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Thyroglobulin is a sensitive measure of both deficient and excess iodine intakes in children and indicates no adverse effects on thyroid function in the UIC range of 100-299 μg/L: a UNICEF/ICCIDD study group report.
J Clin Endocrinol Metab. 2013 Mar; 98(3):1271-80.JC

Abstract

CONTEXT

The median urinary iodine concentration (UIC) is a biomarker of iodine intake. According to the World Health Organization, a median UIC in the range 100-199 μg/L indicates adequate and 200-299 μg/L more than adequate intake. Thyroglobulin (Tg) may be a promising functional biomarker of both iodine deficiency and excess.

OBJECTIVES

Using a standardized dried blood spots-Tg assay in children, we evaluated the Tg response to both low- and high-iodine intake and estimated the population cutoff point for iodine deficiency or excess. Also, we compared thyroid functions within the UIC ranges of 100-199 vs 200-299 μg/L.

DESIGN AND SETTING

We conducted a cross-sectional study in primary schools in 12 countries.

SUBJECTS

SUBJECTS were 6 to 12 years old (n = 2512).

MAIN OUTCOME MEASURES

We measured UIC, TSH, total T4, Tg, and thyroid antibodies.

RESULTS

Over a range of iodine intakes from severely deficient to excessive, Tg concentrations showed a clear U-shaped curve. Compared with iodine-sufficient children, there was a significantly higher prevalence of elevated Tg values in children with iodine deficiency (UIC <100 μg/L) and iodine excess (UIC >300 μg/L). There was no significant change in the prevalence of elevated Tg, TSH, T4, or thyroid antibodies comparing children within the UIC ranges of 100-199 vs 200-299 μg/L.

CONCLUSIONS

In school-aged children, 1) Tg is a sensitive indicator of both low and excess iodine intake; 2) a median Tg of <13 μg/L and/or <3% of Tg values >40 μg/L indicates iodine sufficiency in the population; 3) the acceptable range of median UIC in monitoring iodized salt programs could be widened to a single category of sufficient iodine intake from 100 to 299 μg/L.

Authors+Show Affiliations

Human Nutrition Laboratory and Secretariat of International Council for Control of Iodine Deficiency Disorders (ICCIDD) Global Network, Swiss Federal Institute of Technology (ETH), 8092 Zürich, Switzerland. michael.zimmermann@hest.ethz.chNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23345097

Citation

Zimmermann, Michael B., et al. "Thyroglobulin Is a Sensitive Measure of Both Deficient and Excess Iodine Intakes in Children and Indicates No Adverse Effects On Thyroid Function in the UIC Range of 100-299 μg/L: a UNICEF/ICCIDD Study Group Report." The Journal of Clinical Endocrinology and Metabolism, vol. 98, no. 3, 2013, pp. 1271-80.
Zimmermann MB, Aeberli I, Andersson M, et al. Thyroglobulin is a sensitive measure of both deficient and excess iodine intakes in children and indicates no adverse effects on thyroid function in the UIC range of 100-299 μg/L: a UNICEF/ICCIDD study group report. J Clin Endocrinol Metab. 2013;98(3):1271-80.
Zimmermann, M. B., Aeberli, I., Andersson, M., Assey, V., Yorg, J. A., Jooste, P., Jukić, T., Kartono, D., Kusić, Z., Pretell, E., San Luis, T. O., Untoro, J., & Timmer, A. (2013). Thyroglobulin is a sensitive measure of both deficient and excess iodine intakes in children and indicates no adverse effects on thyroid function in the UIC range of 100-299 μg/L: a UNICEF/ICCIDD study group report. The Journal of Clinical Endocrinology and Metabolism, 98(3), 1271-80. https://doi.org/10.1210/jc.2012-3952
Zimmermann MB, et al. Thyroglobulin Is a Sensitive Measure of Both Deficient and Excess Iodine Intakes in Children and Indicates No Adverse Effects On Thyroid Function in the UIC Range of 100-299 μg/L: a UNICEF/ICCIDD Study Group Report. J Clin Endocrinol Metab. 2013;98(3):1271-80. PubMed PMID: 23345097.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Thyroglobulin is a sensitive measure of both deficient and excess iodine intakes in children and indicates no adverse effects on thyroid function in the UIC range of 100-299 μg/L: a UNICEF/ICCIDD study group report. AU - Zimmermann,Michael B, AU - Aeberli,Isabelle, AU - Andersson,Maria, AU - Assey,Vincent, AU - Yorg,Jorge A Jara, AU - Jooste,Pieter, AU - Jukić,Tomislav, AU - Kartono,Djoko, AU - Kusić,Zvonko, AU - Pretell,Eduardo, AU - San Luis,Teofilo O L,Jr AU - Untoro,Juliawati, AU - Timmer,Arnold, Y1 - 2013/01/23/ PY - 2013/1/25/entrez PY - 2013/1/25/pubmed PY - 2013/5/1/medline SP - 1271 EP - 80 JF - The Journal of clinical endocrinology and metabolism JO - J. Clin. Endocrinol. Metab. VL - 98 IS - 3 N2 - CONTEXT: The median urinary iodine concentration (UIC) is a biomarker of iodine intake. According to the World Health Organization, a median UIC in the range 100-199 μg/L indicates adequate and 200-299 μg/L more than adequate intake. Thyroglobulin (Tg) may be a promising functional biomarker of both iodine deficiency and excess. OBJECTIVES: Using a standardized dried blood spots-Tg assay in children, we evaluated the Tg response to both low- and high-iodine intake and estimated the population cutoff point for iodine deficiency or excess. Also, we compared thyroid functions within the UIC ranges of 100-199 vs 200-299 μg/L. DESIGN AND SETTING: We conducted a cross-sectional study in primary schools in 12 countries. SUBJECTS: SUBJECTS were 6 to 12 years old (n = 2512). MAIN OUTCOME MEASURES: We measured UIC, TSH, total T4, Tg, and thyroid antibodies. RESULTS: Over a range of iodine intakes from severely deficient to excessive, Tg concentrations showed a clear U-shaped curve. Compared with iodine-sufficient children, there was a significantly higher prevalence of elevated Tg values in children with iodine deficiency (UIC <100 μg/L) and iodine excess (UIC >300 μg/L). There was no significant change in the prevalence of elevated Tg, TSH, T4, or thyroid antibodies comparing children within the UIC ranges of 100-199 vs 200-299 μg/L. CONCLUSIONS: In school-aged children, 1) Tg is a sensitive indicator of both low and excess iodine intake; 2) a median Tg of <13 μg/L and/or <3% of Tg values >40 μg/L indicates iodine sufficiency in the population; 3) the acceptable range of median UIC in monitoring iodized salt programs could be widened to a single category of sufficient iodine intake from 100 to 299 μg/L. SN - 1945-7197 UR - https://www.unboundmedicine.com/medline/citation/23345097/Thyroglobulin_is_a_sensitive_measure_of_both_deficient_and_excess_iodine_intakes_in_children_and_indicates_no_adverse_effects_on_thyroid_function_in_the_UIC_range_of_100_299_μg/L:_a_UNICEF/ICCIDD_study_group_report_ L2 - https://academic.oup.com/jcem/article-lookup/doi/10.1210/jc.2012-3952 DB - PRIME DP - Unbound Medicine ER -