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Stopping the supply of iodized salt alone is not enough to make iodine nutrition suitable for children in higher water iodine areas: A cross-sectional study in northern China.
Ecotoxicol Environ Saf. 2020 Jan 30; 188:109930.EE

Abstract

BACKGROUND

For the sake of children's health, iodized salt supply has been stopped in many areas with excessive iodine in the drinking water, but children's iodine nutrition status and thyroid function after terminating the iodized salt supply is unknown. Objective We assessed the iodine nutrition, thyroid function and influencing factors for thyroid abnormalities in children from areas with different concentrations of water iodine; the supply of iodized salt has been stopped in high water iodine areas. This study aimed to evaluate whether the strategy of stopping the supplies of iodized salt alone is enough to avoid thyroid dysfunction in all areas with excess water iodine while still meeting the iodine nutrition needs of children.

METHODS

A cross-sectional study was conducted in children from four areas with different drinking water iodine concentrations in Tianjin, China. The drinking water samplings and spot urine samples were collected to estimate the external and internal iodine exposure levels. The thyroid volume was measured, and blood samples were collected to assess thyroid function. Logistic regression analysis was used to analyze risk factors for thyroid abnormalities. A dietary survey was conducted to determine the sources of iodine nutrition among the areas with different iodine concentrations in the drinking water.

RESULTS

In the area with a drinking water iodine concentration ≥300 μg/L, the median urinary iodine concentration (UIC) in children was 476.30 (332.20-639.30) μg/L, which was higher than that in other groups (all P < 0.05), and the prevalence of thyroid nodules and the thyroid goiter rate were higher than those in the <100 μg/L, 100-150 μg/L and 150-300 μg/L areas (all P < 0.01). Binary logistic regression analysis indicated that the risk of thyroid abnormalities was significantly increased in the UIC 200-299 μg/L group (OR: 4.534; 95% CI: 1.565, 13.135; bootstrapped 95% CI: 1.689, 21.206, P = 0.004) and in the UIC ≥ 300 μg/L group (OR: 6.962; 95% CI: 2.490, 19.460; bootstrapped 95% CI: 2.838, 32.570, P = 0.001) compared to the 100-199 μg/L group. The iodine contribution rates from water in areas with water iodine concentrations ≥300 μg/L are up to 63.04%.

CONCLUSIONS

After termination of the iodized salt supply, the level of iodine nutrition of children in the area with drinking water iodine concentrations ≥300 μg/L is still excessive. The water source needs to be replaced in this area. In the area with a water iodine concentration of 150-300 μg/L, it is proposed that stopping the supply of iodized salt is sufficient to achieve the proper iodine nutrition status in children.

Authors+Show Affiliations

Tianjin Centers for Disease Control and Prevention, 6 Huayue Road, Hedong District, Tianjin, 300011, PR China.Tianjin Centers for Disease Control and Prevention, 6 Huayue Road, Hedong District, Tianjin, 300011, PR China.Tianjin Health Education Center, 6 Huayue Road, Hedong District, Tianjin, 300011, PR China.Tianjin Centers for Disease Control and Prevention, 6 Huayue Road, Hedong District, Tianjin, 300011, PR China.Tianjin Centers for Disease Control and Prevention, 6 Huayue Road, Hedong District, Tianjin, 300011, PR China.Tianjin Centers for Disease Control and Prevention, 6 Huayue Road, Hedong District, Tianjin, 300011, PR China.Tianjin Centers for Disease Control and Prevention, 6 Huayue Road, Hedong District, Tianjin, 300011, PR China.Tianjin Centers for Disease Control and Prevention, 6 Huayue Road, Hedong District, Tianjin, 300011, PR China.Tianjin Centers for Disease Control and Prevention, 6 Huayue Road, Hedong District, Tianjin, 300011, PR China. Electronic address: 18526238020@163.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31727496

Citation

Wang, Yang, et al. "Stopping the Supply of Iodized Salt Alone Is Not Enough to Make Iodine Nutrition Suitable for Children in Higher Water Iodine Areas: a Cross-sectional Study in Northern China." Ecotoxicology and Environmental Safety, vol. 188, 2020, p. 109930.
Wang Y, Cui Y, Chen C, et al. Stopping the supply of iodized salt alone is not enough to make iodine nutrition suitable for children in higher water iodine areas: A cross-sectional study in northern China. Ecotoxicol Environ Saf. 2020;188:109930.
Wang, Y., Cui, Y., Chen, C., Duan, Y., Wu, Y., Li, W., Zhang, D., Li, F., & Hou, C. (2020). Stopping the supply of iodized salt alone is not enough to make iodine nutrition suitable for children in higher water iodine areas: A cross-sectional study in northern China. Ecotoxicology and Environmental Safety, 188, 109930. https://doi.org/10.1016/j.ecoenv.2019.109930
Wang Y, et al. Stopping the Supply of Iodized Salt Alone Is Not Enough to Make Iodine Nutrition Suitable for Children in Higher Water Iodine Areas: a Cross-sectional Study in Northern China. Ecotoxicol Environ Saf. 2020 Jan 30;188:109930. PubMed PMID: 31727496.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Stopping the supply of iodized salt alone is not enough to make iodine nutrition suitable for children in higher water iodine areas: A cross-sectional study in northern China. AU - Wang,Yang, AU - Cui,Yushan, AU - Chen,Chen, AU - Duan,Yani, AU - Wu,Yinghong, AU - Li,Wenfeng, AU - Zhang,DanDan, AU - Li,Fang, AU - Hou,Changchun, Y1 - 2019/11/11/ PY - 2019/09/25/received PY - 2019/11/04/revised PY - 2019/11/05/accepted PY - 2019/11/16/pubmed PY - 2019/11/16/medline PY - 2019/11/16/entrez KW - Children KW - Iodized salt KW - Thyroid abnormalities KW - Urinary iodine KW - Water iodine KW - Water replacement SP - 109930 EP - 109930 JF - Ecotoxicology and environmental safety JO - Ecotoxicol. Environ. Saf. VL - 188 N2 - BACKGROUND: For the sake of children's health, iodized salt supply has been stopped in many areas with excessive iodine in the drinking water, but children's iodine nutrition status and thyroid function after terminating the iodized salt supply is unknown. Objective We assessed the iodine nutrition, thyroid function and influencing factors for thyroid abnormalities in children from areas with different concentrations of water iodine; the supply of iodized salt has been stopped in high water iodine areas. This study aimed to evaluate whether the strategy of stopping the supplies of iodized salt alone is enough to avoid thyroid dysfunction in all areas with excess water iodine while still meeting the iodine nutrition needs of children. METHODS: A cross-sectional study was conducted in children from four areas with different drinking water iodine concentrations in Tianjin, China. The drinking water samplings and spot urine samples were collected to estimate the external and internal iodine exposure levels. The thyroid volume was measured, and blood samples were collected to assess thyroid function. Logistic regression analysis was used to analyze risk factors for thyroid abnormalities. A dietary survey was conducted to determine the sources of iodine nutrition among the areas with different iodine concentrations in the drinking water. RESULTS: In the area with a drinking water iodine concentration ≥300 μg/L, the median urinary iodine concentration (UIC) in children was 476.30 (332.20-639.30) μg/L, which was higher than that in other groups (all P < 0.05), and the prevalence of thyroid nodules and the thyroid goiter rate were higher than those in the <100 μg/L, 100-150 μg/L and 150-300 μg/L areas (all P < 0.01). Binary logistic regression analysis indicated that the risk of thyroid abnormalities was significantly increased in the UIC 200-299 μg/L group (OR: 4.534; 95% CI: 1.565, 13.135; bootstrapped 95% CI: 1.689, 21.206, P = 0.004) and in the UIC ≥ 300 μg/L group (OR: 6.962; 95% CI: 2.490, 19.460; bootstrapped 95% CI: 2.838, 32.570, P = 0.001) compared to the 100-199 μg/L group. The iodine contribution rates from water in areas with water iodine concentrations ≥300 μg/L are up to 63.04%. CONCLUSIONS: After termination of the iodized salt supply, the level of iodine nutrition of children in the area with drinking water iodine concentrations ≥300 μg/L is still excessive. The water source needs to be replaced in this area. In the area with a water iodine concentration of 150-300 μg/L, it is proposed that stopping the supply of iodized salt is sufficient to achieve the proper iodine nutrition status in children. SN - 1090-2414 UR - https://www.unboundmedicine.com/medline/citation/31727496/Stopping_the_supply_of_iodized_salt_alone_is_not_enough_to_make_iodine_nutrition_suitable_for_children_in_higher_water_iodine_areas:_A_cross_sectional_study_in_northern_China_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0147-6513(19)31261-8 DB - PRIME DP - Unbound Medicine ER -
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