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Optimal and safe upper limits of iodine intake for early pregnancy in iodine-sufficient regions: a cross-sectional study of 7190 pregnant women in China.
J Clin Endocrinol Metab. 2015 Apr; 100(4):1630-8.JC

Abstract

CONTEXT

The WHO Technical Consultation recommends urinary iodine concentrations (UIC) from 250 to 499 μg/L as more-than-adequate iodine intake and UIC ≥ 500 μg/L as excessive iodine for pregnant and lactating women, but scientific evidence for this is weak.

OBJECTIVE

We investigated optimal and safe ranges of iodine intake during early pregnancy in an iodine-sufficient region of China.

METHOD

Seven thousand one hundred ninety pregnant women at 4-8 weeks gestation were investigated and their UIC, serum thyroid stimulating hormone (TSH), free thyroxine (FT4), thyroid-peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb), and thyroglobulin (Tg) were measured.

RESULTS

The prevalence of overt hypothyroidism was lowest in the group with UIC 150-249 μg/L, which corresponded to the lowest serum Tg concentration (10.18 μg/L). Prevalences of subclinical hypothyroidism (2.4%) and isolated hypothyroxinemia (1.7%) were lower in the group with UIC 150-249 μg/L. Multivariate logistic regression indicated that more-than-adequate iodine intake (UIC 250-499 μg/L) and excessive iodine intake (UIC ≥ 500 μg/L) were associated with a 1.72-fold and a 2.17-fold increased risk of subclinical hypothyroidism, respectively. Meanwhile, excessive iodine intake was associated with a 2.85-fold increased risk of isolated hypothyroxinemia. Moreover, the prevalence of TPOAb positivity and TgAb positivity presented a U-shaped curve, ranging from mild iodine deficiency to iodine excess.

CONCLUSION

The upper limit of iodine intake during early pregnancy in an iodine-sufficient region should not exceed UIC 250 μg/L, because this is associated with a significantly high risk of subclinical hypothyroidism, and a UIC of 500 μg/L should not be exceeded, as it is associated with a significantly high risk of isolated hypothyroxinemia.

Authors+Show Affiliations

The Endocrine Institute and The Liaoning Provincial Key Laboratory of Endocrine Diseases, Departments of Endocrinology and Metabolism (X.S., C.H., C.L., J.M., W.W., X.X., C.F., Z.S., W.T.) and Obstetrics and Gynecology (T.M.), The First Hospital of China Medical University, Shenyang, China; Shenyang Women's and Children's Hospital (C.L.), Shenyang, China; Departments of Obstetrics and Gynecology (B.X) and Endocrinology (S.Z.), No. 202 Hospital of People's Liberation Army, Shenyang, China; Department of Endocrinology (J.D.), The First Affiliated Hospital of Dalian Medical University, Dalian, China; Department of Endocrinology (Z.G.), Dalian Municipal Central Hospital Affiliated of Dalian Medical University, Dalian, China; and Department of Endocrinology (X.Z.), The First Hospital of Dandong, Dandong, China.No 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 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

25629356

Citation

Shi, Xiaoguang, et al. "Optimal and Safe Upper Limits of Iodine Intake for Early Pregnancy in Iodine-sufficient Regions: a Cross-sectional Study of 7190 Pregnant Women in China." The Journal of Clinical Endocrinology and Metabolism, vol. 100, no. 4, 2015, pp. 1630-8.
Shi X, Han C, Li C, et al. Optimal and safe upper limits of iodine intake for early pregnancy in iodine-sufficient regions: a cross-sectional study of 7190 pregnant women in China. J Clin Endocrinol Metab. 2015;100(4):1630-8.
Shi, X., Han, C., Li, C., Mao, J., Wang, W., Xie, X., Li, C., Xu, B., Meng, T., Du, J., Zhang, S., Gao, Z., Zhang, X., Fan, C., Shan, Z., & Teng, W. (2015). Optimal and safe upper limits of iodine intake for early pregnancy in iodine-sufficient regions: a cross-sectional study of 7190 pregnant women in China. The Journal of Clinical Endocrinology and Metabolism, 100(4), 1630-8. https://doi.org/10.1210/jc.2014-3704
Shi X, et al. Optimal and Safe Upper Limits of Iodine Intake for Early Pregnancy in Iodine-sufficient Regions: a Cross-sectional Study of 7190 Pregnant Women in China. J Clin Endocrinol Metab. 2015;100(4):1630-8. PubMed PMID: 25629356.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Optimal and safe upper limits of iodine intake for early pregnancy in iodine-sufficient regions: a cross-sectional study of 7190 pregnant women in China. AU - Shi,Xiaoguang, AU - Han,Cheng, AU - Li,Chenyan, AU - Mao,Jinyuan, AU - Wang,Weiwei, AU - Xie,Xiaochen, AU - Li,Chenyang, AU - Xu,Bin, AU - Meng,Tao, AU - Du,Jianling, AU - Zhang,Shaowei, AU - Gao,Zhengnan, AU - Zhang,Xiaomei, AU - Fan,Chenling, AU - Shan,Zhongyan, AU - Teng,Weiping, Y1 - 2015/01/28/ PY - 2015/1/29/entrez PY - 2015/1/30/pubmed PY - 2015/8/8/medline SP - 1630 EP - 8 JF - The Journal of clinical endocrinology and metabolism JO - J. Clin. Endocrinol. Metab. VL - 100 IS - 4 N2 - CONTEXT: The WHO Technical Consultation recommends urinary iodine concentrations (UIC) from 250 to 499 μg/L as more-than-adequate iodine intake and UIC ≥ 500 μg/L as excessive iodine for pregnant and lactating women, but scientific evidence for this is weak. OBJECTIVE: We investigated optimal and safe ranges of iodine intake during early pregnancy in an iodine-sufficient region of China. METHOD: Seven thousand one hundred ninety pregnant women at 4-8 weeks gestation were investigated and their UIC, serum thyroid stimulating hormone (TSH), free thyroxine (FT4), thyroid-peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb), and thyroglobulin (Tg) were measured. RESULTS: The prevalence of overt hypothyroidism was lowest in the group with UIC 150-249 μg/L, which corresponded to the lowest serum Tg concentration (10.18 μg/L). Prevalences of subclinical hypothyroidism (2.4%) and isolated hypothyroxinemia (1.7%) were lower in the group with UIC 150-249 μg/L. Multivariate logistic regression indicated that more-than-adequate iodine intake (UIC 250-499 μg/L) and excessive iodine intake (UIC ≥ 500 μg/L) were associated with a 1.72-fold and a 2.17-fold increased risk of subclinical hypothyroidism, respectively. Meanwhile, excessive iodine intake was associated with a 2.85-fold increased risk of isolated hypothyroxinemia. Moreover, the prevalence of TPOAb positivity and TgAb positivity presented a U-shaped curve, ranging from mild iodine deficiency to iodine excess. CONCLUSION: The upper limit of iodine intake during early pregnancy in an iodine-sufficient region should not exceed UIC 250 μg/L, because this is associated with a significantly high risk of subclinical hypothyroidism, and a UIC of 500 μg/L should not be exceeded, as it is associated with a significantly high risk of isolated hypothyroxinemia. SN - 1945-7197 UR - https://www.unboundmedicine.com/medline/citation/25629356/Optimal_and_safe_upper_limits_of_iodine_intake_for_early_pregnancy_in_iodine_sufficient_regions:_a_cross_sectional_study_of_7190_pregnant_women_in_China_ L2 - https://academic.oup.com/jcem/article-lookup/doi/10.1210/jc.2014-3704 DB - PRIME DP - Unbound Medicine ER -