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Neonatal Thyroid-Stimulating Hormone Concentrations in Belgium: A Useful Indicator for Detecting Mild Iodine Deficiency?  [PDF]
Stefanie Vandevijvere, Wim Coucke, Jean Vanderpas, Caroline Trumpff, Maarten Fauvart, Ann Meulemans, Sandrine Marie, Marie-Fran?oise Vincent, Roland Schoos, Fran?ois Boemer, Timothy Vanwynsberghe, Eddy Philips, Fran?ois Eyskens, Brigitte Wuyts, Valbona Selimaj, Bart Van Overmeire, Christine Kirkpatrick, Herman Van Oyen, Rodrigo Moreno-Reyes
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0047770
Abstract: It has been proposed that neonatal thyroid-stimulating hormone (TSH) concentrations are a good indicator of iodine deficiency in the population. A frequency of neonatal TSH concentrations above 5 mU/L below 3% has been proposed as the threshold indicating iodine sufficiency. The objective of the present study was to evaluate feasibility and usefulness of nation-wide neonatal TSH concentration screening results to assess iodine status in Belgium. All newborns born in Belgium during the period 2009–2011 (n = 377713) were included in the study, except those suffering from congenital hypothyroidism and premature neonates. The frequency of neonatal TSH concentrations above 5 mU/L from 2009 to 2011 in Belgium fluctuated between 2.6 and 3.3% in the centres using the same TSH assay. There was a significant inverse association between neonatal TSH level and birth weight. The longer the duration between birth and screening, the lower the TSH level. Neonatal TSH levels were significantly lower in winter than in spring or autumn and significantly lower in spring and summer than in autumn while significantly higher in spring compared to summer. In conclusion, despite that pregnant women in Belgium are mildly iodine deficient, the frequency of neonatal TSH concentrations above 5 mU/L was very low, suggesting that the neonatal TSH threshold proposed for detecting iodine deficiency needs to be re-evaluated. Although neonatal TSH is useful to detect severe iodine deficiency, it should not be recommended presently for the evaluation of iodine status in mildly iodine deficient regions.
Hypothyroxinemia Induced by Mild Iodine Deficiency Deregulats Thyroid Proteins during Gestation and Lactation in Dams  [PDF]
Wei Wei,Yi Wang,Jing Dong,Yuan Wang,Hui Min,Binbin Song,Zhongyan Shan,Weiping Teng,Qi Xi,Jie Chen
International Journal of Environmental Research and Public Health , 2013, DOI: 10.3390/ijerph10083233
Abstract: The main object of the present study was to explore the effect on thyroidal proteins following mild iodine deficiency (ID)-induced maternal hypothyroxinemia during pregnancy and lactation. In the present study, we established a maternal hypothyroxinemia model in female Wistar rats by using a mild ID diet. Maternal thyroid iodine content and thyroid weight were measured. Expressions of thyroid-associated proteins were analyzed. The results showed that the mild ID diet increased thyroid weight, decreased thyroid iodine content and increased expressions of thyroid transcription factor 1, paired box gene 8 and Na +/I ? symporter on gestational day (GD) 19 and postpartum days (PN) 21 in the maternal thyroid. Moreover, the up-regulated expressions of type 1 iodothyronine deiodinase (DIO1) and type 2 iodothyronine deiodinase (DIO2) were detected in the mild ID group on GD19 and PN21. Taken together, our data indicates that during pregnancy and lactation, a maternal mild ID could induce hypothyroxinemia and increase the thyroidal DIO1 and DIO2 levels.
Prevalence of thyroid nodules in an occupationally radiation exposed group: a cross sectional study in an area with mild iodine deficiency
Paolo Trerotoli, Anna Ciampolillo, Giuseppe Marinelli, Riccardo Giorgino, Gabriella Serio
BMC Public Health , 2005, DOI: 10.1186/1471-2458-5-73
Abstract: A cross-sectional study was designed to evaluate the prevalence of thyroid nodules in radiation exposed workers, compared with a stratified sample of non exposed workers. After giving written consent to participate in the study, all the recruited subjects (304 exposed and 419 non exposed volunteers) were interviewed to fill in an anamnestic questionnaire, and underwent a physical examination, ultrasound thyroid scan, serum determinations of fT3, fT4 and TSH, fine needle aspiration biopsy. The sample was subdivided into one group exposed to a determined quantity of radiation (detected by counter), one group exposed to an undetectable quantity of radiation, and the non exposed control group.The prevalence of thyroid nodules <1 cm in diameter, defined as incidentalomas, in the exposed group with detected doses, was 11.28% in males and 9.68% in females, while in the exposed group with undetectable dose the prevalence was 10.39% in males and 16.67% in females. In the non exposed group the prevalence of incidentalomas was 9.34% in males and 13.20% in females. These prevalences were not statistically different when analysed by a multiple test comparison with the bootstrap method and stratification for sex.Instead, the prevalence of thyroid nodules > 1 cm in diameter resulted statistically different in exposed and non exposed health staff: 18.68% in non exposed males vs exposed: 3.76% (determined dose) and 9.09% (undetectable dose) in males, and 20.30% in non exposed females versus 3.23% (detected dose) and 9.52% (undetectable dose) in exposed females.There was a higher proportion of healthy staff in the exposed group than in the non exposed: (80.45% vs 68.68% in males; 80.65% vs 57.87% in females).In our study, occupational exposure to radiation combined with mild iodine deficiency did not increase the risk of developing thyroid nodules. The statistically significant higher prevalence of thyroid nodules in the non exposed group could be explained by the high percentage (22
Iodine Deficiency in Northern Paris Area: Impact on Fetal Thyroid Mensuration  [PDF]
Dominique Luton,Corinne Alberti,Edith Vuillard,Guillaume Ducarme,Jean Fran?ois Oury,Jean Guibourdenche
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0014707
Abstract: Iodine is essential for normal fetal and neonatal development. We studied the prevalence and impact on fetal thyroid development of iodine deficiency in pregnant women in the northern part of the Paris conurbation.
Consuming iodine enriched eggs to solve the iodine deficiency endemic for remote areas in Thailand
Wiyada Charoensiriwatana, Pongsant Srijantr, Punthip Teeyapant, Jintana Wongvilairattana
Nutrition Journal , 2010, DOI: 10.1186/1475-2891-9-68
Abstract: A model of community hen egg farm was selected at an iodine deficiency endemic area in North Eastern part of Thailand. The process for the preparation of high content iodine enriched hen food was demonstrated to the farm owner with technical transfer in order to ensure the sustainability in the long term for the community. The iodine content of the produced iodine enriched hen eggs were determined and the iodine status of volunteers who consumed the iodine enriched hen eggs were monitored by using urine iodine excretion before and after the implement of iodine enrichment in the model farm.The content of iodine in eggs from the model farm were 93.57 μg per egg for the weight of 55 - 60 g egg and 97.76 μg for the weight of 60 - 65 g egg. The biological active iodo-organic compounds in eggs were tested by determination of the base-line urine iodine of the volunteer villagers before and after consuming a hard boiled iodine enriched egg per volunteer at breakfast for five days continuous period in 59 volunteers of Ban Kew village, and 65 volunteers of Ban Nong Nok Kean village. The median base-line urine iodine level of the volunteers in these two villages before consuming eggs were 7.00 and 7.04 μg/dL respectively. After consuming iodine enriched eggs, the median urine iodine were raised to the optimal level at 20.76 μg/dL for Ban Kew and 13.95 μg/dL for Ban Nong Nok Kean.The strategic programme for iodine enrichment in the food chain with biological iodo-organic compound from animal origins can be an alternative method to fortify iodine in the diet for Iodine Deficiency Endemic Areas at the community level in Thailand.Iodine deficiency disorders (IDD) had been widely recognized as one of the important public health problems especially in developing countries throughout the world [1]. Thailand, one of the developing countries in South East Asia has started the public health activities on elimination of IDD endemic areas since 1989. In 1991, a national survey on total go
Endemic goitre in the Sudan despite long-standing programmes for the control of iodine deficiency disorders
Medani,Abdel Monim MH; Elnour,Abdelsalam A; Saeed,Amal M;
Bulletin of the World Health Organization , 2011, DOI: 10.1590/S0042-96862011000200011
Abstract: objective: to describe the status of iodine deficiency disorders (idds) in the sudan more than 25 years after the initiation of idd control programmes and to explore the causes of endemic goitre in the country. methods: testing for idds was carried out in 6083 schoolchildren 6 to 12 years of age from the capital cities of nine states in different areas of the country using the three indicators recommended by the world health organization: the prevalence of goitre, laboratory measurements of urinary iodine concentration in casual urine samples and serum thyroglobulin (tg) levels. serum levels of thyroxine (t4), triiodothyronine (t3) and thyroid-stimulating hormone (tsh), as well as urinary secretion of thiocyanate, which can affect the transport of iodine into thyrocytes, were also measured. findings: the prevalence of goitre in the different samples ranged from 12.2% to 77.7% and was 38.8% overall. the overall median urinary iodine concentration was 6.55 μg/dl, with the lowest median value having been found in kosti city (2.7 μg/dl), situated in the centre of the country, and the highest (46.4 μg/dl) in port sudan, on the red sea coast. the highest mean serum tg level (66.98 ng/ml) was found in kosti city, which also had the highest prevalence of goitre. conclusion: idds still constitute a public health problem throughout urban areas in the sudan and iodine deficiency appears to be the main etiological factor involved.
Study of the Prevalence of Endemic Goiter and Its Relation with Urinary Iodine and Thyroid Hormonal Levels in 6-18 Year Old School Children in Rafsanjan in 2000
GR Asadi Karam,M Sajadi,M Sheykh Fatollahee,AH Zangiabadi
Journal of Shahid Sadoughi University of Medical Sciences , 2004,
Abstract: Introduction: Endemic goiter due to iodine deficiency is one of the health problems in the developing countries. Material & Methods: In this cross-sectional study, 109 schoolboys and 92 schoolgirls, aged between 6 and 18 years in Rafsanjan city were selected randomly by proportionate-multistage cluster sampling method. All the students underwent clinical examination for presence of goiter according to criteria recommended by WHO, and urinary iodine excretion, T4, FTI and TSH were measured. Results: The point Prevalence rate of goiter in boys and girls were 71.6% and 55.6%, respectively. Prevalence rates of Grade I and II were 51.3% and 12.9%, respectively. Urinary iodine excretion was normal in 68.1% (>10 μg/dl) mild in 30.6% (5-9.9 μg/dl) and moderate in 1.3% (2.1-4.9 μg/dl). Of 68.1% of schoolchildren with normal urinary iodine, 56.9% showed different grades of goiter. There was no relation between goiter stages and urinary iodine deficiency (P>0.05). T4, FTI and TSH in 96% of schoolchildren were normal. In 3%, TSH levels were more than the normal range (>3.5 μU/ml) and in 1%, T4 concentration was less than the normal range (0.05). Conclusion: With respect to the fact that urinary iodine levels were normal in 68.1% of the students and thyroid parameters were normal in 94% of the subjects, the very high prevalence rate of goiter in the city of Rafsanjan seems to be due to certain unknown etiological factors which needs further studies
The prevalence of thyroid dysfunction in elderly cardiology patients with mild excessive iodine intake in the urban area of S?o Paulo
Duarte, Glaucia C.;Tomimori, Eduardo K.;Camargo, Rosalinda Y. A.;Rubio, Ileana G.S.;Wajngarten, Mauricio;Rodrigues, Amanda G.;Knobel, Meyer;Medeiros-Neto, Geraldo;
Clinics , 2009, DOI: 10.1590/S1807-59322009000200011
Abstract: objectives: to evaluate the prevalence of thyroid dysfunction in elderly cardiac patients in an outpatient setting. subjects and methods: a total of 399 consecutive patients (268 women, age range 60-92 years) who were followed at heart institute were evaluated for thyroid dysfunction with serum free t4, tsh, anti-peroxidase antibodies, urinary iodine excretion measurements and thyroid ultrasound. results: hyperthyroidism (overt and subclinical) was present in 29 patients (6.5%), whereas hypothyroidism (overt and subclinical) was found in 32 individuals (8.1%). cysts were detected in 11 patients (2.8%), single nodules were detected in 102 (25.6%), and multinodular goiters were detected in 34 (8.5%). hashimoto's thyroiditis was present in 16.8% patients, most of whom were women (83.6%). the serum tsh increased with age and was significantly higher (p= <0.01) in patients, compared to the normal control group. no significant differences in serum tsh and free t4 values were observed when patients with atrial fibrillation (af) where compared with those without arrhythmia. the median urinary iodine levels were 210 μg/l (40-856 μg/l), and iodine levels were higher in men than in women (p<0.01). excessive iodine intake (urinary iodine >300 μg/l) was observed in one-third of patients (30.8%). conclusions: elderly patients have a higher prevalence of both hypo- and hyperthyroidism as well as thyroid nodules when compared with the general population. about one-third of the older patients had elevated urinary secretion of iodine and a higher prevalence of chronic hashimoto's thyroiditis. it is recommended that ultrasonographic studies, tests for thyroid function and autoimmunity should be evaluated in elderly patients.
Influence of dietary iodine deficiency on the thyroid gland in Slc26a4-null mutant mice
Tomoyuki Iwata, Tadao Yoshida, Masaaki Teranishi, Yoshiharu Murata, Yoshitaka Hayashi, Yasuhiko Kanou, Andrew J Griffith, Tsutomu Nakashima
Thyroid Research , 2011, DOI: 10.1186/1756-6614-4-10
Abstract: We evaluated the thyroid volume in histological sections with the use of three-dimensional reconstitution software, we measured serum levels of total tri-iodothyronine (TT3) and total thyroxine (TT4) levels, and we studied the thyroid gland morphology by transmission electron microscopy.TT4 levels became low but TT3 levels did not change significantly after eight weeks of an iodine-deficient diet compared to levels in the control diet animals. Even in Slc26a4-null mice fed an iodine-deficient diet, the volume of the thyroid gland did not increase although the size of each epithelial cell increased with a concomitant decrease of thyroid colloidal area.An iodine-deficient diet did not induce goiter in Slc26a4-null mice, suggesting that other environmental, epigenetic or genetic factors are involved in goiter development in PDS.Pendred syndrome (PDS) is an autosomal recessive disorder characterized by sensorineural hearing impairment, presence of goiter, and a partial defect in iodine organification [1]. The goiter in PDS is variable in its presentation; it can develop at any age (although generally after puberty), but may be totally absent in some affected individuals [2]. Also, there is substantial intrafamilial and regional variation, and nutritional iodine intake may be a significant modifier of the thyroid phenotype [1]. Kopp et al. suggested that under conditions of sufficient iodine intake, thyroid enlargement may be very mild or absent, and hence these patients are often simply categorized as having enlarged vestibular aqueduct [1]. Sato et al. also suggested that even in patients with impaired iodide transport, high iodine intake may prevent the development of goiter [3].Slc26a4-null (Slc26a4-/-) mutant mice were generated by Everett et al. [2]. Slc26a4-/- mice are profoundly deaf with vestibular dysfunction, but they lack goiter and thyroid histological abnormalities. We hypothesized that the absence of goiter and hypothyroidism in Slc26a4-/- mice was due to
Appropriate Iodine Nutrition in Iran: 20 Years of Success
Hossein Delshad,Ladan Mehran,Fereidoun Azizi
Acta Medica Iranica , 2010,
Abstract: Iodine is a trace element in the human body, its only known function is the synthesis of thyroid hormones. Effects of iodine deficiency, termed iodine deficiency disorders (IDD), include endemic goiter, hypothyroidism, cretinism, decreased fertility rate, increased infant mortality and mental retardation. 2.2 billion people worldwide are at risk for IDD. Of these, 30-70% have goiter and 1-10% have cretinism. Two decades ago the I.R. Iran was among the countries most severely affected by iodine deficiency, but during the last two decades has made much progress in the development of universal salt iodization strategies and IDD prevention, and since 1996 meets all WHO/UNICEF/ICCIDD criteria for the sustainable elimination of iodine deficiency.
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