Higher urinary bisphenol A concentration and excessive iodine intake are associated with nodular goiter and papillary thyroid carcinoma.

In the present study, we investigated whether bisphenol A (BPA) levels and excessive iodine intake were associated with papillary thyroid carcinoma (PTC) and nodular goiter (NG). We determined total BPA concentrations (TBC) in paired serum and urine samples, and urinary iodine concentrations (UIC) in urine samples collected from PTC patients, NG patients, and healthy individuals, then compared BPA concentrations and UIC within and between each patient group. The results showed that there were no gender-specific differences in serum TBC and UIC in each group, and no differences across all patient groups. Urinary BPA concentrations (UBC) were higher in the NG and PTC groups compared with the control group. UBC showed gender-specific differences in the NG and PTC group. Furthermore, UIC were higher in the NG and PTC groups compared with the control group. Higher UBC and excessive iodine intake were risk factors for NG and PTC according to multivariate logistic regression analysis. There was a significant correlation between UBC and UIC in each group. These data suggested that higher UBC and excessive iodine intake are associated with NG and PTC. The metabolic and functional pathways between BPA and iodine are potentially linked to the pathogenesis and progression of NG and PTC.

Is neopterin level a predictive and differential biomarker in patients with thyroid disorders?

Neopterin production provides information about the extent of cellular immune activation. Measurement of neopterin levels may also provide predictive and prognostic information in patients with malignant thyroid diseases. In the present study, neopterin levels were investigated in patients with thyroid disorders (no.=68). Twenty-four patients had papillary thyroid cancers and the rest of them benign thyroid disorders. Results were compared with a healthy control group (no.=30). It was observed that there was a significant difference in neopterin levels between the control group and the thyroid disorders group (p<0.05). The mean neopterin levels in malignant and benign patients were also significantly different (p<0.05). Monitoring of urinary neopterin profile may be used in early diagnosis of papillary thyroid cancer. Neopterin seems to be a differential biomarker for malignant and benign thyroid disorders.

Assessment of iodine intake in the Israel coastal area.

BACKGROUND: Iodine intake is necessary to maintain normal thyroid function and prevent iodine deficiency disorders. In 1990, a resolution calling for universal salt iodination to eliminate iodine deficiency worldwide was taken by the World Health Organization and endorsed by some 130 countries. As of today, very little is known about iodine intake and the prevalence of iodine deficiency disorders in Israel, and the authorities do not require iodine enrichment of regular salt. OBJECTIVE: To assess the current level of iodine intake in an unselected group of residents from the Israeli costal area. METHODS: Spot urine samples were collected from three groups: Group A comprising 51 pregnant women attending the Womens Health Clinic at our institution, with a mean age of 32 years and at gestational week 28; group B consisting of 35 healthy subjects, mean age 38; and group C consisting of 16 euthyroid subjects harboring nodular goiters. Tap water and mineral water were also analyzed for iodine content. Iodine concentration was measured using the catalytic reduction of ceric ammonium sulfate method. RESULTS: When considering all groups together the median urinary iodine concentration was 143 micrograms/L, with 27% of the study population having concentrations under 100 micrograms/L and 7.8% under 50 micrograms/L. Values were distributed similarly between sites of residency, and no significant differences were seen between groups. The mean iodine concentration for tap drinking water was 22.8 micrograms/L (range 0.5-53.5 micrograms/L) and for mineral water 7 micrograms/L (range 0-15 micrograms/L). CONCLUSIONS: Overall, iodine intake appeared to be satisfactory in our study population, however mild deficiency may exist in up to 26% of this group. A nationwide survey is needed to better determine the status of iodine intake in Israel, allowing for recommendations on salt-iodine enrichment in the future.

Increased urinary excretion of sulfated 3,3',5-triiodothyronine in patients with nodular goiters receiving suppressive thyroxine therapy.

Increased serum 3,3',5-triiodothyronine sulfate (T3S) levels have been detected in various pathophysiologic states. However, little is known about T3S concentrations in other biological fluids. By employing a highly sensitive, specific, and reproducible radioimmunoassay (RIA), we measured T3S in the serum and urine of 20 premenopausal women with benign nodular goiters before and after administration of thyroxine for 6 months (T4; 3.2 micrograms/kg/day). Serum T3 concentrations did not change significantly after treatment (2.0 vs. 1.7 nmol/L; p > 0.05). However, the mean serum T4 and free T4 concentrations were significantly higher after treatment (138 vs. 88 nmol/L and 28 vs. 17 pmol/L; p < 0.01, respectively). Serum thyroid stimulating hormone (TSH) levels were significantly reduced after T4 treatment (0.13 vs. 0.66 mU/L, p < 0.01) and the serum levels of T3S were significantly increased after treatment (82 vs. 45 pmol/L; p < 0.01). A good correlation was observed between increased serum T3S and T4 concentrations (r = 0.66; p < 0.001). The sulfoconjugate of T3 was significantly increased in creatinine-corrected urine after treatment (606 vs. 253 pmol/umol Cr.; p < 0.01). There was a significant correlation between increased creatinine-corrected urine T3S and increased serum free T4 (r = 0.65; p < 0.001). In summary, significant increases in serum and urine T3S levels were noted in T4-treated patients with subnormal serum TSH and borderline elevated T4. We thus conclude that the sulfation pathway may play a role in the homeostasis of thyroid hormone metabolism in T4-treated subjects with relative hyperthyroxinemia. In addition, the creatinine-corrected urine concentrations of T3S may serve as an index for the evaluation of T4-treated patients with elevated levels of T4.

Urinary glycosaminoglycans in Graves' ophthalmopathy.

An increased accumulation of glycosaminoglycans (GAG) in retrobulbar tissues has been reported in patients with thyroid eye disease. We examined the quantitative urinary GAG excretion in 101 patients with Graves' ophthalmopathy of different classes, 36 patients with Graves' hyperthyroidism without ophthalmopathy, 14 patients with toxic nodular goitre and 103 control subjects. Glycosaminoglycans were isolated from 24-h urine collections by precipitation with cetylpyridinium chloride and ethanol followed by photometrical quantification of hexuronic acids after reaction with carbazole. In comparison with the control group (15.8, 10.4, 21.6 mg/24 h; median, 25th, 75th percentile) a significant (P less than 0.005) elevation of urinary GAG excretion was found in patients with ophthalmopathy (19.2, 12.2, 28.7 mg/24 h), whereas patients with Graves' hyperthyroidism and no ophthalmopathy (16.2, 11.9, 21.7 mg/24 h) and patients with toxic nodular goitre (15.8, 11.5, 21.2 mg/24 h) exhibited no markedly increased values. Especially, patients with active, untreated ophthalmopathy showed on average a twofold increase (36.7, 28.1, 48.4 mg/24 h) in urinary GAG excretion. In contrast, high values were not found in patients with inactive ophthalmopathy and elevated values decreased under treatment, which correlated with clinical findings. Further, relapses were also accompanied by high GAG excretion. Thus, using a simple laboratory method, quantitative determination of urinary GAG excretion appears to present an effective parameter for the activity of Graves' ophthalmopathy.

[Comparison of adrenergic activity in Graves-Basedow disease and in nodular goiter]. / Porównanie aktywnosci ukladu adrenergicznego w chorobie Graves-Basedowa i w wolu guzkowym.

The 24-hour urinary excretion of dopamine, noradrenaline and adrenaline was determined in 27 patients with Graves-Basedow disease and 14 patients with hyperactive nodular goitre. The determinations were done before the treatment and after achieving the euthyroid state. The catecholamines were determined by the fluorimetric method which is a modification of the trihydroxyindole method. On the basis of 24-hour excretion of catecholamines with urine the activity of the sympathetic system was compared in both these diseases. No significant differences were found in this 24-hour urinary excretion of catecholamines between both groups. The obtained results suggest a similar degree of adrenergic activity in these two diseases, suggesting thus a secondary character of adrenergic stimulation in hyperthyroidism independently of its causes.

[Iodine deficiency in Salzburg in spite of iodized table salt prophylaxis]. / Jodmangel in Salzburg trotz Jodsalzprophylaxe.

Urinary iodine excretion was determined in 293 medical technical and nursing students in hospitals of the province Salzburg. The average urinary iodine excretion amounted to 46.6 +/- 18 micrograms iodine per gram creatinine. 67.6% of the students showed a deficiency of iodine II, whilst 98.3% had a deficiency of iodine I according to WHO criteria. Urinary iodine levels and natriuria are closely correlated, indicating that iodized table salt probably constitutes the most important source of iodine. 73 of the students had a palpable giotre, 10 of these being nodular. Our investigations, together with those of Innsbruck, Graz and Vienna, demonstrate the existence of generalized iodine deficiency in spite of iodized salt prophylaxis, which has been legally enforced in all of Austria since 1963. Iodized table salt prophylaxis has, thus, led to a drastic decrease in goitres in children, but is not sufficient to eliminate iodine deficiency in adults. An increased level of iodization of table salt, as has been put into force in Switzerland, must be called for in Austria, too.