Inter-relationship between evolutions of the temporal trend of urinary iodine excretion with iodized salt accessibility and thyroid function in an exclusive cohort of mothers residing in a mild iodine-deficient region

Rostami, Rahim; Ashrafi, Zahra; Nourooz-Zadeh, Sarmad; Nikibakhsh, Ahamad Ali; Nourooz-Zadeh, Jaffar

Volume 6, Issue 1 (January 2020) Journal of Research in Applied and Basic Medical Sciences 2020, 6(1): 1-8 | Back to browse issues page

Mendeley

Zotero

RefWorks

Rostami R, Ashrafi Z, Nourooz-Zadeh S, Nikibakhsh A A, Nourooz-Zadeh J. Inter-relationship between evolutions of the temporal trend of urinary iodine excretion with iodized salt accessibility and thyroid function in an exclusive cohort of mothers residing in a mild iodine-deficient region. Journal of Research in Applied and Basic Medical Sciences 2020; 6 (1) :1-8
URL: http://ijrabms.umsu.ac.ir/article-1-91-en.html

Inter-relationship between evolutions of the temporal trend of urinary iodine excretion with iodized salt accessibility and thyroid function in an exclusive cohort of mothers residing in a mild iodine-deficient region

Rahim Rostami

, Zahra Ashrafi

, Sarmad Nourooz-Zadeh

, Ahamad Ali Nikibakhsh

, Jaffar Nourooz-Zadeh ^*

5) Nephrology and Kidney Transplant Research Center, Urmia University of Medical Sciences Urmia, Iran , jaffarnouroozzadeh@yahoo.co.uk

Abstract: (3285 Views)

Background and aims: Maternal iodine deficiency (UIC<150 µg/L) is common in regions with borderline iodine sufficiency. Hence, exploring evolution of the temporal trend for UIC during pregnancy as well as impact of possible modifiers aids in defining the timing and the dose of iodide administration supplement during foetal development. The aim of present investigation was to evaluate the inter-relationships between UIC and iodized salt accessibility and thyroid function as assessed by thyroid-stimulating hormone (TSH) in an exclusive cohort of pregnant women depending on household salt as the predominant source of iodine intake.
Materials and Methods: Healthy pregnant women (n=95; gestation > 4 and < 8 weeks) and non-pregnant women (n=40) with similar lifestyle and dietary habits were enrolled. UIC, TSH and table-salt iodine content were determined.
Results: Median UIC (µg/L) according to trimesters was significantly lower than that of controls (61.6, 130.2 and 90.3 vs 133.8). Accordingly, prevalence of subjects with UIC<150 µg/L were 97.9, 67.4, 77.9 and 60. Median TSH (mIU/L) according to trimesters and control group were 1, 1.6, 1.4 and 1.6. Accordingly, prevalence of subjects with abnormal lower TSH limit was 17.2, 8.5, 3.2 and 2.4.
Conclusion: This investigation demonstrates that UIC varies according to the foetal life cycle and that the highest frequencies of severe iodine (UIC <50 μg/L) were identified at the first- and third trimesters. This investigation paves the way for future studies aiming at exploring the therapeutic impact of iodine supplementation on body iodine stores during pregnancy.

Keywords: Thyroid stimulation hormone (TSH), urinary iodine excretion (UIC), Pregnancy, Iodine, Maternal iodine deficiency

Full-Text [PDF 853 kb] (1384 Downloads)

Type of Study: orginal article | Subject: Special

References

1. Nazarpour S, Ramezani Tehrani F, Simbar M, Minooee S, Rahmati M, Mansournia MA, et al. Establishment of trimester-specific reference range for thyroid hormones during pregnancy. Clin Biochem 2018;53:49-54. [DOI:10.1210/er.2009-0011] [PMID]

2. Pearce EN, Andersson M, Zimmermann MB. Global iodine nutrition: Where do we stand in 2013? Thyroid 2013;23:523-8. [DOI:10.1089/thy.2013.0128] [PMID]

3. Bath SC, Furmidge-Owen VL, Redman CW, Rayman MP. Gestational changes in iodine status in a cohort study of pregnant women from the United Kingdom: season as an effect modifier. Am J Clin Nutr 2015;101:1180-87. [DOI:10.3945/ajcn.114.105536] [PMID] [PMCID]

4. Koukkou E, Ilias I, Mamalis I, Adonakis GG, Markou KB. Serum Thyroglobulin Concentration Is a Weak Marker of Iodine Status in a Pregnant Population with Iodine Deficiency. Eur Thyroid J 2016;5:120-4. [DOI:10.1159/000446070] [PMID] [PMCID]

5. Granfors M, Andersson M, Stinca S, Akerud H, Skalkidou A, Poromaa IS, et al. Iodine deficiency in a study population of pregnant women in Sweden. Acta Obstet Gynecol Scand 2015;94:1168-74. [DOI:10.1111/aogs.12713] [PMID]

6. Lindorfer H, Krebs M, Kautzky-Willer A, Bancher-Todesca D, Sager M, Gessl A. Iodine deficiency in pregnant women in Austria. Eur J Clin Nutr 2015;69:349-54. [DOI:10.1038/ejcn.2014.253] [PMID]

7. Kirkegaard-Klitbo DM, Perslev K, Andersen SL, Perrild H, Knudsen N, Weber T, et al. Iodine deficiency in pregnancy is prevalent in vulnerable groups in Denmark. Dan Med J 2016; 63 (11): 1-5. [Pub Med]

8. Konrade I, Kalere I, Strele I, Makrecka-Kuka M, Jekabsone A, Tetere E, et al. Iodine deficiency during pregnancy: a national cross-sectional survey in Latvia. Public Health Nutr 2015;18:2990-7. [DOI:10.1017/S1368980015000464] [PMID]

9. Charlton K, Skeaff S. Iodine fortification: why, when, what, how, and who? Curr Opin Clin Nutr Metab Care 2011;14:618-24. [DOI:10.1097/MCO.0b013e32834b2b30] [PMID]

10. Delshad H, Touhidi M, Abdollahi Z, Hedayati M, Salehi F, Azizi F. Inadequate iodine nutrition of pregnant women in an area of iodine sufficiency. J Endocrinol Invest 2016;39:755-62. [DOI:10.1007/s40618-016-0438-4] [PMID]

11. Raverot V, Bournaud C, Sassolas G, Orgiazzi J, Claustrat F, Gaucherand P, et al. Pregnant French women living in the Lyon area are iodine deficient and have elevated serum thyroglobulin concentrations. Thyroid 2012;22:522-8. [DOI:10.1089/thy.2011.0184] [PMID]

12. Caldwell KL, Pan Y, Mortensen ME, Makhmudov A, Merrill L, Moye J. Iodine status in pregnant women in the National Children's Study and in U.S. women (15-44 years), National Health and Nutrition Examination Survey 2005-2010. Thyroid 2013;23:927-37. [DOI:10.1089/thy.2013.0012] [PMID] [PMCID]

13. Abel MH, Korevaar TIM, Erlund I, Villanger GD, Caspersen IH, Arohonka P, et al. Iodine Intake is Associated with Thyroid Function in Mild to Moderately Iodine Deficient Pregnant Women. Thyroid 2018;28:1359-71. [DOI:10.1089/thy.2018.0305] [PMID] [PMCID]

14. Delshad H, Azizi F. Review of Iodine Nutrition in Iranian Population in the Past Quarter of Century. Int J Endocrinol Metab 2017;15: 1-6. [DOI:10.5812/ijem.57758] [PMID] [PMCID]

15. Rostami R, Beiranvend A, Nourooz-Zadeh J. Nutritional Iodine Status in Gestation and its Relation to Geographic Features in Urmia County of Northwest Iran. Food and Nutrition Bulletin 2012;33:267-72. [DOI:10.1177/156482651203300407] [PMID]

16. Dunn JT, Crutchfield HE, Gutekunst R, Dunn AD. Two simple methods for measuring iodine in urine. Thyroid 1993;3:119-23. [DOI:10.1089/thy.1993.3.119] [PMID]

17. DeMaeyer EM, Lowenstein FW, Thilly CH. The control of endemic goitre. Geneva: World Health Organization; 1979. [Who]

18. WHO, UNICEF, ICCIDD. Assessment of iodine deficiency disorders and monitoring their elimination: a guide for programme managers. The World Health Organization 2007; 3rd Ed. [Who]

19. Azizi F. Iodine nutrition in pregnancy and lactation in Iran. Public Health Nutr 2007;10:1596-9. [DOI:10.1017/S1368980007360977] [PMID]

20. Fuse Y, Ohashi T, Yamaguchi S, Yamaguchi M, Shishiba Y, Irie M. Iodine status of pregnant and postpartum Japanese women: effect of iodine intake on maternal and neonatal thyroid function in an iodine-sufficient area. J Clin Endocrinol Metab 2011;96:3846-54. [DOI:10.1210/jc.2011-2180] [PMID]

21. Koukkou E, Kravaritis S, Mamali I, Markantes GG, Michalaki M, Adonakis GG, et al. No increase in renal iodine excretion during pregnancy: a telling comparison between pregnant women and their spouses. Hormones (Athens) 2014;13:375-81. [PubMed]

22. Delange F, Fisher DA. 1995. The thyroid gland. In Clinical Paediatric Endocrinology. 3rd Ed. C. Brook, editor. Oxford: Blackwell publ. 397-433. 1996.

23. Laurberg P, Andersen S, Bjarnadottir RI, Carle A, Hreidarsson A, Knudsen N, et al. Evaluating iodine deficiency in pregnant women and young infants-complex physiology with a risk of misinterpretation. Public Health Nutr 2007;10:1547-52. [DOI:10.1017/S1368980007360898] [PMID]

24. Li C, Peng S, Zhang X, Xie X, Wang D, Mao J, et al. The Urine Iodine to Creatinine as an Optimal Index of Iodine During Pregnancy in an Iodine Adequate Area in China. J Clin Endocrinol Metab 2016;101:1290-8. [DOI:10.1210/jc.2015-3519] [PMID]

25. Cheung KL, RL L. Renal Physiology of Pregnancy. Adv Chronic Kidney Dis. 2013;20:209-14. [DOI:10.1053/j.ackd.2013.01.012] [PMID] [PMCID]

26. Mehran L, Amouzegar A, Delshad H, Askari S, Hedayati M, Amirshekari G, et al. Trimester-specific reference ranges for thyroid hormones in Iranian pregnant women. J Thyroid Res 2013;1-6. [DOI:10.1155/2013/651517] [PMID] [PMCID]

27. Nazarpour S, Ramezani Tehrani F, Simbar M, Minooee S, Rahmati M, Mansournia MA, et al. Establishment of trimester-specific reference range for thyroid hormones during pregnancy. Clin Biochem 2018;53:49-54. [DOI:10.1016/j.clinbiochem.2018.01.006] [PMID]