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Objective:To evaluate the consistency of individual iodine nutrition levels by serum iodine, plasma iodine and whole blood iodine, and to provide reference for iodine-related epidemiological investigation.Methods:Healthy adults aged 18 - 59 years were recruited from the Research Center of Environment and Health in Water Source Area of South-to-North Water Diversion of Hubei University of Medicine. Whole blood sample was collected and serum and plasma were separated. The content of iodine in serum, plasma and whole blood was determined by inductively coupled plasma mass spectrometry (ICP-MS), and the linear relationship, precision and accuracy of the standard curve of the detection method were evaluated. The difference of three kinds of blood iodine levels was analyzed by variance analysis of compatibility group design, and Passing-Bablok regression and Bland-Altman plot were used to evaluate the consistency between serum iodine and plasma iodine.Results:The linear range of iodine in serum, plasma and whole blood was 0.0 - 25.0 μg/L, and the correlation coefficients ( R2) were all > 0.999. The relative standard deviation of 8 mixed blood samples ranged from 1.9% to 4.3% ( n = 6), and the determination results of blood iodine certified standard substances were all within the reference range. The recovery rate of the added standard ranged from 99% to 106%. The iodine levels in serum, plasma and whole blood of 50 volunteers were (57.31 ± 8.06), (57.49 ± 8.50) and (33.89 ± 5.40) μg/L, respectively, and there was no statistically significant difference between serum iodine and plasma iodine ( P = 0.904). The results of Passing-Bablok regression showed that there was no statistically significant difference in bias between serum iodine and plasma iodine ( P = 0.538). The Bland-Altman plot indicated that the difference between serum iodine and plasma iodine was within the consistency limit. Conclusion:The results of plasma iodine and serum iodine are in good agreement, and plasma iodine can be used as an evaluation index of individual iodine nutrition level. But there is no consistency between whole blood iodine and serum iodine.
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Objective:To investigate the impact of switching to low iodine drinking water in areas with high water iodine levels on the iodine nutritional status and thyroid function of pregnant women.Methods:A cross-sectional survey was conducted in Gaoqing County, Zibo City, Shandong Province. Pregnant women who underwent prenatal examinations at the Obstetrics Clinic of Gaoqing County People's Hospital from 2019 to 2021 were selected as the survey subjects. With reference to the Criteria for the Classification of Water Source High Iodine Areas and High Iodine Disease Areas (GB/T 19380-2016), pregnant women with drinking water iodine > 100 μg/L were considered as the high water iodine group and ≤100 μg/L was the non-high water iodine group. Basic information, one random urine sample, fasting blood sample, 24-hour urine sample and drinking water sample of pregnant women were collected, and thyroid ultrasound examination was performed on pregnant women. Urinary iodine (UI) concentration (UIC) and drinking water iodine concentration (WIC) were measured by inductively coupled plasma mass spectrometry, and 24-hour urinary iodine excretion (UIE) and daily iodine intake (TII) of pregnant women were calculated. Serum thyroid hormone (TSH), free triiodothyronine (FT 3), free thyroxine (FT 4), thyroid peroxidase antibody (TPOAb) and anti-thyroid autoantibodies (TgAb) were determined by automatic chemiluminescence immunoassay. Creatinine (CR) was determined using deproteinized endpoint microplate method and UI/CR was calculate. Results:A total of 797 pregnant women were included, and the UIC was 150.2 (88.1, 281.3) μg/L, the iodine nutrition was generally at an appropriate level. Among them, 584 pregnant women in the non-high water iodine group had a UIC of 120.9 (74.9, 191.5) μg/L, which was at the iodine deficiency level; 213 pregnant women in the high water iodine group had a UIC of 321.1 (201.9, 569.1) μg/L, which was at the iodine super-appropriate level; the differences in WIC, UIC, UIE, TII, and UI/CR between the two groups were statistically significant ( Z = 21.63, 13.34, 15.14, 15.14, 11.81, P < 0.001). After stratification by different gestational periods, the differences were statistically significant when comparing WIC and TSH in pregnant women in the non-high water iodine group and UI/CR in pregnant women in the high water iodine group by gestational period ( H = 59.13, 7.30, 13.60, P < 0.05). A total of 744 pregnant women were tested for thyroid function, and 128 cases of TSH > 2.5 mU/L, 15 cases of hypothyroxemia, and 19 cases of subclinical hypothyroidism were detected, with detection rates of 17.2%, 2.0%, and 2.6%, respectively. The differences were statistically significant when comparing TSH and TPOAb levels and the proportion of pregnant women with TSH > 2.5 mU/L in the high water iodine and non-high water iodine groups ( Z = 3.04, - 2.17, χ 2 = 6.94, P = 0.002, 0.030, 0.008). The thyroid glands of pregnant women were examined in 720 cases, and 30 cases of goiter and 150 cases of thyroid nodules were detected, with detection rates of 4.2% and 20.8%, respectively. The median thyroid volume was 8.92 ml in the high water iodine group and 8.60 ml in the non-high water iodine group, which were both within the normal range, with no statistically significant difference between the groups ( Z = - 0.75, P = 0.455). Conclusions:After changing to low iodine water, the overall iodine nutrition of pregnant women in Gaoqing County is now at an appropriate level, and the reduction of water iodine effectively reduces the risk of TSH abnormalities in local pregnant women. However, pregnant women in the non-high water iodine group are iodine deficiency, and pregnant women in the high water iodine group are at iodine super-appropriate, and the iodine nutrition level of pregnant women in this area is highly variable, which causes the "illusion" that the overall iodine level of local pregnant women is suitable.
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Thyroid cancer is one of the common malignant tumors in the endocrine system, and its incidence is increasing year by year. At present, the main diagnostic methods for thyroid cancer are ultrasound and thyroid puncture cytology. However, due to low sensitivity and/or specificity, it is increasingly difficult to meet the current clinical diagnostic needs. The discovery of biomarkers in thyroid cancer provides important clues for the diagnosis, pathogenesis and prognosis of the disease. As one of the essential trace elements in human body, iodine is closely related to the thyroid gland. Clarifying the relationship between iodine nutritional status and biomarkers of thyroid cancer has important practical significance for the diagnosis, pathogenesis and prognosis of thyroid cancer. Based on the research of systems biology, this article analyzes the influence of iodine nutritional status on biomarkers of thyroid cancer from four aspects of gene, transcription, protein and metabolism,
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Objective:Through the detection of iodine nutrition level and thyroid function of pregnant women in Xinjiang Uygur Autonomous Region (Xinjiang), to preliminary study the pregnant women's iodine nutrition level, thyroid function status and the relationship between the two and influencing factors.Methods:From March to June in 2020, stratified cluster random sampling method was adopted. Two counties (cities) in Southern and Northern Xinjiang were selected as survey sites, and about 100 pregnant women (a total of 412) were selected from each county (city) as survey subjects. Random urine samples and blood samples were collected to detect urinary iodine and serum thyroid function indicators [thyroid stimulating hormone (TSH), free triiodothyronine (FT 3), free thyroxine (FT 4), anti-thyroglobulin antibody (Tg-Ab) and anti-thyroid peroxidase antibody (TPO-Ab)]. Results:The median and interquartile range [ M ( Q1, Q3)] of pregnant women's urinary iodine was 228.4 (143.15, 327.95) μg/L. Serum FT 3, FT 4 and TSH levels [ M ( Q1, Q3)] were 4.22 (3.92, 4.61), 13.79 (12.63, 15.26) pmol/L and 1.82 (1.26, 2.52) mU/L, respectively. The overall positive rates of Tg-Ab and TPO-Ab were 5.61% (23/412) and 11.95% (49/412), respectively. The positive rates of Tg-Ab and TPO-Ab in Southern and Northern Xinjiang were 4.78% (10/209), 10.05% (21/209), 6.40% (13/203) and 13.79% (28/203), respectively. The positive rates of Tg-Ab and TPO-Ab in Northern Xinjiang were higher than those in Southern Xinjiang, but the difference was not statistically significant (χ 2 = 1.31, 2.17, P > 0.05). The positive rate of TPO-Ab in pregnant women was the influencing factor of abnormal thyroid function, and the odds ratio ( OR) [95% confidence interval ( CI)] was 3.22 (1.31 - 7.93). Conclusions:Pregnant women in Xinjiang are generally at an appropriate level of iodine, but the state of thyroid function still needs continuous attention. In addition, it is necessary to strengthen the thyroid function examination of pregnant women with positive thyroid autoantibodies to prevent and control the occurrence of abnormal thyroid function in pregnant women.
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Objective To study the iodine nutrition status and analyze the detection of thyroid nodules and its related influencing factors in 450 health check-up residents in Chengdu area and to provide evidence for the prevention of thyroid nodules. Methods A total of 450 residents who underwent health check-up in the Western Theater General Hospital from January 2019 to January 2022 were selected as the research subjects. The gender, age, weight and other basic conditions of the subjects were investigated, and their urinary iodine levels and occurrence of thyroid nodules were examined. Univariate and multivariate methods were used to analyze the influencing factors of occurrence of thyroid nodules. Results The overall urinary iodine level of the 450 health check-up people in Chengdu area was (96.89 -212.38) μg/L, with an average of (164.86±42.58) μg/L. The urinary iodine level of males was significantly higher than that of females (P60 years old (P60 years old , people in rural areas and people with history of diabetes mellitus in the thyroid nodule group were higher than that in the non-thyroid nodule group, and thyroid stimulating hormone (TSH), thyroglobulin antibody (TGAb) and anti-thyroid peroxidase antibody (TPOAb) were higher than those in the non-thyroid nodule group (P60 years old, history of diabetes mellitus and high levels of TGAb and TPOAb were risk factors for the occurrence of thyroid nodules (P<0.05). Conclusion The overall iodine nutrition level of 450 health check-up people in Chengdu is in the appropriate range, and the detection rate of thyroid nodules is high. It is necessary to strengthen the examination of thyroid nodules in key populations (women , history of diabetes mellitus, the elderly, etc.), and provide early detection and active intervention to prevent the occurrence and progression of thyroid nodules.
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Objective To investigate the status of maternal iodine deficiency in Lishui City of Zhejiang Province， and explore the effect of maternal iodine deficiency on the growth and development of infants. Methods A total of 209 pregnant women living in Liandu District of Lishui City from January 2017 to December 2018 were selected by stratified sampling method. Urine iodine level in pregnant women and iodine content in edible salt at home were determined to assess the status of iodine deficiency and to analyze the influencing factors. Their babies were followed up for 1 year， and metabolic disease screening and physical examination were carried out to evaluate the growth and development. Results The median of urinary iodine levels in 2017 and 2018 were 165 µg·L-1 and 192 µg·L-1， respectively. Both of the values met the standard of iodine sufficiency. The results of salt iodine content in pregnant women's homes showed that 7 cases （3.35%） were without iodized salt and 202 cases （96.65%） with iodized salt， including 186 cases （89.00%） with qualified iodized salt. Univariate analysis showed that pregnancy， education level， intake of iodized salt， cooking methods of salt， intake frequency of iodine-rich food and knowledge of iodine nutrition had significant impact on iodine deficiency in pregnant women （P<0.05）. Logistic regression analysis showed that early pregnancy （OR=1.626） and adding salt into heat oil （OR=1.874） were risk factors for iodine deficiency in pregnant women， while intake of qualified iodized salt （OR=0.593） was a protective factor. Follow-up results showed that there were no abnormalities in newborn screening， and babies of 2 women （2.41%） with iodine deficiency were short in height at 1， 6 and 12 months of age. Conclusion Attention should be paid to the monitoring of pregnant women's urinary iodine levels to guide the scientific supplementation of iodine， so as not to affect the growth and development of infants.
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Iodine is an essential component of thyroid hormone biosynthesis. It plays an important role in the growth, development, maturation and the function of organs and systems. Epidemiological and animal studies have shown that the effect of iodine on human body is bidirectional. Insufficient and excessive intake of iodine will cause adverse consequences and affect human health. At present, the research on the harm of iodine nutritional abnormalities to human health mostly focuses on morphology and function of thyroid. In fact, iodine nutritional abnormalities not only affect thyroid, but also have many adverse effects on other aspects of the body. There is evidence of a link between abnormal iodine nutrition, dyslipidemia and cardiovascular disease, which will lead to abnormal levels of triglycerides, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol in the body. This paper reviews the research progress on the relationship between iodine nutrition, thyroid function and body lipid metabolism, in order to provide a theoretical basis for the "scientific and precise" prevention and treatment of iodine deficiency disorders in China.
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With the effective implementation of universal salt iodization measures to prevent iodine deficiency disorders, severe iodine deficiency in pregnant women has been rare. However, due to the difficulty in changing the state of iodine deficiency in natural environment and insufficient iodine intake in diet to meet the iodine nutritional needs during pregnancy, mild or moderate iodine deficiency in pregnancy still occurs frequently, and may have adverse effects on the development of nervous system of their offspring. At the same time, the effect of excessive iodine intake of pregnant women on the development of nervous system of their offspring can not be ignored. In addition, if the ability of thyroid regulation in pregnant women is out of balance that leads to thyroid dysfunction and even hormone secretion disorder, which can not meet the needs of fetal growth and development, it may also affect the nervous system function of their offspring. This paper summarizes the human population studies in recent years: the effects of maternal mild to moderate iodine deficiency, iodine excess, abnormal thyroid function and thyroid hormone treatment on neuro development of offspring, and the mechanism of corresponding animal iodine related exposure experiments, in order to provide scientific basis for "precise prevention and treatment" of iodine deficiency disorders in the future.
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Objective:To understand the iodine nutritional status and the prevalence of goiter and thyroid nodules among children in Suqian City, and to provide a basis for prevention and treatment of iodine deficiency disorders.Methods:From May 2019 to July 2020, the counties (districts) in Suqian City were divided into 5 areas according to east, west, south, north, and middle, each area selected 1 township (street) every year, and 40 non-boarding students aged 8 - 10 years were selected (balanced age and gender) from 1 primary school from each township (street). Children's urine samples and household salt samples were collected to detect urinary iodine and salt iodine contents, and some children were subjected to thyroid examination and height and weight measurements.Results:A total of 1 999 urine samples were collected from children aged 8 to 10 years, and the median urinary iodine was 221.0 μg/L. There was a statistically significant difference among different counties (districts, H = 147.89, P < 0.05). A total of 1 999 edible salt samples were collected from children's homes, and the salt iodine content was (24.01 ± 4.55) mg/kg. Among them, iodized salts was 1 979, the coverage rate of iodized salt was 99.00%; the qualified iodized salts was 1 910, and the iodized salt qualified rate was 96.51%, and the consumption rate of qualified iodized salt was 95.55%. A total of 1 000 cases of children's thyroid were examined, and 22 cases of goiter, 51 cases of solid thyroid nodules, and 54 cases of thyroid cyst were detected, and the detection rates were 2.20%, 5.10%, and 5.40%, respectively. There were significant differences in the detection rates of solid nodules and cysts beteen different counties (districts, χ 2 = 16.41, 37.66 , P < 0.05), but there was no significant difference in the detection rates of goiter (χ 2 = 8.65 , P > 0.05). According to Spearman correlation analysis, children's thyroid volume was positively correlated with height and weight ( r = 0.403, 0.315, P < 0.05). Conclusions:The iodine nutrition of children in Suqian City is at an excessively suitable level of iodine, and the salt iodine monitoring indicators meet the national iodine deficiency disorders elimination standards (the coverage rate of iodized salt ≥ 95%, and the consumption rate of qualified iodized salt > 90%). The children's thyroid volume is affected by factors such as height and weight.
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Objective:To investigate the serum thyroglobulin (Tg) levels of women in early pregnancy in Dali City, Yunnan Province, and provide a scientific basis for evaluation of individual iodine nutrition of early pregnant women in this area.Methods:Dali City, Yunnan Province was divided into 5 sampling areas according to east, west, south, north and middle. One township (town) was selected from each area, and at least 20 women in early pregnancy were selected from each township (town) as survey subjects. General condition and medical history of all subjects were collected, and random urine samples and fasting venous blood samples were collected for determination of urinary iodine and thyroid function indexes, and a portable ultrasound machine was used for thyroid ultrasonography. After excluding the patients with a history of thyroid disease and abnormal thyroid function, the level of Tg in the included early pregnant women was analyzed.Results:A total of 120 women in early pregnancy were investigated, aged from 19 to 40 years. Among them, 61 cases came from urban areas and 59 were from rural areas. The median urinary iodine was 156.54 μg/L, which was at the appropriate level of iodine nutrition. A total of 102 women with normal thyroid function in early pregnancy were included, and the Tg level was 11.56 (6.67, 15.27) ng/ml. Among them, 58 cases were in urban areas and 44 cases were in rural areas. There was no significant difference in serum Tg levels between rural and urban women in early pregnancy ( U = 1 362.50, P = 0.559). Conclusion:The serum Tg level of women in early pregnancy in Dali City can provide a reference for evaluation of individual iodine nutrition of relevant populations in this area.
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The current prevention and control strategy of iodine deficiency disorders in China is "adjust measures to local conditions, guide by classification and supplement iodine scientifically". The ultimate goal of the implementation of this prevention and control strategy is to carry out "precise iodine supplementation". However, at present, the implementation of "precise iodine supplementation" faces some difficulties, mainly how to accurately measure individual iodine nutrition. This paper discusses the current framework of iodine nutrition indicators, the advantages and disadvantages of various indicators, the gold standard for measuring the indicators, and the application scope and joint application of each indicator from three aspects: the intake of iodine, the level of iodine and the excretion of iodine.
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Objective:To learn about the status of thyroid function and intelligence quotient (IQ) of children in areas with different iodine nutrition levels in Xinjiang Uygur Autonomous Region, and to explore the health risk of children with median urinary iodine of 200 - 299 μg/L, and to provide a basis for scientific iodine supplementation.Methods:In May 2019, in Xinjiang Uygur Autonomous Region, Altay Prefecture and Kashgar Prefecture were selected, where the median urinary iodine of children aged 8 to 10 years were 100 - 199 and 200 - 299 μg/L for three consecutive years (2017 - 2019). A stratified random sampling method was used to select 400 children aged 8 to 10 years in each of the two regions, urine and blood samples were collected to detect urinary iodine and thyroid function [thyrotropin stimulating hormone (TSH), free thyroxine (FT 4), free triiodothyronine (FT 3), anti-thyroglobulin antibody (TgAb), and anti-thyroperoxidase antibody (TPOAb)]. At the same time, children's IQ was measured and determined by Second Revision of Combined Raven's Test (CRT-C2) in China and Second Revision of Combined Raven's Test for Children-the Rural, in China (CRT-RC2). Results:The median urinary iodine of children aged 8 to 10 years in Altay Prefecture and Kashgar Prefecture was 188.6 and 250.1 μg/L, respectively. There was no statistically significant difference in thyroid function indexes TSH and FT 3 levels between the two regions ( Z = - 0.58, t = 0.49, P > 0.05), while there was statistically significant difference in FT 4 level ( t = 60.08, P < 0.001). There was no statistically significant difference in TgAb positive rate [3.6% (14/394), 4.0% (16/399)] between the two regions (χ 2 = 0.11, P = 0.736), but the difference of TPOAb positive rate [9.6% (38/394), 30.6% (122/399)] was statistically significant (χ 2 = 53.93, P < 0.001), while the difference of dual antibody positive rate [0.8% (3/394), 2.0% (8/399)] was not statistically significant ( P = 0.134). There was no statistically significant difference in the detection rates of subclinical hypothyroidism [8.9% (35/394), 11.0% (44/399)], subclinical hyperthyroidism [1.0% (4/394), 1.3% (5/399)] and hyperthyroidism [0.3% (1/394), 0.8% (3/399)] in children between the two regions ( P > 0.05). The IQ results of children in the two regions were 96.55 ± 11.36 and 89.57 ± 12.35, respectively, and there was no significant difference between them ( t = 2.79, P = 0.095). Conclusions:The thyroid function status of children is similar in the two regions with median urinary iodine of 100 - 199 μg/L and 200 - 299 μg/L in children aged 8 to 10 years, but the TPOAb positive rate is significantly different. Children whose iodine nutritional level is at or above the appropriate level have no obvious changes in intelligence. It is suggested that median urinary iodine at 200 - 299 μg/L is a relatively safe iodine nutrition state.
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Objective To understand the iodine nutrition status of pregnant women in Tianjin from 2015 to 2019, and to provide a theoretical basis for pregnant women's scientific iodine supplement in the future. Methods A total of 6 939 pregnant women were randomly selected from 16 districts in Tianjin. The urine samples and home salt of the pregnant women were collected to test iodine content. Results The iodine content was determined in a total of 6 939 household salt samples of the pregnant women. The coverage rate of iodized salt was 81.78%, the consumption rate of qualified iodized salt was 66.85%, and the median salt iodine content was 25.96 mg/kg. A total of 6,938 urine samples were determined for iodine content. The median urinary iodine of the pregnant women (154.26 µg/L) reached an appropriate level of iodine nutrition, but there was an imbalance in the regional distribution (suburbs < urban areas, pregnant women in the third trimester of suburbs < pregnant women in the third trimester of urban areas, and non-elderly pregnant women in the suburbs < non-elderly pregnant women in the suburban areas). Spearman correlation analysis found that urinary iodine was positively correlated with salt iodine and the coverage rate of iodized salt (all P<0.05). The urinary iodine level in pregnant women who consumed uniodized salt was lower than the level in those who consumed qualified iodized salt (P<0.05). Conclusion The coverage rate of iodized salt and the consumption rate of qualified iodized salt in Tianjin had not yet reached the national standard for eliminating iodine deficiency disorders. Although the median urine iodine level of pregnant women generally reached an appropriate level, the level of pregnant women's urinary iodine in the suburbs was significantly lower than that in urban areas. The urinary iodine level of pregnant women in the first trimester, suburban areas (pregnant women in the first and third trimester) and pregnant women who consumed uniodized salt were still in the iodine deficiency level. Therefore, it is necessary to continue to strengthen the monitoring of pregnant women's iodine nutrition, strengthen the promotion of scientific consumption of qualified iodized salt in key populations, and provide a basis for formulating a scientific iodine supplementation policy for pregnant women.
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Objective To explore the iodine nutritional status among school-age children within 5 years of implementation of the new salt iodine standard in Suzhou, and to provide a basis for dynamically adjusting the salt iodization strategy. Methods The observation period (2012-2019) was divided into two sub-periods: the adjustment transition period (2012-2014) and the adjustment completion period (2015-2019). According to the “Jiangsu Iodine Deficiency Disease Surveillance Program”, household salt samples and urine samples of school-age children aged 8 to 10 years were collected to detect the content of salt iodine and urine iodine. The coverage rate of iodized salt, qualified iodized salt consumption rate, and the median urinary iodine were determined. Results Totally 2 893 and 9 132 salt samples were collected in the adjustment transition and adjustment completion periods, with the median salt iodine content being 26.50 and 23.20 mg/kg, respectively. The iodized salt coverage rates were 97.03% (2 807/2 893) and 91.01% (2 633/2 893), and the consumption rates of qualified iodized salt were 97.25% (8 881/9 132) and 93.93% (8 578/9 132), respectively, in the two periods. The differences between the coverage rate of iodized salt and the consumption rate of qualified iodized salt between the two periods were statistically significant (χ2=38.465, P2 trend= 17.528, P<0.01). During the adjustment transition period, the median urinary iodine content of school-age children in Suzhou was 215.61 μg/L , and the proportion of urine iodine value <50 μg/L was 1.5%, while during the adjustment completion period the median urinary iodine and proportion of urine iodine value <50 μg/L were 192.60 μg/L and 2.40%, respectively. The difference in urine iodine between the two periods was statistically significant (Z=-9.918, P<0.01); Conclusions Five years after the implementation of the new salt iodization standard, the iodine nutritional level of school-age children in Suzhou was generally at an appropriate level. However, there was no significant changes in iodine nutritional levels in some areas after the adjustment of the new standard, suggesting that surveillance on iodine nutrition should be continuously consolidated in the future.
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Objective:To investigate the effect of iodine nutrition status and sorts of indexes on homocysteine (HCY) in the second trimester of pregnancy under conditions with normal thyroid function.Methods:481 second-trimester pregnant (13th to 27th week of pregnancy) women with normal thyroid function were selected for the study. Urinary iodine concentration (UIC), thyroid auto-antibody, HCY and biochemical indexes were measured. The HCY levels were compared among subjects with different iodine nutritional status, and factors related to HCY level were analyzed.Results:Patients were stratified into iodine deficiency, iodine adequate, iodine more than adequate and iodine excess groups and the proportion were 57.0% ( n=274), 29.7% ( n=143), 10.8% ( n=52) and 2.5% ( n=12), respectively. The overall median UIC was 134.1 μg/L. There was significant difference in HCY levels between iodine excess group and iodine adequate group(1.83 μmol/L vs. 2.46 μmol/L, P=0.036). Spearman correlation analysis showed that HCY was negatively correlated with iodine excess, free triiodothyronine (FT3), thyroglobulin antibody, and fasting blood glucose( r=-0.101, P=0.026; r=-0.099, P=0.03; r=-0.192, P<0.01; r=-0.099, P=0.03), and was positively correlated with TPOAb ( r=0.177, P<0.01). Multiple linear regression analysis showed that HCY was independently negatively correlated with iodine excess (β=-1.505, P=0.043) and FT3 (β=-0.661, P=0.008). Conclusion:Up to 57% women in the second trimester of pregnancy are with iodine deficiency and normal thyroid function. Moderate iodine excess and elevated FT3 levels are beneficial to the decrease of HCY levels and thus reduce the risk of vascular complications in pregnant women.
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Objective:To investigate the effects of different levels of iodine intake on thyroid function in Wistar rats after pregnancy, and to provide experimental basis for scientific supplementation of iodine and thyroid function screening during pregnancy.Methods:One hundred and fifty female SPF Wistar rats weaned for 2 weeks were selected. Female Wistar rats were intervened with iodine nutrition by drinking deionized water containing potassium iodide (KI). According to the random number table, female Wistar rats were divided into 5 groups [severe iodine deficiency (SID) group, mild iodine deficiency (MID) group, control group (NI), mild iodine excess (MIE) group, and severe iodine excess (SIE) group, 30 rats per group]. The iodine doses of the five groups were 0.0, 1.5, 5.5, 70.0 and 350.0 μg/d, respectively. The animal model was established and intervened for 3 months to detect the 24 h urinary iodine content of rats, and compared with the NI group to determine the success of the model or not. After successful modeling, the tested female Wistar rats were mated with male Wistar rats (female : male=2-3 : 1). There were about 15 pregnant rats in each group, and continued to intervene the pregnant rats for 21 d with the same doses as the modeling conditions. The abdominal aortic blood of non-pregnant and pregnant rats was taken. After serum separation, 5 items [free thyroxine (FT 4), free triiodothyronine (FT 3), thyroid stimulating hormone (TSH), anti-thyroglobulin antibodies (TgAb), thyroid peroxidase antibody (TPOAb)] of serum thyroid function were detected in each group. Results:There was significant difference in urinary iodine content between the five groups (the medians urinary iodine were 3.540, 51.410, 286.801, 644.192 and 2 368.701, respectively, H = 94.791, P < 0.01). Rats with different iodine nutrition levels were successfully established. There were no significant differences in TSH level, TPOAb and double antibodies positive rates of non-pregnant rats among groups ( P > 0.05). There were statistically significant differences in the levels of FT 4, FT 3 and the positive rate of TgAb among groups ( P < 0.05). The level of FT 4 in SID group was lower than that in NI group ( P < 0.05). The level of FT 3 in SID group was higher than that in NI group ( P < 0.05). The positive rate of TgAb in SIE group was higher than that in NI group ( P < 0.05). There were no significant differences in TSH, FT 4 and FT 3 levels of pregnant rats among groups ( P > 0.05). There were significant differences in the positive rates of TgAb, TPOAb and double antibodies among the groups ( P < 0.05). The positive rates of TgAb, TPOAb and double antibodies in MIE and SIE groups were higher than those in NI group ( P < 0.05). The positive rate of TPOAb in MIE group was higher than that in NI group ( P < 0.05), and the positive rates of double antibodies in MID and MIE groups were higher than that in NI group ( P < 0.05). Conclusions:Iodine deficiency can lead to the change of thyroid hormone level in non pregnant rats, while iodine excess can increase the positive rate of related antibodies in non pregnant and pregnant rats.
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Objective:To understand the knowledge and behavior changes of pregnant women on iodine deficiency disorders (IDD) prevention and treatment in iodine deficiency areas in Anhui Province before and after the implementation of the intervention measures, and to provide a scientific basis for pregnant women's iodine nutrition improvement.Methods:From March to December 2018, from Lujiang County, an iodine deficiency area in Anhui Province, Lucheng and Nihe towns were selected as the survey sites. Relying on the township health centers, pregnant women in early pregnancy (≤12 weeks) were selected as the survey subjects, and long-term follow-up was conducted. The edible salt samples of pregnant women in early pregnancy were collected and salt iodine content was detected by direct titration method. The urine samples of pregnant women in the morning in early, middle (13 - 28 weeks) and late pregnancies (≥29 weeks) were collected, urinary iodine content was determined by arsenic-cerium catalytic spectrophotometry. Baseline questionnaire survey was conducted for pregnant women in early pregnancy, mainly including basic information, IDD prevention and treatment knowledge (pregnant women prone to iodine deficiency, the harm of iodine deficiency in pregnant women, suitable iodine supplement methods for pregnant women and foods with high iodine content), and the consumption frequency of iodine-rich foods. After the baseline survey, the knowledge publicity on IDD prevention and treatment was carried out in townships, and iodine-rich foods such as kelp and laver were recommended to supplement iodine. The intervention activities lasted for 6 months, and retrospective questionnaire survey was conducted on pregnant women in late pregnancy.Results:A total of 128 edible salt samples were collected from the families of pregnant women in early pregnancy, and the median salt iodine was 21.5 mg/kg. The iodized salt coverage rate was 99.2% (127/128), the qualified rate of iodized salt was 98.4% (125/127), and the consumption rate of qualified iodized salt was 97.7% (125/128). A total of 129, 95 and 70 urine samples were collected from pregnant women in early, middle and late pregnancies, the medians urinary iodine were 179.0, 185.5 and 189.7 μg/L, respectively, all of which were at the appropriate iodine level. The total awareness rates of IDD prevention and treatment before and after intervention were 22.4% (28/125) and 64.6% (82/127), respectively, and the difference was statistically significant (χ 2 = 45.538, P < 0.01). Compared with the awareness rates before the intervention, the awareness rates of the harm of iodine deficiency in pregnant women, suitable iodine supplement methods for pregnant women and foods with high iodine content were all higher after the intervention ( P < 0.01). There were statistically significant differences in the frequency of eating kelp, laver and other iodine-rich foods among pregnant women in early, middle and late pregnancies (χ 2 = 163.170, 102.373, P < 0.01). Before the intervention, 57 (45.2%) pregnant women had not eaten kelp, which decreased to 1 (0.8%) pregnant woman after the intervention. Before the intervention, 72 (57.1%) pregnant women had not eaten laver and other iodine-rich foods, which decreased to 7 (5.5%) pregnant women after the intervention. Conclusions:After the intervention, the awareness rate of IDD prevention and treatment knowledge and the frequency and proportion of iodine-rich foods consumption among pregnant women in iodine deficiency areas in Anhui Province have increased significantly. It is recommended to carry out publicity and education on IDD prevention and treatment knowledge in early pregnancy.
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Objective:To understand the iodine content of drinking water and iodine nutrition of key population in Anyang City, Henan Province, and to provide a basis for taking targeted prevention and control measures and scientific adjustment of intervention strategies.Methods:In 2019, stratified sampling method was used to carry out water iodine survey in all townships in Anyang City, and in townships with the median water iodine > 10 μg/L, water iodine survey was carried out in administrative villages, and water iodine content was detected. Two hundred children aged 8 - 10 years and 100 pregnant women were selected from each county (city, district) to test iodine contents of their household salt and urine, respectively.Results:Six hundred and eight water samples were collected in Anyang City, and the median water iodine was 5.98 μg/L. One thousand one hundred and fifty-six samples were collected, and the median water iodine was 34.10 μg/L. A total of 1 605 salt samples were collected in the city, and the median salt iodine was 24.30 mg/kg, the coverage rate of iodized salt was 91.8% (1 473/ 1 605). A total of 1 605 urine samples were collected from children in the city, and the median urinary iodine was 170.10 μg/L. Urine samples of 804 pregnant women were collected, and the median urinary iodine was 190.00 μg/L.Conclusion:Most areas of Anyang City still belong to iodine deficiency area, and the median urinary iodine of children and pregnant women is within the suitable range of iodine.
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Objective To investigate the relationship between iodine nutritional status and thyroid hormone levels,and to provide a guideline for monitoring iodine nutrition and thyroid function.Methods A crosssectional survey was performed by randomly selecting 341 samples (health pregnant women with a first child) from the Second People's Hospital of Guiyang,Bihai Community Medical Center and Jinhuayuan Community Center from October 2015 to September 2016.Levels of serum hormones and antibodies relative to throid of pregnant women in Guanshan Lake District of Guiyang at different pregnant times,which included throid stimulating hormone (TSH),free three triiodothyronine (FT3),free thyroxine (FT4),thyroid peroxidase antibody (TPOAb),and thyroglobulin antibody (TgAb),were measured by the electrochemical luminescence method,and urinary iodine levels were measured by heat digestion.Results The median urinary iodine of pregnant women at early,middle and late stages (T1,T2 and T3 stages) were 191.8,198.9 and 214.5 μg/L,respectively.FT3 increased first and then decreased during pregnancy.Levels of FT3 in the T2 stage were significandy higher than those in T1 and T3 stages (FT3 medians at the three stages were 4.49,4.83 and 4.57 pmol/L),and the differences were statistically significant (P ＜ 0.05).FT4 levels decreased during pregnancy (FT4 medians at the three stages were 16.32,14.65 and 13.22 pmol/L),and the differences among the three groups were statistically significant (H =67.517,P ＜ 0.01).Statistically significant differences were not found in the TSH levels among the three groups ~SH medians at the three stages were 2.05,2.01 and 2.39 mU/L,H =1.297,P ＞ 0.05).The medians of TPOAb and TgAb during T2 stage (9.60 and 19.02 U/ml) were significantly lower than those of other groups (18.92 and 24.75 U/ml at stage T1,and 13.46 and 22.06 U/ml at stage T3),and the differences were statistically significant (P ＜ 0.05).TSH levels were consistent with urinary iodine levels.TSH levels in the excessive iodine group (urine iodine:250 ～ 499 μg/L,2.54 mU/L) were significantly higher than those in the adequate iodine group (urine iodine:150 ～ 249 μg/L,1.97 mU/L) and deficient iodine group (urine iodine:＜ 150 μg/L,1.91 mU/L),and the differences were statistically significant (P ＜ 0.05).No correlations were found between levels of FT3,FT4,TPOAb,TgAb and levels of the urinary iodine.There was a significant positive correlation between urinary iodine levels and TSH levels (rs =0.180,P ＜ 0.01).The incidence of abnormal thyroid function in pregnant women was 29.33％ (100/341),which was composed of clinical hypothyroidism (accounting for 0.88％,3/341),subclinical hypothyroidism (accounting for 25.51％,87/341),low T4 level (accounting for 1.76％,6/341),clinical hyperthyroidism (accounting for 0.59％,2/341),subclinical hyperthyroidism (accounting for 0.59％,2/341),and TPOAb positive and TgAb positive (accounting for 12.61％,43/341).These abnormalities occurred mainly in the T1 and T3 stages.The prevalence of subclinical hypothyroidism increased with increasing of urinary iodine level,and the difference was statistically significant (x2 =11.269,P ＜ 0.05).Conclusion There is a positive correlation between pregnancy iodine nutritional status and its TSH level,so it is important to monitor the level of urinary iodine during pregnancy and to screen the thyroid function and antibodies in the early and middle time of pregnancy.
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Objective To investigate the composition and pathological subtypes of thyroid cancer in patients with thyroid nodule surgery in Guiyang in recent 8 years, and to analyze their influencing factors. Methods A retrospective pathological analysis of 4 262 thyroid surgery cases in Affiliated Hospital of Guizhou Medical University during the 2009-2016 to investigate the proportion of thyroid cancer and pathological subtype. The iodine content of salt was reduced at the end of 2012 in Guiyang. 2009-2012 as the pre down-regulation group(n＝1 572), 2013-2016 as the after down-regulation group ( n＝2 690), then comparative analysis before and after the adjustment of the iodine content of salt composition of thyroid cancer and changes of pathological subtype was performed. Results From 2009 to 2016, the proportion of thyroid cancer were 17.08%, 17.52%,15.65%, 18.58%, 19.80%, 29.35%, 35.34%, and 48.33%, increased year by year (P＜0.05). Thyroid microcarcinoma were 2.14%, 4.74%, 3.40%, 3.65%, 3.80%, 7.03%, 9.10%, and 25.95%(P＜0.05). The constituent ratio of thyroid cancer after adjustment of salt iodine content was higher than before. Papillary thyroid carcinoma is the main pathological subtype before and after adjustment of salt iodine content. The proportion of female patients was higher than that of males. The age of patients with thyroid cancer after adjustmen was higher than before ( P＜0. 05). Conclusions In the past 8 years, the constituent ratio of thyroid cancer and thyroid microcarcinoma in Guiyang increased year by year. The reason may be related to the increase of radiation in the environment, the improvement of medical level and the higher detection rate of thyroid microcarcinoma. The relationship between iodine nutrition and thyroid cancer needs to be further studied.[Key words] Thyroid cancer; Thyroid microcarcinoma; Thyroid papillary carcinoma; Pathological type;Iodized salt; Iodine nutrition