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Effect of excess iodine intake on thyroid diseases in different populations: A systematic review and meta-analyses including observational studies.
PLoS One 2017; 12(3):e0173722Plos

Abstract

BACKGROUND

Although several reports concerning the association of iodine excess and thyroid disease have appeared, no systematic review of the association between iodine excess intake and thyroid diseases, especially hyperthyroidism and hypothyroidism, has yet been reported.

METHOD

We conducted a systematic search of Ovid MEDLINE, PubMed, Cochrane Central Register of Controlled Trials databases, Ichushi-Web and CiNii database for intervention trials and observational studies. Search terms were constructed from related words for excess AND iodine intake or excretion AND thyroid hormones or diseases AND study designs. After considering the qualitative heterogeneity among studies, a meta-analysis was conducted and odds ratios and 95% confidence intervals (CI) were estimated in random-effects models. A protocol was registered with PROSPERO (No. CRD42015028081).

RESULTS

50 articles were included, including three intervention trials, six case-control studies, six follow-up studies and 35 cross-sectional studies. Three cross-sectional studies in adults included in meta-analysis. Odds ratio of overt and subclinical hypothyroidism between excess and adequate populations were 2.78 (CI:1.47 to 5.27) and 2.03 (CI:1.58 to 2.62) in adults, respectively. Source of excess iodine status was mainly iodized salt or water in included studies.

CONCLUSION

Although universal salt iodization has improved goiter rates, chronic exposure to excess iodine from water or poorly monitored salt are risk factors for hypothyroidism in free-living populations. Monitoring of both iodine concentration in salt as well as the iodine concentration in local drinking water are essential to preventing thyroid diseases. Hypothyroidism should be also carefully monitored in areas with excess iodine. Because of the low quality and limited number of included studies, further evidence and review are required.

Authors+Show Affiliations

Department of Social and Preventive Epidemiology, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo, Japan.Department of Social and Preventive Epidemiology, School of Public Health, the University of Tokyo, Bunkyo-ku, Tokyo, Japan.Department of Social and Preventive Epidemiology, School of Public Health, the University of Tokyo, Bunkyo-ku, Tokyo, Japan.Department of Social and Preventive Epidemiology, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo, Japan. Department of Social and Preventive Epidemiology, School of Public Health, the University of Tokyo, Bunkyo-ku, Tokyo, Japan.

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

28282437

Citation

Katagiri, Ryoko, et al. "Effect of Excess Iodine Intake On Thyroid Diseases in Different Populations: a Systematic Review and Meta-analyses Including Observational Studies." PloS One, vol. 12, no. 3, 2017, pp. e0173722.
Katagiri R, Yuan X, Kobayashi S, et al. Effect of excess iodine intake on thyroid diseases in different populations: A systematic review and meta-analyses including observational studies. PLoS ONE. 2017;12(3):e0173722.
Katagiri, R., Yuan, X., Kobayashi, S., & Sasaki, S. (2017). Effect of excess iodine intake on thyroid diseases in different populations: A systematic review and meta-analyses including observational studies. PloS One, 12(3), pp. e0173722. doi:10.1371/journal.pone.0173722.
Katagiri R, et al. Effect of Excess Iodine Intake On Thyroid Diseases in Different Populations: a Systematic Review and Meta-analyses Including Observational Studies. PLoS ONE. 2017;12(3):e0173722. PubMed PMID: 28282437.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of excess iodine intake on thyroid diseases in different populations: A systematic review and meta-analyses including observational studies. AU - Katagiri,Ryoko, AU - Yuan,Xiaoyi, AU - Kobayashi,Satomi, AU - Sasaki,Satoshi, Y1 - 2017/03/10/ PY - 2016/09/16/received PY - 2017/02/24/accepted PY - 2017/3/11/entrez PY - 2017/3/11/pubmed PY - 2017/8/18/medline SP - e0173722 EP - e0173722 JF - PloS one JO - PLoS ONE VL - 12 IS - 3 N2 - BACKGROUND: Although several reports concerning the association of iodine excess and thyroid disease have appeared, no systematic review of the association between iodine excess intake and thyroid diseases, especially hyperthyroidism and hypothyroidism, has yet been reported. METHOD: We conducted a systematic search of Ovid MEDLINE, PubMed, Cochrane Central Register of Controlled Trials databases, Ichushi-Web and CiNii database for intervention trials and observational studies. Search terms were constructed from related words for excess AND iodine intake or excretion AND thyroid hormones or diseases AND study designs. After considering the qualitative heterogeneity among studies, a meta-analysis was conducted and odds ratios and 95% confidence intervals (CI) were estimated in random-effects models. A protocol was registered with PROSPERO (No. CRD42015028081). RESULTS: 50 articles were included, including three intervention trials, six case-control studies, six follow-up studies and 35 cross-sectional studies. Three cross-sectional studies in adults included in meta-analysis. Odds ratio of overt and subclinical hypothyroidism between excess and adequate populations were 2.78 (CI:1.47 to 5.27) and 2.03 (CI:1.58 to 2.62) in adults, respectively. Source of excess iodine status was mainly iodized salt or water in included studies. CONCLUSION: Although universal salt iodization has improved goiter rates, chronic exposure to excess iodine from water or poorly monitored salt are risk factors for hypothyroidism in free-living populations. Monitoring of both iodine concentration in salt as well as the iodine concentration in local drinking water are essential to preventing thyroid diseases. Hypothyroidism should be also carefully monitored in areas with excess iodine. Because of the low quality and limited number of included studies, further evidence and review are required. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/28282437/Effect_of_excess_iodine_intake_on_thyroid_diseases_in_different_populations:_A_systematic_review_and_meta_analyses_including_observational_studies_ L2 - http://dx.plos.org/10.1371/journal.pone.0173722 DB - PRIME DP - Unbound Medicine ER -