional study. J Endocrinol Invest 2021; 44:2307-2314. [PMID: 33704696 DOI: 10.1007/s40618-021-01538-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 02/16/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Although Iran has been considered iodine replete since 2000, the first national survey of iodine intake among Iranian pregnant women in 2014 indicated that despite the adequate intake of iodine by the general population, this vulnerable group has moderate iodine deficiency. Therefore, in this national cross-sectional interventional study, we aimed to assess the iodine intake and thyroid function of Iranian pregnant women 2 years after implementing national iodine supplementation for this vulnerable group. MATERIALS AND METHODS In this cross-sectional study, we conducted a national interventional survey of pregnant women. A total of 1200 pregnant women (400 women from each trimester) from 12 provinces of Iran were recruited from the antenatal care clinics from October 2018 to March 2019. The median urinary iodine concentration (MUIC), as an indicator of iodine status in three spot urine samples, was measured, along with the serum total T4 (TT4), thyrotropin (TSH), thyroglobulin (Tg), thyroid peroxidase antibody (TPO-Ab), and iodine content of household salt. RESULTS The mean age of the cohort was 28 ± 6.2 years, with the mean gestational age of 22.7 ± 13.0 weeks. The overall MUIC (IQR) of pregnant women was 188 µg/L (124.2-263 µg/L). Also, the MUICs in the three trimesters of pregnancy were 174 µg/L (110-254), 175 µg/L (116-251), and 165 µg/L (114-235), respectively. The MUICs ≥ 150, 100-149, and < 100 µg/L were found in 63, 19.8, and 16.2% of the subjects, respectively. The mean TT4 level was 12 ± 4.5 µg/dL, and the median (IQR) level of TSH was 2.37 mIU/L (1.66-3.18 mIU/L). According to our local reference range, 118 (10.5%) pregnant women had subclinical hypothyroidism, 6 (0.53%) women had isolated hypothyroxinemia, and 65 (5.7%) women were TPO-Ab positive. Also, the median (IQR) level of Tg was 10.08 µg/dL (5.7-20.4 µg/dL), and the median iodine content of household salt was 29.6 µg/g; the iodine content was ≥ 30 µg/g in 85% of household salt. The results showed that more than 95% of households were under iodized salt coverage. CONCLUSION The results of this study indicated that iodine supplementation with at least 150 µg of iodine per day improved the iodine intake of pregnant women. Except for subclinical hypothyroidism, the prevalence of clinical hypothyroidism, clinical/subclinical thyrotoxicosis, TPO-Ab positivity, and isolated hypothyroxinemia decreased significantly, which emphasizes the importance of iodine supplementation during pregnancy.
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Affiliation(s)
- H Delshad
- Micronutrient Research Office, Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - A Raeisi
- Iran's Ministry of Health and Medical Education, Tehran, Iran
| | - Z Abdollahi
- General of Nutrition Department, Iran's Ministry of Health and Medical Education, Tehran, Iran
| | - M Tohidi
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - M Hedayati
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - P Mirmiran
- Nutrition Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - F Nobakht
- National IDD Program, Iran's Ministry of Health and Medical Education, Tehran, Iran
| | - F Azizi
- Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P. O. Box 19395-4763, Tehran, Iran.
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Ayalew BS, Hassen SL, Marefiyaw TA, Yesuf MS, Abebe DD, Temesgen MM. Prevalence of urinary iodine concentration among school children: in Dessie City, Ethiopia. BMC Pediatr 2021; 21:423. [PMID: 34560868 PMCID: PMC8461862 DOI: 10.1186/s12887-021-02887-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 09/08/2021] [Indexed: 11/10/2022] Open
Abstract
Background Urinary iodine is recommended by the world health organization as the main indicator to assess iodine status in a population. Despite this recommendation little is known about urinary iodine concentration in the study area. Therefore, this study aimed to determine the level of urinary iodine concentration among school-aged children. Methods An institution-based cross-sectional study design was used to assess the level of urinary iodine from April to June 2019 and a systematic random sampling technique was applied to select study participants. Socio-demographic characteristics were assessed using a pretested structured questionnaire and the laboratory method by Sandell–Kolthoff reaction method was used. Data were cleaned, coded, and entered into Epi data version 3.1 and then exported to SPSS version 21 software for analysis. Result A total of 634 study participants were enrolled in the study with a median age of 12 years (±SD = 2.0). The majority of the children were females (55.4%) and more than half of respondents report the use of iodized salt always. Median urinary iodine concentration was 158.5 μg/L (±SD = 104.1) with minimum and maximum values of 5.1 μg/L and 528.8 μg/L, respectively. The overall iodine deficiency in this study was 18.6% and severe deficiency constituted 7.4%. Conclusions The iodine deficiency of the school children aged 6 to 14 in the present study was 18.6% indicating high prevalence. A high proportion of iodine deficiency was observed among females and it increases as age increases. This indicates the need for an additional strategy to control iodine deficiency.
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Affiliation(s)
- Birtukan Shiferaw Ayalew
- Research and Technology Transfer Directorate, Amhara Public Health Institute Dessie Branch, Dessie, Amhara Region, Ethiopia.
| | - Seid Legesse Hassen
- Research and Technology Transfer Directorate, Amhara Public Health Institute Dessie Branch, Dessie, Amhara Region, Ethiopia
| | - Tefera Alemu Marefiyaw
- Public Health Emergency Management Directorate, Amhara Public Health Institute, Bahir Dar, Amhara Region, Ethiopia
| | - Mohammed Seid Yesuf
- Laboratory directorates, Amhara Public Health Institute Dessie Branch, Dessie, Amhara Region, Ethiopia
| | - Daniel Dagne Abebe
- Laboratory directorates, Amhara Public Health Institute Dessie Branch, Dessie, Amhara Region, Ethiopia
| | - Minwuyelet Maru Temesgen
- Research and Technology Transfer Directorate, Amhara Public Health Institute Dessie Branch, Dessie, Amhara Region, Ethiopia
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de Oliveira Campos R, de Jesus LM, Morais DA, de Sousa Júnior WT, de Oliveira Souza VC, Oliveira CA, Júnior FB, Macedo M, Hegedüs L, Ramos HE. Low urinary selenium levels are associated with iodine deficiency in Brazilian schoolchildren and adolescents. Endocrine 2021; 73:609-616. [PMID: 33719010 DOI: 10.1007/s12020-021-02681-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 02/27/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Selenium (Se) and iodine (Io) are important micronutrients for the proper functioning of the thyroid gland, as they are crucial for the synthesis and activation of the thyroid hormones (TH) triiodothyronine (T3) and thyroxine (T4). OBJECTIVE To evaluate the Se and Io nutritional status among schoolchildren. METHODOLOGY Cross-sectional, descriptive and analytical study conducted in 982 schoolchildren aged 6-14 years from public schools in the state of Bahia, Brazil. Sociodemographic and anthropometric variables, as well as urinary Se (USC) and Io concentrations (UIC) using the inductively coupled plasma mass spectrometry (ICP-MS) method and thyroid-stimulating hormone (TSH) from filter paper blood collection, were evaluated. RESULTS The median USC and UIC were 38.7 and 210.0 (IQR: 26.8-52.9 and 129.3-334.1 μg/L, respectively). The prevalence of iodine deficiency and excessive UIC were observed in 17.1% and 30.9% of schoolchildren, respectively. Concomitant low USC and IoD was found in 3.9% of schoolchildren. There was a positive correlation between USC and UIC (r = 0.60; p = 0.00). The median TSH was 0.95 (IQR: 0.69-1.30 µUI/L). CONCLUSIONS This study demonstrates that USC is a good biomarker for assessing Se status, meantime more studies are needed to establish cutoff USC in child population. Despite adequate median intake, a subgroup of schoolchildren had IoD and low USC. The correlation between UIC and USC point at the importance of two micronutrients, raising the question whether measuring Se should be included in monitoring programs that address the prevention of nutritional disturbances.
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Affiliation(s)
- Renata de Oliveira Campos
- Health and Science Center, Federal University Reconcavo of Bahia, Santo Antonio de Jesus, BA, Brazil
- Postgraduate Program in Interactive Processes of Organs and Systems, Health & Science Institute, Federal University of Bahia, Salvador, BA, Brazil
- Bioregulation Department, Health and Science Institute, Federal University of Bahia, Salvador, BA, Brazil
| | - Lorena Maia de Jesus
- Bioregulation Department, Health and Science Institute, Federal University of Bahia, Salvador, BA, Brazil
| | - Déborah Araújo Morais
- Laboratory of Toxicology and Essentiality of Metals, School of Pharmaceutical Sciences of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Wellington Tavares de Sousa Júnior
- Laboratory of Toxicology and Essentiality of Metals, School of Pharmaceutical Sciences of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Vanessa Cristina de Oliveira Souza
- Laboratory of Toxicology and Essentiality of Metals, School of Pharmaceutical Sciences of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Clotilde Assis Oliveira
- Health and Science Center, Federal University Reconcavo of Bahia, Santo Antonio de Jesus, BA, Brazil
| | - Fernando Barbosa Júnior
- Laboratory of Toxicology and Essentiality of Metals, School of Pharmaceutical Sciences of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Mariana Macedo
- Federal University of Jequitinhonha e Mucuri Valleys, Teófilo Otoni, Brazil
| | - Laszlo Hegedüs
- Department of Endocrinology and Metabolism, University of Southern Denmark, Odense, 5000, Denmark
| | - Helton Estrela Ramos
- Postgraduate Program in Interactive Processes of Organs and Systems, Health & Science Institute, Federal University of Bahia, Salvador, BA, Brazil.
- Bioregulation Department, Health and Science Institute, Federal University of Bahia, Salvador, BA, Brazil.
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Abstract
Iodine deficiency is still the main cause of preventable thyroid disorders, worldwide. To optimize iodine intake, programs of voluntary or mandatory iodization of salt have been implemented in several iodine-deficient countries and iodine sufficiency has been achieved in many. Despite the clear beneficial effects on thyroid health, some concerns have been raised on the presumed detriment of iodine prophylaxis on thyroid autoimmunity. Very recent studies aimed at evaluating the long-term consequences of iodine supplementation on thyroid autoimmunity and related dysfunction, have clearly demonstrated that the early post-iodization increase in thyroid antibody positivity is largely transient and not clinically relevant, since the prevalence of overt thyroid dysfunction has remained reassuring low over two decades. The recommended iodine intake is therefore safe with regard to thyroid autoimmunity, the benefits largely outweighing the risks in a population with a stable median iodine concentration not exceeding 300 μg/L. Thus, a possible increase in thyroid autoimmunity should not represent a limitation to promoting iodine supplementation in the general population, also taking into account the steady rise in prevalence of autoimmune disorders which has occurred in the last few decades because of environmental factors other than iodine.
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Affiliation(s)
- R M Ruggeri
- Department of Clinical and Experimental Medicine, University of Messina, via Consolare Valeria, 1, 98125, Messina, Italy.
- Endocrine Unit At University Hospital "AOU Policlinico G.Martino", Messina, Italy.
| | - F Trimarchi
- Department of Clinical and Experimental Medicine, University of Messina, via Consolare Valeria, 1, 98125, Messina, Italy
- Accademia Peloritana Dei Pericolanti at the University of Messina, Messina, Italy
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Jin Y, Coad J, Zhou SJ, Skeaff S, Benn C, Brough L. Use of Iodine Supplements by Breastfeeding Mothers Is Associated with Better Maternal and Infant Iodine Status. Biol Trace Elem Res 2021; 199:2893-2903. [PMID: 33094447 DOI: 10.1007/s12011-020-02438-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 10/11/2020] [Indexed: 12/21/2022]
Abstract
Adequate iodine status during conception, pregnancy and lactation is essential for supporting infant neurodevelopment. Iodine status in adults and children was improved after two New Zealand government initiatives, but the status of breastfeeding women is unknown. This study aimed to investigate the iodine intake and status of lactating mother-infant pairs at 3 months postpartum and to assess maternal iodine knowledge and practice. Iodine intake was estimated by a weighed 4-day diet diary (4DDD). Maternal urinary iodine concentrations (UIC) in spot urine, breast milk iodine concentrations (BMIC) and infant UIC were measured. Questions about iodine-specific knowledge and practice were asked. In 87 breastfeeding mother-infant pairs, maternal iodine intake was 151 (99, 285) μg/day, and 58% had an intake below the estimated average requirement (EAR) of 190 μg/day. Maternal median UIC (MUIC) was 82 (46, 157) μg/L indicating iodine deficiency (i.e., < 100 μg/L). Women who used iodine-containing supplements had a significantly higher MUIC (111 vs 68 μg/L, P = 0.023) and BMIC (84 vs 62 μg/L, P < 0.001) than non-users. Infants fed by women using iodine-containing supplements had a higher MUIC (150 vs 86 μg/L, P = 0.036) than those of non-users. A total of 66% (57/87) of women had no or low iodine knowledge. The iodine knowledge score was a statistically significant predictor of consuming iodine-containing supplements [(beta = 1.321, P = 0.008)]. Despite a decade of initiatives to increase iodine intakes in New Zealand, iodine knowledge was low; iodine intake and status of these lactating women were suboptimal, but women who used iodine-containing supplement were more likely to achieve adequate status.Study Registration Number (Australia and New Zealand Clinical Trials Registry): ACTRN12615001028594.
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Affiliation(s)
- Ying Jin
- School of Health Sciences, College of Health, Massey University, Palmerston North, New Zealand
| | - Jane Coad
- Nutrition Science, School of Food and Advance Technology, College of Sciences, Massey University, Private Bag 11 222, Palmerston North, 4474, New Zealand
| | - Shao J Zhou
- School of Agriculture, Food and Wine, Faculty of Sciences & Robinson Research Institute, University of Adelaide, Adelaide, Australia
| | - Sheila Skeaff
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | - Cheryl Benn
- Mid Central and Whanganui District Health Board, Palmerston North, New Zealand
| | - Louise Brough
- Nutrition Science, School of Food and Advance Technology, College of Sciences, Massey University, Private Bag 11 222, Palmerston North, 4474, New Zealand.
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Businge CB, Longo-Mbenza B, Kengne AP. Iodine nutrition status in Africa: potentially high prevalence of iodine deficiency in pregnancy even in countries classified as iodine sufficient. Public Health Nutr 2021; 24:3581-3586. [PMID: 32744219 PMCID: PMC8369456 DOI: 10.1017/s1368980020002384] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To assess the burden of iodine deficiency in pregnancy in Africa using estimated pregnancy median urinary iodine concentration (pMUIC). DESIGN pMUIC for each African country was estimated using a regression equation derived by correlating the school-age children (SAC) median UIC (mUIC) and pMUIC from countries around the globe, and the SAC mUIC data for African countries obtained from the Iodine Global Network (IGN) 2017 and 2019 Score cards. SETTING Iodine deficiency was endemic in many African countries before the introduction of iodine fortification, mainly through universal salt iodisation programmes about 25 years ago. There is a scarcity of data on the level of iodine nutrition in pregnancy in Africa. Women living in settings with pMUIC below 150 µg/l are at risk of iodine deficiency-related pregnancy complications. PARTICIPANTS Fifty of the fifty-five African countries that had data on iodine nutrition status. RESULTS A cut-off school age mUIC ≤ 175 µg/l is correlated with insufficient iodine intake in pregnancy (pregnancy mUIC ≤ 150 μg/l). Twenty-two African countries had SAC mUIC < 175 μg/l, which correlated with insufficient iodine intake during pregnancy (pMUIC < 150 μg/l). However, nine of these twenty-two countries had adequate iodine intake based on SAC mUIC. CONCLUSIONS There is likely a high prevalence of insufficient iodine intake in pregnancy, including in some African countries classified as having adequate iodine intake in the general population. A SAC mUIC ≤ 175 µg/l predicts insufficient iodine intake among pregnant women in these settings.
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Affiliation(s)
- Charles Bitamazire Businge
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Department of Obstetrics and Gynaecology, Faculty of Health Sciences, Walter Sisulu University, Mthatha, South Africa
| | - Benjamin Longo-Mbenza
- Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo
- Lomo University of Research, Kinshasa, Democratic Republic of Congo
| | - Andre Pascal Kengne
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Non-Communicable Research Unit, South African Medical Research Council, Cape Town, South Africa
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Deischinger C, Deischinger D, Gessl I, Krebs M, Marculescu R, Kautzky-Willer A, Kosi-Trebotic L. Oral Contraceptive Intake and Iodine Status in Young Women. Ann Nutr Metab 2021; 77:231-235. [PMID: 34350850 DOI: 10.1159/000518135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 06/15/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Similar to pregnant women, women taking an oral contraceptive (OC) might have elevated iodine requirements due to the altered hormonal state. This is the first study aimed at investigating the prevalence of iodine deficiency and possible influences of OC intake on urine creatinine and iodine levels in young women. METHODS One hundred fifty-five women between the age of 18 and 35 years (62 taking an OC and 93 controls) participated in a cross-sectional pilot study at the Medical University of Vienna, which included a 1-spot urine sample and a questionnaire on OC intake as well as a food questionnaire. RESULTS The median urinary iodine concentration (UIC) in this study was 68 μg/L (41, 111 μg/L) suggesting an inadequate iodine status in the women according to the WHO guidelines. Median UIC (OC: 89 μg/L, IQR 55-120; control: 59 μg/L, IQR 39-91, p = 0.010) and urine creatinine (OC: median = 99.0 μg/L, IQR 74.9-175.5; control: 77.0 μg/L, IQR 49.6-147.2, p = 0.030) levels were significantly higher in OC women than in the control group. UIC corrected for urine creatinine was comparable between both groups. CONCLUSION With similar creatinine-corrected UICs in both groups, OC intake might not have a significant impact on iodine status. However, the low median UIC in a vulnerable group of young women potentially conceiving in the following years points at the necessity of optimizing the iodine intake in the Austrian population and reiterates the insufficiency of the current iodine supplementation measures.
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Affiliation(s)
- Carola Deischinger
- Clinical Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Unit of Gender Medicine, Vienna, Austria
| | - Doris Deischinger
- Clinical Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Unit of Gender Medicine, Vienna, Austria
| | - Irina Gessl
- Clinical Division of Rheumatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Michael Krebs
- Clinical Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Unit of Gender Medicine, Vienna, Austria
| | - Rodrig Marculescu
- Clinical Institute for Medical and Chemical Laboratory Diagnostics, Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Alexandra Kautzky-Willer
- Clinical Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Unit of Gender Medicine, Vienna, Austria
| | - Lana Kosi-Trebotic
- Clinical Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Unit of Gender Medicine, Vienna, Austria
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Liu L, Liu P, Lin Q, Su X, Huang J, Meng F, Fan L, Wan S, Liu J, Cao W, Zhang L, Shen H. Iodine nutrition status of women after 10 years of Lipiodol supplementation: a cross-sectional study in Xinjiang, China. Br J Nutr 2021; 126:9-21. [PMID: 33028431 DOI: 10.1017/S0007114520003918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This study examined the contribution of long-term use of Lipiodol capsules, as a supplement to iodised salt to the control of iodine deficiency disorders among women in Xinjiang of China. A total of 1220 women across Kashgar, Aksu, Turpan and Yili Prefectures were surveyed in 2017. Lipiodol capsules were administered twice yearly in Kashgar and once yearly in Aksu and Turpan, but not in Yili. Urinary iodine concentration (UIC), free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH), thyroglobulin antibody, thyroid peroxidase antibody and thyroid volume values were assessed. All the women in the four areas were in a state of non-iodine deficiency by UIC. The UIC were higher than adequate in Kashgar and Aksu (619·4 v. 278·6 μg/l). Thyroid hormone levels differed significantly in Turpan and Yili (FT3: 4·4 v. 4·6 pmol/l, FT4: 13·8 v. 14·2 pmol/l, TSH: 2·0 v. 2·7 mIU/l), but did not differ significantly in Kashgar, Aksu and Yili. The four areas did not differ significantly with regard to thyroid nodules, autoimmune thyroiditis or goitre. However, the detection rates of subclinical hypothyroidism (16·6 %) and total thyroid dysfunction (25·4 %) were higher among women in Yili. The supplementation with Lipiodol capsules had improved the iodine nutrition status of women in iodine-deficient areas of Xinjiang since 2006. To avoid negative effects of excess iodine, we suggest a gradual discontinuation of Lipiodol capsules in women with special needs based on the existing iodine nutrition level of local women.
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Maggio MC, Ragusa SS, Aronica TS, Granata OM, Gucciardino E, Corsello G. Neonatal screening for congenital hypothyroidism in an Italian Centre: a 5-years real-life retrospective study. Ital J Pediatr 2021; 47:108. [PMID: 33952334 PMCID: PMC8097769 DOI: 10.1186/s13052-021-01053-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 04/21/2021] [Indexed: 12/02/2022] Open
Abstract
Introduction Congenital hypothyroidism is an endocrine disease with a significant incidence in the general population (1:2000–1:3000 newborns in Italy) and a different geographical distribution, partially explained by endemic iodine deficiency, genetic traits and autoimmune thyroid diseases. Objectives Aims of this study are: to evaluate the incidence of positive neonatal blood spot screening for CH in western Sicily, identified by the screening centre of the Children Hospital “G. Di Cristina”, ARNAS, Palermo; to evaluate the impact of a lower TSH cutoff in the neonatal blood spot screening for CH. Materials and methods The TSH threshold of the neonatal screening was established as ≥6 mU/L of whole blood. We analysed the screening centre data in the period January 2013–April 2018, for a total number of 85.373 babies (45.7% males; 54.3% females). Results 4.082 Babies (4.8%) required a second screening. Among these, 372 (0.44%) were out of range. The diagnosis of congenital hypothyroidism (CH) was confirmed in 182 babies (0.21%). 77/372 newborns (20.7%) with confirmed high TSH levels showed whole blood TSH levels ≥6 - < 7 mU/L. In synthesis, 48.9% of the out of range re-testing had a confirmed diagnosis of CH. Conclusion The reduction of TSH cutoff to 6 mU/L allowed to identify 77/372 neonates (20.7%) with confirmed out of range TSH, otherwise not recruited by the previously employed TSH cutoff.
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Affiliation(s)
- Maria Cristina Maggio
- Department of Health Promotion Sciences, Maternal and Infantile Care, Internal Medicine and Medical Specialities PROMISE, "G. D'Alessandro", University of Palermo, Via del Vespro 133, 90127, Palermo, Italy.
| | - Saveria Sabrina Ragusa
- Department of Health Promotion Sciences, Maternal and Infantile Care, Internal Medicine and Medical Specialities PROMISE, "G. D'Alessandro", University of Palermo, Via del Vespro 133, 90127, Palermo, Italy
| | - Tommaso Silvano Aronica
- U.O.S. Screening Neonatale e Metabolico Allargato of the Children Hospital "G. Di Cristina", ARNAS, Palermo, Italy
| | - Orazia Maria Granata
- U.O.S. Screening Neonatale e Metabolico Allargato of the Children Hospital "G. Di Cristina", ARNAS, Palermo, Italy
| | - Eleonora Gucciardino
- U.O.S. Screening Neonatale e Metabolico Allargato of the Children Hospital "G. Di Cristina", ARNAS, Palermo, Italy
| | - Giovanni Corsello
- Department of Health Promotion Sciences, Maternal and Infantile Care, Internal Medicine and Medical Specialities PROMISE, "G. D'Alessandro", University of Palermo, Via del Vespro 133, 90127, Palermo, Italy
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Jin Y, Coad J, Skeaff SA, Zhou SJ, Brough L. Iodine status of postpartum women and their infants aged 3, 6 and 12 months: Mother and Infant Nutrition Investigation (MINI). Br J Nutr 2021;:1-10. [PMID: 33858523 DOI: 10.1017/S000711452100129X] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
To alleviate the re-emergence of iodine deficiency in New Zealand, two strategies, the mandatory fortification of bread with iodised salt (2009) and a government-subsidised iodine supplement for breast-feeding women (2010), were introduced. Few studies have investigated mother and infant iodine status during the first postpartum year; this study aimed to describe iodine status of mothers and infants at 3, 6 and 12 months postpartum (3MPP, 6MPP and 12MPP, respectively). Partitioning of iodine excretion between urine and breast milk of exclusive breast-feeding (EBF) women at 3MPP was determined. In total, eighty-seven mother-infant pairs participated in the study. Maternal and infant spot urinary iodine concentration (UIC) and breast milk iodine concentration (BMIC) were determined. The percentage of women who took iodine-containing supplements decreased from 46 % at 3MPP to 6 % at 12MPP. Maternal median UIC (MUIC) at 3MPP (82 (46, 157) µg/l), 6MPP (85 (43, 134) µg/l) and 12MPP (95 (51, 169) µg/l) were <100 µg/l. The use of iodine-containing supplements increased MUIC and BMIC only at 3MPP. Median BMIC at all time points were below 75 µg/l. Infant MUIC at 3MPP (115 (69, 182) µg/l) and 6MPP (120 (60, 196) µg/l) were below 125 µg/l. Among EBF women at 3MPP, an increased partitioning of iodine into breast milk (highest proportion 60 %) was shown at lower iodine intakes, along with a reduced fractional iodine excretion in urine (lowest proportion 40 %), indicating a protective mechanism for breastfed infants' iodine status. In conclusion, this cohort of postpartum women was iodine-deficient. Iodine status of their breastfed infants was suboptimal. Lactating women who do not consume iodine-rich foods and those who become pregnant again should take iodine-containing supplements.
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Abstract
BACKGOUND Even a minor iodine deficiency can result in adverse thyroidal health consequences while excess iodine intake can also result in thyroid function disorders. One source of iodine is seaweed which as a foodstuff is enjoying an increasing profile in Western countries. Apart from its potential involvement in thyroidal health, gaseous iodine released from seaweeds plays a significant role in influencing coastal climate through cloud formation. SUMMARY Sources of dietary iodine, its assessment, recommended dietary intake, and consequences of iodine excess are outlined. The benefits and possible dangers of dietary intake of iodine-rich seaweed are described. Studies linking seaweed intake to breast cancer prevalence are discussed as is the role of gaseous iodine released from seaweeds influencing weather patterns and contributing to iodine intake in coastal populations. KEY MESSAGES Universal salt iodization remains the optimum method of achieving optimum iodine status. Promoting increased dietary iodine intake is recommended in young women, in early pregnancy, and in vegan and vegetarian diets. Even where iodine intake is enhanced, regular assessment of iodine status is necessary. Caution against consumption of brown seaweeds (kelps) is required as even small amounts can have antithyroid actions while product labelling may be insufficient. Gaseous iodine produced from seaweeds can have a significant effect on cloud formation and associated global warming/cooling. Increased overall iodine deposition through rainfall and apparent uptake in populations dwelling in seaweed-rich coastal regions may provide a partial natural remedy to global iodine deficits.
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Affiliation(s)
- Peter P.A. Smyth
- *Peter P.A. Smyth, 8 Fairlawns Saval Park Road Dalkey, Co Dublin A96FX09 (Ireland),
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Pinheiro C, Xavier Moreira N, Ferreira P, Matta Coelho C, Guimarães J, Pereira G, Cortez A, Bracchi I, Pestana D, Barreiros Mota I, Prucha C, Martins C, Alves Ribeiro C, Pinto E, Almeida A, Delerue-Matos C, Montenegro N, Dias CC, Moreira-Rosário A, Azevedo LF, Brantsæter AL, Ramalho C, Cruz Fernandes V, Costa Leite J, Calhau C, Keating E. Iodine knowledge is associated with iodine status in Portuguese pregnant women: results from the IoMum cohort study. Br J Nutr 2021;:1-9. [PMID: 33461643 DOI: 10.1017/S0007114521000155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Lack of knowledge about iodine has been suggested as a risk factor for iodine deficiency in pregnant women, but no studies have addressed this issue in Portugal. So, the aim of this study was to investigate iodine knowledge among Portuguese pregnant women and its association with iodine status. IoMum, a prospective observational study, included 485 pregnant women recruited at Centro Hospitalar e Universitário de S. João, Porto, between the 10th and 13th gestational weeks. Partial scores for knowledge on iodine importance, on iodine food sources or on iodised salt were obtained through the application of a structured questionnaire. Then, a total iodine knowledge score was calculated and grouped into low, medium and high knowledge categories. Urinary iodine concentration (UIC) was measured in spot urine samples by inductively coupled plasma MS. Of the pregnant women, 54 % correctly recognised iodine as important to neurocognitive development, 32 % were unable to identify any iodine-rich food and 71 % presented lack of knowledge regarding iodised salt. Of the women, 61 % had a medium total score of iodine knowledge. Knowledge on iodine importance during pregnancy was positively associated with iodine supplementation and also with UIC. Nevertheless, median UIC in women who correctly recognised the importance of iodine was below the cut-off for adequacy in pregnancy (150 µg/l). In conclusion, knowledge on iodine importance is positively associated with iodine status. Despite this, recognising iodine importance during pregnancy may not be sufficient to ensure iodine adequacy. Literacy-promoting actions are urgently needed to improve iodine status in pregnancy.
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Zhou H, Lu Y, Pan B, Zhao Q, Ma ZF. Iodine Deficiency as Assessed by Neonatal TSH in a Sample of Mother-and-Newborn Pairs in Jiangsu Province, China. Biol Trace Elem Res 2021; 199:70-75. [PMID: 32253700 DOI: 10.1007/s12011-020-02135-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 03/25/2020] [Indexed: 12/20/2022]
Abstract
China has eliminated iodine deficiency disorders since 2011 via the implementation of universal salt iodisation. Following this, a new revised salt iodisation policy was introduced to reduce iodine content in table salt. Since maternal iodine deficiency can lead to cognitive impairment and cretinism in infants, the aim of our study was to assess if the iodine status of pregnant women and neonates was affected by the introduction of new salt iodisation policy. The medical records of the pregnant women and their neonates in the Northern Jiangsu People's Hospital, Yangzhou, Jiangsu Province, China, between January 2018 and May 2018 were reviewed and obtained. Our study included 374 mother-and-newborn pairs. Mean age of the participants was 28 ± 4 years. TSH, FT3 and FT4 of the participants remained within the reference range. The prevalence of thyroid dysfunction was 4.3%. The overall mean neonatal TSH, birth weight and prevalence of low birth weight (LBW) was 2.56 ± 1.59 mIU/L, 3348 ± 465 g and 2.4%, respectively. The prevalence of neonatal TSH values > 5 mIU/L was 8.3%, which suggested the emergence of mild iodine deficiency (i.e. 3.0-19.9%) in our province. In conclusion, although our study reported an improvement of iodine status to mild iodine deficiency in 2017, our pregnant women remained to be iodine deficient. We recommended an ongoing monitoring of iodine status and advocate for the routine iodine supplementation together with iodised salt in Chinese pregnant women.
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Affiliation(s)
- Hang Zhou
- Clinical Medical College, Yangzhou University, Yangzhou, 225009, Jiangsu Province, China
- Department of Clinical Nutrition, Northern Jiangsu People's Hospital, Yangzhou, 225001, Jiangsu Province, China
| | - Yiming Lu
- Clinical Medical College, Yangzhou University, Yangzhou, 225009, Jiangsu Province, China
- Department of Orthopedics, Northern Jiangsu People's Hospital, Yangzhou, 225001, Jiangsu Province, China
| | - Binyu Pan
- Department of Clinical Nutrition, Suzhou Ninth People's Hospital, Suzhou, 215200, Jiangsu Province, China
| | - Qihua Zhao
- Clinical Medical College, Yangzhou University, Yangzhou, 225009, Jiangsu Province, China
- Department of Clinical Nutrition, Northern Jiangsu People's Hospital, Yangzhou, 225001, Jiangsu Province, China
| | - Zheng Feei Ma
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, 215123, Jiangsu Province, China.
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Vural M, Koc E, Evliyaoglu O, Acar HC, Aydin AF, Kucukgergin C, Apaydin G, Erginoz E, Babazade X, Sharifova S, Perk Y. Iodine status of Turkish pregnant women and their offspring: A national cross-sectional survey. J Trace Elem Med Biol 2021; 63:126664. [PMID: 33075737 DOI: 10.1016/j.jtemb.2020.126664] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 09/08/2020] [Accepted: 09/30/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND This national cross-sectional survey aimed to assess the iodine status in pregnant women and their offspring, and also to demonstrate regional differences by measuring urinary iodine concentration (UIC). For each woman and her newborn a questionnaire was prepared with basic facts as age, parity number or birth weight and additional information regarding thyroid diseases, use of iodized salt in the household, extra iodine supplementation during pregnancy, education level and wage income. METHODS The target population represented 1444 pregnant women who gave birth between January 1 st, 2018 and 2019, and their offspring. Iodine deficiency for pregnant women and their offspring were defined as urine iodine level <150 μg/L and <100 μg/L, respectively. Results are given as median (25th-75th percentile). RESULTS The median UIC in the group of pregnant woman was 94 (52-153) μg/L. Within the sample of 1444 pregnant women, UIC indicative of mild iodine deficiency (100-149 μg/L) was present in 21 % (n = 306), moderate deficiency (50-99 μg/L) in 30 % (n = 430), and severe deficiency (<50 μg/L) in 23 % (n = 337). This study showed a prevalence of 74 % of iodine deficiency in Turkish pregnant woman. The median UIC in the group of offspring was 96 (41-191) μg/L. Within the new-borns, UIC indicative of mild iodine deficiency (50-99 μg/L) was present in 22 % (n = 323), moderate deficiency (20-49 μg/L) in 15 % (n = 222), and severe deficiency (<20 μg/L) in 13 % (n = 192). This survey showed a prevalence of 51 % of iodine deficiency in Turkish new-borns. Pregnant women with lower socioeconomic and education level, lower access to household iodized salt, lower rates of exposure to povidone-iodine containing skin disinfectant, higher parity and higher iodine deficiency had higher rates of iodine deficiency in their offspring. Regional differences were observed both in mothers and their offspring concerning their iodine status. CONCLUSIONS Our findings suggest that iodine deficiency is still an important public health problem in Turkey. More drastic measures should be taken to decrease these important iodine deficiencies, both in pregnant women and in their offspring.
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Affiliation(s)
- Mehmet Vural
- Department of Pediatrics, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Kocamustafapasa, Fatih, 34098, Istanbul, Turkey.
| | - Esin Koc
- Department of Pediatrics, Gazi University Faculty of Medicine, 06500, Ankara, Turkey
| | - Olcay Evliyaoglu
- Department of Pediatrics, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Kocamustafapasa, Fatih, 34098, Istanbul, Turkey
| | - Hazal Cansu Acar
- Department of Public Health, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Kocamustafapasa, Fatih, 34098, Istanbul, Turkey
| | - Abdurrahman Fatih Aydin
- Department of Medical Biochemistry, Istanbul Medical Faculty, Istanbul University, Çapa, Fatih, 34104, Istanbul, Turkey
| | - Canan Kucukgergin
- Department of Medical Biochemistry, Istanbul Medical Faculty, Istanbul University, Çapa, Fatih, 34104, Istanbul, Turkey
| | - Gozde Apaydin
- Department of Pediatrics, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Kocamustafapasa, Fatih, 34098, Istanbul, Turkey
| | - Ethem Erginoz
- Department of Public Health, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Kocamustafapasa, Fatih, 34098, Istanbul, Turkey
| | - Xanim Babazade
- Department of Pediatrics, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Kocamustafapasa, Fatih, 34098, Istanbul, Turkey
| | - Sabina Sharifova
- Department of Pediatrics, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Kocamustafapasa, Fatih, 34098, Istanbul, Turkey
| | - Yildiz Perk
- Department of Pediatrics, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Kocamustafapasa, Fatih, 34098, Istanbul, Turkey
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de Oliveira Campos R, Ramos HE. Assessing Cassava Flour Consumption Impact on Iodine Nutritional Status in Schoolchildren from Public Schools in Brazil. Biol Trace Elem Res 2021; 199:85-91. [PMID: 32307649 DOI: 10.1007/s12011-020-02144-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 04/06/2020] [Indexed: 10/24/2022]
Abstract
Cassava (Manihot esculenta Crantz) is an important food source in many developing countries. This root contains cyanoglucosides, which can aggravate iodine deficiency disorders (IDDs). To analyze the impact of cassava flour consumption (CFC) on urinary iodine concentration (UIC) among schoolchildren from public schools in Bahia, Brazil. Cross-sectional study was conducted on 1231 schoolchildren (ages 6-14 years old). Anthropometric parameters, household food insecurity, UIC, and CFC were evaluated. CFC prevalence was 90.8%. The mean UIC indicated adequate iodine nutrition in group A (CFC positive) and group B (CFC negative) (203.29 ± 81.08 μg/L versus 225.98 ± 76.59 μg/L, respectively). We found that daily cassava flour intake did not significantly raise the risk of iodine deficiency (ID) (odds ratio [OR] = 1.43 [confidence interval (CI) 0.72-2.82]; p = 0.29), nor did it significantly protect against excessive iodine intake (EII) (OR = 0.70[CI 0.39-1.26]; p = 0.24). The prevalence of iodine deficiency (ID) (12.6% versus 8.9%) and EII (9.6% versus 15%) did not significantly differ between both groups. The results of this study suggest that the cyanides present in cassava flour have very little influence on iodine metabolism, which is probably justified by cassava processing methods.
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Affiliation(s)
- Renata de Oliveira Campos
- Department of Bioregulation, Health & Science Institute, Federal University of Bahia, Avenida Reitor Miguel Calmon, S/N. Vale do Canela. Room 301,, Salvador, BA, 40110-102, Brazil
- Post-Graduate Program in Interactive Processes of Organs and Systems. Health & Science Institute, Federal University of Bahia, Salvador, Brazil
- Health & Science Center, Reconcavo of Bahia Federal University, Santo Antonio de Jesus, Brazil
| | - Helton Estrela Ramos
- Department of Bioregulation, Health & Science Institute, Federal University of Bahia, Avenida Reitor Miguel Calmon, S/N. Vale do Canela. Room 301,, Salvador, BA, 40110-102, Brazil.
- Post-Graduate Program in Interactive Processes of Organs and Systems. Health & Science Institute, Federal University of Bahia, Salvador, Brazil.
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Kaile T, Sikateyo B, Phiri MM, Michelo C. Prevalence of iodine deficiency among pregnant women in Gwembe and Sinazongwe districts of Southern Province, Zambia: a cross-sectional study. BMC Nutr 2020; 6:71. [PMID: 33292776 PMCID: PMC7725116 DOI: 10.1186/s40795-020-00397-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 11/09/2020] [Indexed: 11/16/2022] Open
Abstract
Background Maternal iodine deficiency is one of the common causes of morbidity and mortality during pregnancy. Maternal iodine deficiency during pregnancy is associated with a number of adverse outcomes such as abortion, stillbirth, congenital anomalies, perinatal mortality and irreversible mental retardation. A study conducted in Zambia among pregnant women in 2013 on the prevalence of iodine deficiency showed that iodine deficiency was not a public health concern. The previous study used Urine Iodine concentration (UIC) as a marker of iodine deficiency among the pregnant women. Our study was conducted to assess the prevalence of iodine deficiency among pregnant women in Gwembe and Sinazongwe districts of Southern Province, Zambia, using urine iodine concentration and goitre presence by manual palpation. Methods We carried out a community based, cross sectional study in rural areas of Gwembe and Sinazongwe districts between April 2016 to March 2018. Data were collected from 412 pregnant women by a multistage cluster sampling technique. The presence of a goitre was examined by manual palpation and urinary iodine concentration was determined by the Ultra Violet Method using PerkinElmer Labda UV Spectrometer equipment made in Jena Germany (Model 107,745). As part of the existing baseline data, we used results of a 2013 countrywide study (n = 489) for household salt iodine content which showed a greater than 40 ppm at 76.2%, between 15 and 40 ppm at 19.21% and less than 15 ppm at 4.59%. Statistical analysis was done using Stata version 14.0. The outputs of analysis are presented as median and Interquartile range (IQR) as the urine data were not normally distributed. Further, the categorical and independent variables were presented as proportions (percentages) to describe the distribution and trends in the target sample population. Results The median Urine Iodine concentration (UIC) of the pregnant women was 150 μg/L (Interquartile Range (IQR): 100–200 μg/L). Based on the UIC, There were 49% pregnant women who had inadequate iodine intake with urine iodine concentration of less than 150 μg/L, 34.0% had UIC of 150–249 μg/L indicating adequate iodine intake, 13.0% with UIC of 250–499 μg/L indicating more than adequate iodine intake, and 5.0% with UIC of above 500 μg/L indicating excessive iodine intake. To determine whether the women had access to iodized salt, we used baseline data from 2013 Zambia national survey for iodine concentration in household salt samples as being an average of 40 ppm, which also showed that 95.41% households consumed adequately iodized salt (≥15 ppm). The prevalence of goitre in our study was very low at 0.02% among the pregnant women of all ages who participated in the study (18–49 years). Conclusion Iodine deficiency was still not a public health concern among the pregnant women of Gwembe and Sinazongwe districts of Southern Province in Zambia. Goitre prevalence has remained very low in this study area. The UIC and goitre observations were consistent with the Zambia National Food and Nutrition Commission findings in 2013 report. However, our study showed more pregnant women with insufficient than adequate iodine status indicating the risk of developing IDD is still high in this region. It also reinforces the argument that strengthening of the existing salt iodization program is needed in order to make a homogenous iodated salt available to the communities. The National Food and Nutrition Commission of Zambia needs to find innovative ways of sensitizing people about the adverse effects of IDDs and how these could be prevented. It is recommended that iodine supplementation be introduced as part of the package of Antenatal clinic care for all pregnant women.
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Affiliation(s)
- Trevor Kaile
- Department of Pathology and Microbiology, The University of Zambia, Ridgeway Campus, Lusaka, Zambia.
| | - Bornwell Sikateyo
- Department of Medical Education Development, The University of Zambia, School of Medicine, Ridgeway Campus, Lusaka, Zambia
| | - Masauso M Phiri
- Department of Pathology and Microbiology, The University of Zambia, Ridgeway Campus, Lusaka, Zambia
| | - Charles Michelo
- The University of Zambia, School of Public Health, Ridgeway Campus, Lusaka, Zambia
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Doggui R, Al-Jawaldeh H, Al-Jawaldeh A. Trend of Iodine Status in the Eastern Mediterranean Region and Impact of the Universal Salt Iodization Programs: a Narrative Review. Biol Trace Elem Res 2020; 198:390-402. [PMID: 32221799 DOI: 10.1007/s12011-020-02083-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 02/14/2020] [Indexed: 12/14/2022]
Abstract
Recognizing the importance of iodine deficiency as a single most important preventable cause of brain damage, World Health Organization (WHO) urged all countries to scale up salt iodization since 1991 where iodine deficiency was declared as a global public health problem. All countries committed to report on the national iodine status of school-aged children (6-12 years), every 3 years. This paper aims to evaluate the progress of countries in Eastern Mediterranean Region (EMR) toward the eradication of iodine deficiency disorders (IDD) and recommend operational action to support implementation of the WHO Regional Nutrition Strategy (2020-2030). Salt iodization in EMR has been scaled up with significant progress in increasing the proportion of dietary salt which is adequately iodized. As a result, many countries such as Qatar, Kuwait, Bahrain, Jordan, Oman, and Iran have achieved, or are now on the threshold of achieving IDD elimination. The WHO in coordination with United Nations Children's Fund is working with member states to ensure suitability of these achievements. Hence, efficient monitoring will help member states to measure the magnitude of IDD as a public health problem and to monitor the effects of the intervention on the iodine status of a population. Policy makers should take proactive steps to enforce mandatory regulatory measures for USI, through a multi-sectoral coordination, and careful assessments and estimates of iodine nutritional status. Coordination between the two national programs of USI and salt reduction intake is necessary.
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Affiliation(s)
- Radhouene Doggui
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA.
| | - Hanin Al-Jawaldeh
- Health Science Department, The American University of Madaba, Madaba, 11821, Jordan
| | - Ayoub Al-Jawaldeh
- Department of Nutrition Sciences, University of Vienna, UZA2 Althantstrasse 14, 1090, Vienna, Austria
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Lopes-Pereira M, Roque S, Costa P, Quialheiro A, Santos NC, Goios A, Vilarinho L, Correia-Neves M, Palha JA. Impact of iodine supplementation during preconception, pregnancy and lactation on maternal thyroid homeostasis and offspring psychomotor development: protocol of the IodineMinho prospective study. BMC Pregnancy Childbirth 2020; 20:693. [PMID: 33187482 PMCID: PMC7664061 DOI: 10.1186/s12884-020-03376-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 10/28/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Iodine deficiency is the most common cause of preventable brain harm and cognitive impairment in children. Portuguese women of childbearing age, pregnant women and their progeny were shown to have inadequate iodine intake. Consequently, the Portuguese Health Authorities have recommended a daily supplementation with 150-200 µg iodine in preconception, pregnancy, and lactation. The IodineMinho study intends to evaluate whether (i) this recommendation impacted on the prevalence of iodine deficiency in pregnant women from the Minho region of Portugal, (ii) the time of initiation of iodine supplementation (if any) influences the serum levels of thyroid hormones at several intervals during pregnancy and (iii) there are serum thyroid-hormone parameters in the 1st trimester of pregnancy that predict psychomotor development of the child at 18 months of age. METHODS Most Portuguese women are followed throughout pregnancy in community Family Health Units, where family physicians may choose to follow the National recommendation or other, concerning iodine sufficiency. This study will recruit women (N = 304) who intend to become pregnant or are already pregnant from 10 representative Units. Physician's approach and prescriptions, sociodemographic, nutrition and clinical information will be obtained at baseline and throughout pregnancy. To evaluate endocrine function, blood and urine samples will be collected at recruitment, once in each trimester of pregnancy, at delivery and 3 months after delivery. Breastmilk samples will be collected for iodine and energy content analysis. Children will be evaluated for psychomotor development at 18 months. Maternal thyroid volume will be evaluated by ultrasound scan at baseline, in the 3rd trimester and at 3 months after delivery. DISCUSSION Iodine deficiency early during development precludes children from achieving full intellectual capabilities. This protocol describes a study that is innovative and unique in its detailed and comprehensive evaluation of maternal and child endocrine and psychomotor parameters. By evaluating the effectiveness of the iodine supplementation recommendation, it will contribute to the public health systems' efforts to provide excellence in maternal and infant care. TRIAL REGISTRATION ClinicalTrials.gov, NCT04288531 . Registered 28 February 2020-Retrospectively registered.
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Affiliation(s)
- Maria Lopes-Pereira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus Gualtar, 4710-057, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal
- Hospital de Braga, Braga, Portugal
| | - Susana Roque
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus Gualtar, 4710-057, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal
| | - Patrício Costa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus Gualtar, 4710-057, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal
| | - Anna Quialheiro
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus Gualtar, 4710-057, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal
| | - Nadine Correia Santos
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus Gualtar, 4710-057, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal
| | - Ana Goios
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus Gualtar, 4710-057, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal
| | - Laura Vilarinho
- Newborn Screening, Metabolism & Genetics Unit, National Institute of Health Dr Ricardo Jorge, Porto, Portugal
| | - Margarida Correia-Neves
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus Gualtar, 4710-057, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal
| | - Joana Almeida Palha
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus Gualtar, 4710-057, Braga, Portugal.
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal.
- Clinical Academic Center, Braga, Portugal.
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Yu Z, Zheng C, Zheng W, Wan Z, Bu Y, Zhang G, Ding S, Wang E, Zhai D, Ma ZF. Mild-to-moderate iodine deficiency in a sample of pregnant women and salt iodine concentration from Zhejiang province, China. Environ Geochem Health 2020; 42:3811-3818. [PMID: 32596780 DOI: 10.1007/s10653-020-00640-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 06/16/2020] [Indexed: 06/11/2023]
Abstract
Since 2011, Zhejiang province has eliminated iodine deficiency disorders (IDD) in its populations. Following this achievement, a new revised iodine concentration in iodised salt was implemented in Zhejiang in 2012. However, the re-emergence of iodine deficiency has been reported in pregnant women. Therefore, the aim of this study was to assess household salt iodine concentration and iodine status of pregnant women in Zhejiang province, China. We conducted a cross-sectional study between April 2018 and August 2018 in Quzhou, Zhejiang province. Pregnant women aged ≥ 18 years who did not have a history of thyroid disease were recruited into the study. They were asked to complete socio-demographic questionnaires including a food frequency questionnaire (FFQ). In addition, a spot urine sample and a household table salt sample were also provided by each participant. A total of 625 pregnant women agreed to participate. The overall median urinary iodine concentration (UIC) was 130 µg/L, indicating mild-to-moderate iodine deficiency in pregnant women. The coverage of iodised salt was 85.2%, and of these, the rate of adequately iodised salt was 98.1%. In conclusion, our results confirmed the re-emergence of iodine deficiency in pregnant women as reported by other studies conducted in Zhejiang province. Therefore, urgent public health actions are needed to improve iodine status of pregnant women in order to prevent the adverse consequences of IDD on the neurodevelopment of foetus.
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Affiliation(s)
- Zengli Yu
- School of Public Health, Xinxiang Medical University, Xinxiang, 453003, People's Republic of China
- School of Public Health, Zhengzhou University, Science Road 100, Zhengzhou, 450001, People's Republic of China
| | - Canjie Zheng
- Quzhou Center for Disease Control and Prevention, 154 Xi'an Road, Quzhou, 324000, Zhejiang Province, People's Republic of China
| | - Wangfeng Zheng
- Quzhou Hospital of Traditional Chinese Medicine, 117 Quhua Road, Quzhou, 324000, Zhejiang Province, People's Republic of China
| | - Zhongxiao Wan
- School of Public Health, Zhengzhou University, Science Road 100, Zhengzhou, 450001, People's Republic of China
- School of Public Health, Soochow University, Suzhou, 215123, People's Republic of China
| | - Yongjun Bu
- School of Public Health, Xinxiang Medical University, Xinxiang, 453003, People's Republic of China
| | - Guofu Zhang
- School of Public Health, Xinxiang Medical University, Xinxiang, 453003, People's Republic of China
| | - Shibin Ding
- School of Public Health, Xinxiang Medical University, Xinxiang, 453003, People's Republic of China
| | - Erhui Wang
- School of Public Health, Xinxiang Medical University, Xinxiang, 453003, People's Republic of China
| | - Desheng Zhai
- School of Public Health, Xinxiang Medical University, Xinxiang, 453003, People's Republic of China
| | - Zheng Feei Ma
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, 215123, People's Republic of China.
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Sant'Ana Leone de Souza L, de Oliveira Campos R, Dos Santos Alves V, Cerqueira TLO, da Silva TM, Teixeira LSG, Feitosa ACR, de Aragão Dantas Alves C, Ramos HE. Hypertension and Salt-Restrictive Diet Promotes Low Urinary Iodine Concentration in High-Risk Pregnant Women: Results from a Cross-Sectional Study Conducted After Salt Iodination Reduction in Brazil. Biol Trace Elem Res 2020; 197:445-453. [PMID: 31933280 DOI: 10.1007/s12011-020-02028-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 01/01/2020] [Indexed: 11/26/2022]
Abstract
During pregnancy, the demand for daily iodine increases by 50-70% which occurs to reach around 250 μg/day. Limited information is available on the association of high-risk pregnancy (HRP) with urinary iodine concentration (UIC) and variables such as socioeconomic factors. To analyze iodine nutritional status and socioeconomic, demographic and anthropometric characteristics among women with HRP screened at the main referral public health center at Bahia, Brazil, a cross-sectional study was conducted in 241 women with HRP (15-46 years old) in Salvador, Bahia, Brazil. The median UIC (MUIC) was 119 μg/L (25-75th, 58.7-200.4 μg/L), indicating mild iodine deficiency. Low UIC (< 150 μg/L) was detected in 61.8% (n = 149) - 18.3% between 100 and 150 μg/L, 24.5% between 50 and 100 μg/L, and 19.1% with UIC < 50 μg/L. Overall, 53% (n = 128) of our population adhered to a low-salt diet, and 32.5% (n = 77) had hypertension. Among the 73% of hypertensive women adhering to a salt-restricted diet, there was a 112% increased risk of iodine deficiency observed (OR = 2.127; 95% confidence interval [1.178-3.829]; p = 0.011). Adhering to a salt-restricted diet was associated with iodine deficiency (OR = 1.82; 95% confidence interval [1.073-3.088], p = 0,026). Hypertension and salt restriction diet significantly increased susceptibility for iodine deficiency in HRP. Therefore, low-salt diet when prescribed to pregnant women (PW) might be carefully followed by iodine nutritional status assessment or universal preconception iodine supplementation.
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Affiliation(s)
- Luciana Sant'Ana Leone de Souza
- Department of Bioregulation, Health & Science Institute, Federal University of Bahia, Avenida Reitor Miguel Calmon, S/N. Vale do Canela, Room 301, Salvador, BA, Brazil
- Post-graduate Program in Interactive Processes of Organs and Systems. Health & Science Institute, Federal University of Bahia, Salvador, Bahia, Brazil
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia, Brazil
| | - Renata de Oliveira Campos
- Department of Bioregulation, Health & Science Institute, Federal University of Bahia, Avenida Reitor Miguel Calmon, S/N. Vale do Canela, Room 301, Salvador, BA, Brazil
- Post-graduate Program in Interactive Processes of Organs and Systems. Health & Science Institute, Federal University of Bahia, Salvador, Bahia, Brazil
- Federal University of Reconcavo da Bahia, Santo Antonio de Jesus, Bahia, Brazil
| | - Vitor Dos Santos Alves
- Department of Bioregulation, Health & Science Institute, Federal University of Bahia, Avenida Reitor Miguel Calmon, S/N. Vale do Canela, Room 301, Salvador, BA, Brazil
| | - Taíse Lima Oliveira Cerqueira
- Department of Bioregulation, Health & Science Institute, Federal University of Bahia, Avenida Reitor Miguel Calmon, S/N. Vale do Canela, Room 301, Salvador, BA, Brazil
| | | | | | - Alina Coutinho Rodrigues Feitosa
- Federal University of Reconcavo da Bahia, Santo Antonio de Jesus, Bahia, Brazil
- Maternidade Professor José Maria de Magalhaes Netto, Salvador, Bahia, Brazil
| | - Crésio de Aragão Dantas Alves
- Post-graduate Program in Interactive Processes of Organs and Systems. Health & Science Institute, Federal University of Bahia, Salvador, Bahia, Brazil
- Department of Pediatrics, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Helton Estrela Ramos
- Department of Bioregulation, Health & Science Institute, Federal University of Bahia, Avenida Reitor Miguel Calmon, S/N. Vale do Canela, Room 301, Salvador, BA, Brazil.
- Post-graduate Program in Interactive Processes of Organs and Systems. Health & Science Institute, Federal University of Bahia, Salvador, Bahia, Brazil.
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Dineva M, Rayman MP, Bath SC. Iodine status of consumers of milk-alternative drinks v. cows' milk: data from the UK National Diet and Nutrition Survey. Br J Nutr 2021; 126:28-36. [PMID: 32993817 DOI: 10.1017/S0007114520003876] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Milk is the main source of iodine in the UK; however, the consumption and popularity of plant-based milk-alternative drinks are increasing. Consumers may be at risk of iodine deficiency as, unless fortified, milk alternatives have a low iodine concentration. We therefore aimed to compare the iodine intake and status of milk-alternative consumers with that of cows' milk consumers. We used data from the UK National Diet and Nutrition Survey from years 7 to 9 (2014-2017; before a few manufacturers fortified their milk-alternative drinks with iodine). Data from 4-d food diaries were used to identify consumers of milk-alternative drinks and cows' milk, along with the estimation of their iodine intake (µg/d) (available for n 3976 adults and children ≥1·5 years). Iodine status was based on urinary iodine concentration (UIC, µg/l) from spot-urine samples (available for n 2845 adults and children ≥4 years). Milk-alternative drinks were consumed by 4·6 % (n 185; n 88 consumed these drinks exclusively). Iodine intake was significantly lower in exclusive consumers of milk alternatives than cows' milk consumers (94 v. 129 µg/d; P < 0·001). Exclusive consumers of milk alternatives also had a lower median UIC than cows' milk consumers (79 v. 132 µg/l; P < 0·001) and were classified as iodine deficient by the WHO criterion (median UIC < 100 µg/l), whereas cows' milk consumers were iodine sufficient. These data show that consumers of unfortified milk-alternative drinks are at risk of iodine deficiency. As a greater number of people consume milk-alternative drinks, it is important that these products are fortified appropriately to provide a similar iodine content to that of cows' milk.
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Çelmeli G, Çürek Y, Özen Kücükçetin İ, Arslan Gülten Z, Özdem S, Akçurin S, Bircan İ. The Results of 16 Years of Iodization: Assessment of Iodine Deficiency Among School-age Children in Antalya, Turkey. J Clin Res Pediatr Endocrinol 2020; 12:256-260. [PMID: 31948188 PMCID: PMC7499140 DOI: 10.4274/jcrpe.galenos.2020.2019.0168] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE Iodine deficiency (ID) continues to be a problem around the world. This study investigated the prevalence of ID and goiter among school-age children in the city center of Antalya, Turkey. The aim was to investigate the effect of an iodization program, which had been running for sixteen years, on nutritional iodine status in this population. METHODS A total of 1,594 school children, aged 6-14 years, were included in this cross-sectional study. ID was evaluated based on median [interquartile range (IQR)] urine iodine/creatine (UI/Cr) (μg/g) ratio and median (IQR) UI concentrations (UIC) (μg/L). UICs were measured using the Sandell-Kolthoff method. Goiter was determined by palpation and staged according to World Health Organization classification. RESULTS Median (IQR) UIC was found to be 174.69 (119.17-242.83) μg/L, and UIC was found to be lower than 50 μg/L in 6.5% of the population. The median UI/Cr ratio increased from 62.3 to 163.3 μg/g and goiter rates had decreased from 34% to 0.3% over the 16 years of the program. However, 19% were still classified as ID (mild, moderate or severe) and, furthermore, 11.5% were classified as excessive iodine intake. CONCLUSION Comparison of two cross-sectional studies, carried out 16-years apart, showed that Antalya is no longer an ID region. However, surveillance should be continued and the percentage of ID and iodine excess individuals in the population should be monitored to avoid emerging problems.
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Affiliation(s)
- Gamze Çelmeli
- University of Health Sciences Turkey, Antalya Training and Research Hospital, Clinic of Pediatric Endocrinology, Antalya, Turkey,* Address for Correspondence: University of Health Sciences Turkey, Antalya Training and Research Hospital, Clinic of Pediatric Endocrinology, Antalya, Turkey Phone: +90 242 249 44 00 E-mail:
| | - Yusuf Çürek
- University of Health Sciences Turkey, Antalya Training and Research Hospital, Clinic of Pediatric Endocrinology, Antalya, Turkey
| | - İkbal Özen Kücükçetin
- Akdeniz University Faculty of Health Sciences, Department of Nutrition and Dietetics, Antalya, Turkey
| | - Zümrüt Arslan Gülten
- Akdeniz University Faculty of Medicine, Department of Pediatrics, Antalya, Turkey
| | - Sebahat Özdem
- Akdeniz University Faculty of Medicine, Department of Biochemistry, Antalya, Turkey
| | - Sema Akçurin
- Akdeniz University Faculty of Medicine, Department of Pediatric Endocrinology, Antalya, Turkey
| | - İffet Bircan
- Akdeniz University Faculty of Medicine, Department of Pediatric Endocrinology, Antalya, Turkey
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Aslan Çin NN, Bezirganoğlu Altuntaş N, Özfer Özçelik A. Is iodized salt efficient to overcome iodine deficiency in pregnants? Turk J Obstet Gynecol 2020; 17:90-97. [PMID: 32850182 PMCID: PMC7406895 DOI: 10.4274/tjod.galenos.2020.20727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Accepted: 04/24/2020] [Indexed: 12/01/2022] Open
Abstract
Objective: Iodine is a trace element that synthesizes thyroid hormones necessary for optimal human growth and development. The relationship between dietary iodine intake and spot urinary iodine excretion in pregnant women has not been previously evaluated in Trabzon city, which is an endemic area of iodine deficiency in the Black Sea region of Turkey. This study aimed to evaluate the relationship between dietary iodine intake and urine iodine excretion in pregnant women. Materials and Methods: This study enrolled 150 pregnant women aged between 19 and 45 years who applied to Clinic of Gynecology and Obstetrics in Trabzon. Spot urine specimens were taken, and dietary iodine intake data were collected using a food frequency questionnaire (FFQ) and 24-hours dietary recall (24-h DR) method. Results: The median urinary iodine concentration (UIC) in the general specimen was 100.6 μg/L. Of the pregnant women, 80.0% had insufficient and 20.0% had sufficient iodine levels, according to UIC. Although total iodine-rich food intake determined by FFQ was sufficient in 20.7% (n=31) of participants, 24-h DR iodine intake was sufficient only 10.7% (n=16). A significant association between urinary iodine excretion and iodine intake was observed in both 24-h DR and FFQ intake estimates (p<0.05). The iodine intake values obtained in both 24-h DR and FFQ and the iodized salt effect were correlated with UIC in all models (p<0.05). Even though 96.0% of pregnant women used iodized salt, its effect on UIC was 15.2%. Conclusion: Both methods indicate that the iodine intake of pregnant women might be insufficient in Trabzon area. Also, although iodized salt use is high in pregnant women in Trabzon, it is not enough to prevent iodine deficiency.
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Affiliation(s)
- Nazlı Nur Aslan Çin
- Ankara University Faculty of Health Sciences, Department of Nutrition and Dietetics, Ankara, Turkey
| | - Neslihan Bezirganoğlu Altuntaş
- University of Health Sciences Turkey, Trabzon Kanuni Training and Research Hospital, Clinic of Gynecology and Obstetrics, Trabzon, Turkey
| | - Ayşe Özfer Özçelik
- Ankara University Faculty of Health Sciences, Department of Nutrition and Dietetics, Ankara, Turkey
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Majstorov V, Miladinova D, Kuzmanovska S, Ittermann T, Pop Gjorcheva D, Vaskova O, Ugrinska A, Milevska Kostova N, Karanfilski B. Schoolchildren thyroid volume in North Macedonia: data from a national survey in an iodine-sufficient country. J Endocrinol Invest 2020; 43:1073-1079. [PMID: 32020533 DOI: 10.1007/s40618-020-01189-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 01/22/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE North Macedonia is historically iodine deficient, but due to the longstanding and effective preventive measures, it has been considered iodine replete since 2003. The aim of the recent national survey was to re-evaluate iodine status and to measure thyroid volume (TVol) by ultrasound in schoolchildren as a representative of the general population. METHODS A stratified probability proportionate to size cluster sampling was used to obtain a representative national sample of school children aged 7-10 years between the 28th of March and 4th of October 2016. Thyroid volume (TVol) was measured using ultrasonography in 1188 children. All TVol measurements were done by a single operator and their medians were compared with an international reference standard. RESULTS Significant positive correlation was found between Tvol and age, height, weight, body surface area (BSA), body mass index (BMI) in both girls and boys (p < 0.001), but not between TVol and urinary ioidine concentration (UIC). The most important predictors for Tvol in all children were age, height, weight, BMI, and BSA ( all p < 0.001). In multivariate regression, independent predictors for TVol were only BSA (p < 0.001) and age (p = 0.004) after being adjusted for sex, BMI, and UIC (R2 = 0.291). The 97th percentile of Tvol in our survey was generally higher than in the reference study and goiter prevalence of 18.3% in boys and 15.6% in girls was found compared to the international standard. CONCLUSION In our survey, Tvol of schoolchildren was larger than in the international reference study, although iodine nutritional status of the country has been considered sufficient for many years. In countries and regions with long and effective, well-documented iodine prophylaxis, the optimal way to have realistic normative TVol would be to create their TVol reference limits. Therefore, the provided data for TVol measured in our survey could be proposed as the national reference TVol for schoolchildren aged 7-10 years.
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Affiliation(s)
- V Majstorov
- Institute of Pathophysiology and Nuclear Medicine, Faculty of Medicine, Ss. Cyril and Methodius University Skopje, Majka Tereza 17, 1000, Skopje, North Macedonia.
| | - D Miladinova
- Institute of Pathophysiology and Nuclear Medicine, Faculty of Medicine, Ss. Cyril and Methodius University Skopje, Majka Tereza 17, 1000, Skopje, North Macedonia
| | - S Kuzmanovska
- Institute of Pathophysiology and Nuclear Medicine, Faculty of Medicine, Ss. Cyril and Methodius University Skopje, Majka Tereza 17, 1000, Skopje, North Macedonia
| | - T Ittermann
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - D Pop Gjorcheva
- Institute of Pathophysiology and Nuclear Medicine, Faculty of Medicine, Ss. Cyril and Methodius University Skopje, Majka Tereza 17, 1000, Skopje, North Macedonia
| | - O Vaskova
- Institute of Pathophysiology and Nuclear Medicine, Faculty of Medicine, Ss. Cyril and Methodius University Skopje, Majka Tereza 17, 1000, Skopje, North Macedonia
| | - A Ugrinska
- Institute of Pathophysiology and Nuclear Medicine, Faculty of Medicine, Ss. Cyril and Methodius University Skopje, Majka Tereza 17, 1000, Skopje, North Macedonia
| | - N Milevska Kostova
- Centre for Regional Policy Research and Cooperation "Studiorum", Skopje, North Macedonia
| | - B Karanfilski
- National Committee for Iodine Deficiency, Ministry of Health, Skopje, North Macedonia
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Abdelrahman A, Salih LMA, Saeed E. Knowledge, attitude, and practice of iodized salt use in Al-Riyadh and Al-Ozozab areas, Khartoum, Sudan. Sudan J Paediatr 2020; 20:26-33. [PMID: 32528198 DOI: 10.24911/sjp.106-1582985547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Iodine deficiency and subsequent iodine deficiency disorders have been a longstanding problem in many areas of the world, including Sudan, and still remains as the leading cause of preventable brain damage. According to the Sudan Household Health Survey, in 2006, the consumption of iodized salt in Sudan was 11%, only to deteriorate later on in 2011 to 9.5%. This is a descriptive cross sectional study which assesses the knowledge, attitude, and practice regarding the use of iodized salt in two socioeconomically different residential areas, Al-Riyadh and Al-Ozozab, Khartoum city, Sudan. From total of 152 participants selected from Al-Riyadh and Al-Ozozab areas (50% from each), there were 87 (57 %) females. Participants from Al-Riyadh had a higher educational and income level than those from Al-Ozozab, and better knowledge regarding the importance of regular iodized salt consumption to treat iodine deficiency (61% and 54%, respectively). However, only 39% of the participants were actually buying iodized salt. There was a significant relationship between residency and buying of iodized salt among the participants from Al-Riyadh (49%) and Al-Ozozab (30%) areas (p-value = 0.02). There was also significant association between the educational level and buying iodized salt (p-value = 0.014), but not with the income (p-value = 0.23). The consumption of potential goitrogenic foods (pearl millet or peanut butter) was high among the participants (n = 142) from Al-Riyadh and Al-Ozozab, and constituted 76% and 83%, respectively. Compulsory national salt specification needs to be established in Sudan, together with monitoring the market availability of iodized salt.
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Affiliation(s)
- Amani Abdelrahman
- Department of Community Medicine, Faculty of Medicine, University of Khartoum, Sudan
| | - Lubna M A Salih
- Fifth Year MBBS Student, Faculty of Medicine, University of Khartoum, Sudan
| | - Elshazaly Saeed
- Prince Abdullah Bin Khaled Coeliac Disease Research Chair, King Saud University, Riyadh, Saudi Arabia
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Trofimiuk-Müldner M, Konopka J, Sokołowski G, Dubiel A, Kieć-Klimczak M, Kluczyński Ł, Motyka M, Rzepka E, Walczyk J, Sokołowska M, Buziak-Bereza M, Tisończyk J, Pach D, Hubalewska-Dydejczyk A. Current iodine nutrition status in Poland (2017): is the Polish model of obligatory iodine prophylaxis able to eliminate iodine deficiency in the population? Public Health Nutr 2020; 23:2467-77. [PMID: 32476639 DOI: 10.1017/S1368980020000403] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The monitoring of the populations' iodine status is an essential part of successful programmes of iodine deficiency elimination. The current study aimed at the evaluation of current iodine nutrition in school children, pregnant and lactating women as a marker of the effectiveness and sustainability of mandatory iodine prophylaxis in Poland. DESIGN The following iodine nutrition indicators were used: urinary iodine concentration (UIC) (all participants) and serum thyroglobulin (pregnant and lactating women). SETTING The study was conducted in 2017 within the National Health Programme in five regions of Poland. PARTICIPANTS The research included 300 pregnant women, 100 lactating women and 1000 school children (aged 6-12 years). RESULTS In pregnant women, median UIC was 111·6 µg/l; there was no significant difference in median UIC according to the region of residence. In 8 % of pregnant women, thyroglobulin level was >40 ng/ml (median thyroglobulin 13·3 ng/ml). In lactating women, median UIC was 68·0 µg/l. A significant inter-regional difference was noted (P = 0·0143). In 18 % of breastfeeding women, thyroglobulin level was >40 ng/ml (median thyroglobulin 18·5 ng/ml). According to the WHO criteria, the investigated sample of pregnant and lactating women was iodine-deficient. Median UIC in school children was 119·8 µg/l (with significant inter-regional variation; P = 0·0000), which is consistent with iodine sufficiency. Ninety-four children (9·4 %) had UIC < 50 µg/l. CONCLUSIONS Mandatory iodisation of household salt in Poland has led to a sustainable optimisation of iodine status in the general population. However, it has failed to assure adequate iodine nutrition during pregnancy and lactation.
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Abstract
Iodine is a micronutrient used by the thyroid gland to produce thyroid hormones, which manage different aspects of body metabolism. Humans depend on exogenous sources of iodine to maintain the normal concentration of thyroid hormones. Pregnancy alters iodine turnover and is associated with significant changes in thyroid function. Daily iodine requirement during pregnancy increases to 250 μg, compared with 150 μg for nonpregnant women. According to recent guidelines of scientific organizations, to improve maternal thyroid status and to prevent child neurocognitive defects, all pregnant and breastfeeding women should take 150 μg of iodine supplementation, not only in iodine-deficient regions but also in iodine-sufficient areas. However, some recent studies have confirmed that iodine supplementation of mildly iodine-deficient pregnant women has no clear benefits as concerns maternal thyroid function or child neurodevelopment.
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Affiliation(s)
- Hossein Delshad
- Micronutrient Research Office, Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Velenjak, Parvaneh Avenue No. 24, Research Institute for Endocrine Sciences, Tehran, Islamic Republic of Iran.
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
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50
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Bouillon R, Antonio L. Nutritional rickets: Historic overview and plan for worldwide eradication. J Steroid Biochem Mol Biol 2020; 198:105563. [PMID: 31809867 DOI: 10.1016/j.jsbmb.2019.105563] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 11/10/2019] [Accepted: 12/02/2019] [Indexed: 02/01/2023]
Abstract
Rickets was first described in great detail in the mid 17th century and was affecting a great number of children in major European cities. The disease, however, existed already in the Roman times. The etiology of this disease remained enigmatic until the 1920s when two different mechanisms, lack of exposure to sunlight and lack of a dietary factor were finally solved by the discovery of vitamin D and its dual origin. Soon thereafter, the implementation of vitamin D supplementation for all infants and small children largely eliminated nutritional rickets in Europe and North America. It took nearly a century to elucidate the complex chemistry, metabolism, mode and spectrum of activity of the vitamin D endocrine system. Nutritional rickets, whether due to simple vitamin D or calcium deficiency or both, remains widely ravaging many infants and children around the world. Asian countries and the Middle East are mainly confronted with vitamin D deficiency whereas many African and some Asian countries face calcium deficiency rickets. Immigrants and refugees or in general people with a darker skin living in moderate climate zone are also confronted with this disease. There is great consensus how this disease could be prevented or cured. In collaboration with most international professional societies, we prepare a memorandum, in line with the successful battle against iodine deficiency disorders, to convince the World Health Organization and its member states to start an implementation program to eradicate nutritional rickets by 2030.
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Affiliation(s)
- Roger Bouillon
- Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Ageing, KU, Leuven, Belgium.
| | - Leen Antonio
- Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Ageing, KU, Leuven, Belgium
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