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Gong B, Wang Y, Zhang JA, Zhang Q, Zhao J, Li J, Wang X, Han Y, Yu Z, Zhang C, Peng B, Xing Y, Li Q, Wang P, Li Y, Teng W, Shan Z. Effects of altitude on thyroid disorders according to Chinese three-rung, ladder-like topography: national cross-sectional study. BMC Public Health 2024; 24:26. [PMID: 38167020 PMCID: PMC10762831 DOI: 10.1186/s12889-023-17569-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 12/22/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Chinese topography appears a three-rung ladder-like distribution of decreasing elevation from northwest to southeast, which is divided by two sloping edges. Previous studies have reported that prevalence of thyroid diseases differed by altitude, and geographical factors were associated with thyroid disorders. To explore the association between three-rung ladder-like regions and thyroid disorders according to unique Chinese topographic features, we conducted an epidemiological cross-sectional study from 2015-2017 that covered all 31 mainland Chinese provinces. METHODS A total of 78,470 participants aged ≥ 18 years from a nationally representative cross-sectional study were included. Serum thyroid peroxidase antibody, thyroglobulin antibody, and thyroid-stimulating hormone levels; urine iodine concentration; and thyroid volume were measured. The three-rung ladder-like distribution of decreasing elevation from northwest to southeast in China was categorized into three topographic groups according to elevation: first ladder, > 3000 m above sea level; second ladder, descending from 3000-500 m; and third ladder, descending from 500 m to sea level. The third ladder was further divided into groups A (500-100 m) and B (< 100 m). Associations between geographic factors and thyroid disorders were assessed using linear and binary logistic regression analyses. RESULTS Participants in the first ladder group were associated with lower thyroid peroxidase (β = -4.69; P = 0.00), thyroglobulin antibody levels (β = -11.08; P = 0.01), and the largest thyroid volume (β = 1.74; P = 0.00), compared with the other groups. The second ladder group was associated with autoimmune thyroiditis (odds ratio = 1.30, 95% confidence interval [1.18-1.43]) and subclinical hypothyroidism (odds ratio = 0.61, 95%confidence interval [0.57-0.66]) (P < 0.05) compared with the first ladder group. Group A (third ladder) (500-100 m) was associated with thyroid nodules and subclinical hypothyroidism (P < 0.05). Furthermore, group B (< 100 m) was positively associated with autoimmune thyroiditis, thyroid peroxidase and thyroglobulin antibody positivity, and negatively associated with overt hypothyroidism, subclinical hypothyroidism, and goiter compared with the first ladder group(P < 0.05). CONCLUSION We are the first to investigate the association between different ladder regions and thyroid disorders according to unique Chinese topographic features. The prevalence of thyroid disorders varied among the three-rung ladder-like topography groups in China, with the exception of overt hyperthyroidism.
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Affiliation(s)
- Boshen Gong
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Youmin Wang
- Department of Endocrinology, The First People's Hospital of An-Hui Medical University, Hefei, Anhui, 230000, P. R. China
| | - Jin-An Zhang
- Department of Endocrinology, Shanghai University of Medicine & Health Science Affiliated Zhoupu Hospital, Shanghai, 201318, P. R. China
| | - Qiao Zhang
- Department of Endocrinology and Metabolism, Guiqian International General Hospital, Guiyang, Guizhou, 550004, P. R. China
| | - Jiajun Zhao
- Department of Endocrinology, Hospital Affiliated With Shandong University, Jinan, Shandong, 250012, P. R. China
| | - Jiashu Li
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Xichang Wang
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Yutong Han
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Ziwei Yu
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Chenyu Zhang
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Bingcong Peng
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Yumin Xing
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Qiuxian Li
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Ping Wang
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Yongze Li
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Weiping Teng
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China.
| | - Zhongyan Shan
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China.
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Fan X, Zhao L, Wang S, Song K, Wang B, Xie Y, Jiang Y, Lin L, Teng W, Cai C, Yao Y. Relation between iodine nutrition and thyroid diseases in Qinghai, China. Front Endocrinol (Lausanne) 2023; 14:1234482. [PMID: 37745704 PMCID: PMC10515197 DOI: 10.3389/fendo.2023.1234482] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 08/18/2023] [Indexed: 09/26/2023] Open
Abstract
Objective To investigate the adult iodine nutrition and the prevalence of thyroid diseases in Qinghai Province, and analyze the correlation between iodine and thyroid diseases, so as to provide a basis for adjusting the salt iodization plan in Qinghai Province. Methods Using cluster and stratified sampling method to select 2628 permanent residents over 18 years old in Qinghai Province for questionnaire survey, physical examination, thyroid color ultrasound, and laboratory index detection. Results 1. The coverage of iodized salt in adults is 99.71%. 2. The detection rates of thyroid disorders in adults were as follows: Clinical hyperthyroidism was 1.20%, subclinical hyperthyroidism was 0.20%, clinical hypothyroidism was 1.00%, subclinical hypothyroidism was 29.20%, and the goiter was 2.10%. The percentages positivity of TPO Ab, TG Ab, goiter was 9.80%, 9.20%, 2.10%, respectively. Among them single thyroid nodule was 6.40%, multi-nodule thyroid gland was 1.80%. 3. The percentages of mild iodine deficiency, moderate iodine deficiency, Severe iodine deficiency, adequate iodine intake (AI), more than adequate iodine intake (MAI)and excessive iodine intake (EI)were 8.41%, 2.17%, 0.26%, 33.22%, 28.35%, and 27.59%, respectively. The percentages of mild, moderate and severe iodine deficiency in urban populations (7.13%, 0.87%, 0.0%) were significantly lower than those in rural populations (9.81%, 3.59%, 0.56%) (P < 0.05), and the rates of adequate, more than adequate iodine intake in urban populations (36.03%, 30.93%) were significantly higher than that in rural populations (30.14%, 25.52%). The rate of excess iodine intake was higher in rural areas (30.38%) than in urban areas (25.04%). 4. The positive rates of subclinical hypothyroidism, goiter, TPO Ab and TG Ab in female adults (35.28%, 3.39%, 13.54%, 13.94%) were higher than those in male adults (23.58%, 0.96%, 6.266%, 4.79%). The detection rate of single thyroid nodules was higher in urban (8.01%) than rural populations (4.70%), while the detection rate of hypothyroidism, subclinical hypothyroidism, and goiter (0.58%, 25.84%, 1.38%) was lower than that in rural populations (1.52%, 32.96%, 2.96%) (P<0.05). 5. There was no statistical significance in the detection rates of clinical hyperthyroidism, subclinical hypothyroidism, subclinical hypothyroidism, goiter, thyroid nodules, TPO Ab and TG Ab positive rates in different iodine nutritional status (P>0.05). The positive rate of hypothyroidism in the iodine deficiency group is higher than in other iodine nutrition groups. Conclusion The nutritional status of iodine in Qinghai Province is iodine excess. Subclinical hypothyroidism was detected at a high rate. Subclinical hypothyroidism, goiter, TPO Ab, and TG Ab were more common in female than in male. The proportion of mild, moderate, and severe iodine deficiency was higher in urban areas than in rural areas. The detection rate of thyroid nodules was higher in urban than in rural areas, and that of hypothyroidism, subclinical hypothyroidism, and goiter was lower than that in rural populations. The detection rate of clinical hypothyroidism was statistically significant in different iodine nutritional states (P< 0.05).
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Affiliation(s)
- Xiaoxia Fan
- Department of Endocrinology, Qinghai Provincial People’s Hospital, Xining, China
- Key Laboratory of Ministry of Education for High Altitude Medicine, Research Center for High Altitude Medicine, Xining, China
- Key Laboratory of Application and Foundation for High Altitude Medicine Research in Qinghai Province (Qinghai−Utah Joint Research Key Lab for High Altitude Medicine) Qinghai University, Xining, China
| | - Lingling Zhao
- Department of Endocrinology, Qinghai Provincial People’s Hospital, Xining, China
| | - Shuqiong Wang
- Department of Endocrinology, Qinghai Provincial People’s Hospital, Xining, China
| | - Kang Song
- Department of Endocrinology, Qinghai Provincial People’s Hospital, Xining, China
| | - Beibei Wang
- Department of Endocrinology, Qinghai Provincial People’s Hospital, Xining, China
| | - Yanling Xie
- Department of Endocrinology, Qinghai Provincial People’s Hospital, Xining, China
| | - Yanping Jiang
- Department of Endocrinology, Qinghai Provincial People’s Hospital, Xining, China
| | - Lijun Lin
- Department of Endocrinology, Qinghai Provincial People’s Hospital, Xining, China
| | - Weiping Teng
- Department of Endocrinology and Metabolism, Institute of Endocrinology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Chunmei Cai
- Key Laboratory of Ministry of Education for High Altitude Medicine, Research Center for High Altitude Medicine, Xining, China
- Key Laboratory of Application and Foundation for High Altitude Medicine Research in Qinghai Province (Qinghai−Utah Joint Research Key Lab for High Altitude Medicine) Qinghai University, Xining, China
| | - Yongli Yao
- Department of Endocrinology, Qinghai Provincial People’s Hospital, Xining, China
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Öztürk M. Is there a relationship between the urinary iodine of pregnant and diabetic patients? J Family Med Prim Care 2023; 12:1083-1086. [PMID: 37636175 PMCID: PMC10451571 DOI: 10.4103/jfmpc.jfmpc_270_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/27/2021] [Accepted: 12/05/2022] [Indexed: 08/29/2023] Open
Abstract
Objectives We investigated the iodine status in this study in pregnant women, diabetic women-men, and nondiabetic men-women living in our region. Methods A total of 385 cases who applied to the endocrine clinic between 2015 and 2020 were reviewed retrospectively. The gender, age, free T3 (pg/ml), free T4 (ng/dl), TSH (μIU/mL), anti-TPO antibody (IU/ml), anti-thyroglobulin antibody (IU/ml), and random urine iodine concentration (μg/L) levels of cases were recorded. The cases were grouped as pregnant, female, male, diabetic female, and diabetic male. Cases with overt thyroid disease, heart failure, liver failure, and kidney failure were excluded. Results There were 6.75% (n = 26) pregnant, 54.8% (n = 211) nondiabetic female patients, 18.9% (n = 73) diabetic female patients, 12.7% (n = 49) nondiabetic male, and 4.15% (n = 16) diabetic male patients. The random urinary iodine level was significantly higher in nondiabetic women (112.9 ± 77.21) and diabetic women (140.7 ± 97.8) than in pregnant women (77.8 ± 31.8) (P = 0.00 and P = 0.03). There was no significant relationship between random urine levels of pregnant women and nondiabetic men (104.1 ± 82.6) (P = 0.16). The random urinary iodine level was significantly higher in diabetic men (170.0 ± 112.1) than in pregnant women (P = 0.00). Conclusions In our region (xxx Region), pregnant women had iodine deficiency. The iodine level in men and women was very close to the lower limit. The urinary iodine level was higher in diabetic women and diabetic men than in both pregnant women and nondiabetic women and nondiabetic men. The results brought us the question: Could the high spot urinary iodine level in diabetic patients be a clue to nephropathy?
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Affiliation(s)
- Mine Öztürk
- Department of Endocrinology and Metabolism, KTO Karatay University Medicine Faculty Hospital, Konya, Turkey
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Tayier R, Wang C, Ma P, Yuan Y, Zhang Y, Wu S, Zhang L. Iodine Nutritional Status of Pregnant Women After 14 Years of Lipiodol Supplementation: a Cross-Sectional Study in Historically Iodine-Deficient Areas of China. Biol Trace Elem Res 2023; 201:14-22. [PMID: 35322354 DOI: 10.1007/s12011-022-03123-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 01/17/2022] [Indexed: 01/11/2023]
Abstract
Southern Xinjiang has a history of serious iodine deficiency. Since 2007, pregnant women in this area have taken iodized salt and oral lipiodol preparations to prevent iodine deficiency disorders. However, the current status of iodine nutrition and thyroid function in this population is unknown. A cross-sectional study was conducted on 555 pregnant women from 5 counties (cities) in southern Xinjiang and 429 pregnant women from 3 counties in northern Xinjiang. The participants were given a questionnaire and serum concentrations of free triiodothyronine (FT3), free thyroxine (FT4), thyrotropic stimulating hormone (TSH), thyroglobulin antibody (Tg-Ab), and thyroid peroxidase antibody (TPO-Ab), and the urine iodine concentration (UIC) was measured. The median UIC and interquartile range [M (IQR)] of the 984 pregnant women in the study was 189.38 (143.15, 288.77) μg/L. Positive Tg-Ab and TPO-Ab titers were detected in 6.74% and 9.55%, 8.30% and 9.84%, and 7.39% and 10.55% in T1, T2, and T3, respectively. The incidence of subclinical hypothyroidism, clinical hypothyroidism, and isolated hypothyroxinemia in pregnant women in areas where lipiodol pills were taken was 4.32%, 0%, and 1.44%, respectively, which was significantly lower than those in areas where lipiodol pills were not taken. The median UIC (IQR) of pregnant women in the two regions was 213.80 (130.44, 331.77) μg/L and 168.30 (155.0, 254.8) μg/L, the UIC of pregnant women who took lipiodol pills was higher than in those who did not take lipiodol pills, and the difference was statistically significant (p < 0.05). According to WHO standards, all pregnant women in southern Xinjiang are in a state of adequate iodine nutrition. Taking lipiodol pills has improved the iodine nutrition level of pregnant women in this area. The results of this study did not find that oral lipiodol pills had adverse effects on pregnant women's thyroid function, but it is necessary to further study the effect of oral lipiodol pills on the offspring.
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Affiliation(s)
- Rishalaiti Tayier
- College of Public Health, Xinjiang Medical University, Urumqi, 830011, Xinjiang, People's Republic of China
| | - Chenchen Wang
- Xinjiang Uighur Autonomous Region Centre for Disease Control and Prevention, Urumqi, 830011, People's Republic of China
| | - Pinjiang Ma
- Xinjiang Uighur Autonomous Region Centre for Disease Control and Prevention, Urumqi, 830011, People's Republic of China
| | - Yimu Yuan
- Xinjiang Production and Construction Corps Hospital, Urumqi, 830011, Xinjiang, People's Republic of China
| | - Yuxia Zhang
- Urumqi Maternal and Child Health Hospital, Urumqi, 830011, Xinjiang, People's Republic of China
| | - Shunhua Wu
- Department of Occupational and Environmental Health, School of Public Health, Xinjiang Medical University, Urumqi, 830001, People's Republic of China.
| | - Ling Zhang
- Xinjiang Uighur Autonomous Region Centre for Disease Control and Prevention, Urumqi, 830011, People's Republic of China.
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Zhang L, Fan L, Li F, Sun Q, Chen Y, He Y, Shen H, Liu L. Study on the Effect of Different Iodine Intake on Hippocampal Metabolism in Offspring Rats. Biol Trace Elem Res 2022; 200:4385-4394. [PMID: 34855145 DOI: 10.1007/s12011-021-03032-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 11/13/2021] [Indexed: 12/22/2022]
Abstract
Iodine is an essential trace element in the human body. Severe maternal iodine deficiency during pregnancy leads to obvious intellectual disability in the offspring. The effects of iodine deficiency on brain development have been demonstrated, but there is no clear evidence of the effects of iodine excess on brain development. To clarify the effects of iodine excess on the brain development of offspring and to provide clues to the mechanisms underlying the effects of iodine deficiency and iodine excess on the brain development of offspring. In this study, animal models with different iodine intakes were constructed using potassium iodate (KIO3). The models included four experimental groups (low-iodine group one (LI, 0μg/L iodine), low-iodine group two (LII, 5μg/L iodine), high-iodine group one (HI, 3000μg/L iodine), and high-iodine group two (HII, 10000μg/L iodine)) and one control group (NI, 100μg/L iodine). There were 20 female rats in each group, and 8 offspring were chosen from each group following birth to assess metabolic alterations. The metabolites of subsets of brain hippocampal tissue were profiled by ultra-performance liquid chromatography-linked electrospray ionization quadrupole time-of-flight mass spectrometry (UPLC-ESI-QTOFMS) and the results were subjected to multivariate data analysis. Differential substances were screened by t test (p<0.05), principal component analysis (PCA), and partial least squares analysis (PLS-DA, VIP>1). The thyroid function of the female rats in the experimental group was abnormally changed. Metabolic analysis showed that the five groups were separated which revealed significant differences in hippocampal tissue metabolism among the five groups of offspring. A total of 12 potential metabolites were identified, with the majority of them being related to amino acid and energy metabolism. These metabolites are involved in various metabolic pathways, are interrelated, and may play a function in brain development. Our study highlights changes in metabolites and metabolic pathways in the brain hippocampus of offspring rats with different iodine intakes compared to controls, revealing new insights into hippocampal metabolism in offspring rats and new relevant targets.
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Affiliation(s)
- Li Zhang
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
| | - Lijun Fan
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
| | - Fan Li
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
| | - Qihao Sun
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yao Chen
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yanhong He
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
| | - Hongmei Shen
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
| | - Lixiang Liu
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China.
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Xu YX, Wang C, Li XD, Guo WL, Liu GY, Zhang HB, Sun Y, Zhu DF, Xu Q. Activation of cholinergic basal forebrain neurons improved cognitive functions in adult-onset hypothyroid mice. Biomed Pharmacother 2022; 153:113495. [DOI: 10.1016/j.biopha.2022.113495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 07/21/2022] [Accepted: 07/27/2022] [Indexed: 11/24/2022] Open
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Ma C, Zhong J, Zou Y, Liu Z, Li H, Pang J, Liu X, Zejipuchi, Tian L, Hou L, Wang D, Cheng X, Qiu L. Establishment of Reference Intervals for Thyroid-Associated Hormones Using refineR Algorithm in Chinese Population at High-Altitude Areas. Front Endocrinol (Lausanne) 2022; 13:816970. [PMID: 35222276 PMCID: PMC8874314 DOI: 10.3389/fendo.2022.816970] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 01/04/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives Diagnosis of thyroid disease among individuals dwelling at high altitude remains a challenge. Reference intervals (RIs) for thyroid-associated hormones among Tibetans living at various high altitudes were established to improve diagnosis. Methods One thousand two hundred eighty-one subjects were randomly recruited from Nyingchi, Shigatse/Lhasa, and Ali of Tibet. Thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4) were measured by the Cobas e601 electrochemiluminescence analyzer. We used multiple linear regression and variance component analysis to assess the effect of sex, age, and altitude on hormones. RIs were established by refineR algorithm and compared with those provided by the manufacturer. Results Serum TSH was significantly lower in males than in females, while FT3 and FT4 were higher in males. Both FT3 and FT4 decreased with increasing age. FT3 increased with altitude, while TSH and FT4 were less influenced by altitude. The RI for TSH was 0.764–5.784 μIU/ml, while for FT4, the RIs were 12.36–19.38 pmol/L in females and 14.84–20.18 pmol/L in males. The RIs for FT3 at Nyingchi, Shigatse/Lhasa, and Ali in females were 4.09–4.98, 4.31–5.45, and 4.82–5.58 pmol/L, while in males, the values were 4.82–5.41, 4.88–5.95, and 5.26–6.06 pmol/L, respectively. The obtained RIs for TSH and FT4 were generally higher, while that for FT3 was narrower than the RIs provided by Cobas. Conclusions Specific RIs were established for thyroid-associated hormones among Tibetans, which were significantly different from those provided by the manufacturer.
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Liu X, Sun J, Fang W, Xu Y, Zhu Z, Liu Y. Current Iodine Nutrition Status and Morbidity of Thyroid Nodules in Mainland China in the Past 20 Years. Biol Trace Elem Res 2021; 199:4387-4395. [PMID: 33582938 PMCID: PMC8516763 DOI: 10.1007/s12011-020-02565-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 12/25/2020] [Indexed: 12/23/2022]
Abstract
The aim of this study was to comprehensively assess the prevalence of goiter and thyroid nodules (TNs) in relation to China's iodine nutrition level over the past 20 years and provide an effective reference for developing health policies. PubMed, EMBASE, Chinese National Knowledge Infrastructure, Chongqing VIP, and Chinese Wan Fang databases were searched for relevant studies from Jan 1996 to Feb 2020. Two reviewers extracted valid data from the eligible citations to determine the morbidity of TNs in different urinary iodine concentrations (UICs) and in patients of different genders, of different ages, who live in different geographic regions, and who live at different altitudes, as well as the P values of interactions between groups. There were 26 articles (34 studies) included in this analysis. The overall morbidity of TNs in mainland China was 23.4%. Morbidity was higher in urban areas (P < 0.001) than in rural and mixed areas. Coastal areas (P < 0.001), female patients (P < 0.001), high-altitude areas (P < 0.001), and residence in south China (P < 0.001) were all associated with higher morbidity of TNs. The lowest morbidity value of TNs, 16%, was in the more-than-adequate iodine subgroup. The highest morbidity, 27.2%, was in the adequate iodine subgroup. The morbidity of TNs increases with age, and women are more likely to have TNs. We also need to perform more epidemiological studies, and in the future, we should cultivate better understanding of the relationship between other thyroid diseases and provide more comprehensive and useful information for other researchers.
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Affiliation(s)
- Xin Liu
- Department of Critical Care Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong China
| | - Jian Sun
- Department of Neurosurgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong China
| | - Wei Fang
- Department of Critical Care Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong China
| | - Yanguo Xu
- Department of Critical Care Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu China
| | - Zizhao Zhu
- Department of General Surgery, The Sixth People’s Hospital of Shenyang, Shenyang, China
| | - Yazhuo Liu
- Department of Clinical Nutrition and Metabolism, The Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning China
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Choi JY, Lee JH, Song Y. Evaluation of Iodine Status among Korean Patients with Papillary Thyroid Cancer Using Dietary and Urinary Iodine. Endocrinol Metab (Seoul) 2021; 36:607-618. [PMID: 34154044 PMCID: PMC8258329 DOI: 10.3803/enm.2021.1005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 04/26/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Concerns have been raised regarding thyroid disorders caused by excessive iodine in Koreans, who have iodine-rich diets. This study evaluated iodine status using dietary iodine intake and urinary iodine in papillary thyroid cancer (PTC) patients. METHODS Dietary data of PTC patients were assessed using a 24-hour recall and food frequency questionnaire (FFQ), and urinary iodine concentrations (UICs) were also obtained. To compare the iodine status of PTC patients, Korean adults with or without thyroid disease from the Korea National Health and Nutrition Examination Survey, which had 24-hour recall data and urinary iodine measurements, were analyzed. RESULTS The median daily iodine intake by 24-hour recall was 341.7 μg/day in PTC patients, similar to the levels of other Korean adults. Based on UICs, the prevalence of excessive iodine was 54.4% in PTC patients, which was similar to the prevalence among subjects with thyroid disease (55.4%) but slightly higher than that in subjects without thyroid disease (47.7%). Based on dietary iodine by 24-hour recall, the prevalence of excessive iodine intake was 7.2%, which was higher than that among subjects with (4.4%) or without (3.9%) thyroid disease. The dietary iodine intake based on 24-hour recall was closely correlated with the UIC (r=0.4826) in PTC patients, but dietary iodine by FFQ was not significantly correlated with either 24-hour recall or UIC-based dietary iodine. CONCLUSION Excessive iodine intake was more common in PTC patients than in subjects without thyroid disease. Further longitudinal research is necessary to elucidate the role of dietary iodine in PTC.
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Affiliation(s)
- Ji Yeon Choi
- Department of Food Science & Nutrition, The Catholic University of Korea, Bucheon,
Korea
| | - Joon-Hyop Lee
- Department of Surgery, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon,
Korea
| | - YoonJu Song
- Department of Food Science & Nutrition, The Catholic University of Korea, Bucheon,
Korea
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10
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Pramanik A, Karmakar J, Grynzspan F, Levine M. Facile Iodine Detection via Fluorescence Quenching of β‐Cyclodextrin:Bimane‐Ditriazole Inclusion Complexes. Isr J Chem 2020. [DOI: 10.1002/ijch.202000092] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Apurba Pramanik
- Department of Chemical Sciences Ariel University 65 Ramat HaGolan Street Ariel Israel
| | - Joy Karmakar
- Department of Chemical Sciences Ariel University 65 Ramat HaGolan Street Ariel Israel
| | - Flavio Grynzspan
- Department of Chemical Sciences Ariel University 65 Ramat HaGolan Street Ariel Israel
| | - Mindy Levine
- Department of Chemical Sciences Ariel University 65 Ramat HaGolan Street Ariel Israel
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11
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Zhao L, Teng D, Shi X, Li Y, Ba J, Chen B, Du J, He L, Lai X, Li Y, Chi H, Liao E, Liu C, Liu L, Qin G, Qin Y, Quan H, Shi B, Sun H, Tang X, Tong N, Wang G, Zhang JA, Wang Y, Xue Y, Yan L, Yang J, Yang L, Yao Y, Ye Z, Zhang Q, Zhang L, Zhu J, Zhu M, Shan Z, Teng W. The Effect of Increased Iodine Intake on Serum Thyrotropin: A Cross-Sectional, Chinese Nationwide Study. Thyroid 2020; 30:1810-1819. [PMID: 32762331 DOI: 10.1089/thy.2019.0842] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background: Subclinical hypothyroidism is diagnosed based on serum thyrotropin (TSH) reference intervals, which in turn are affected by many factors. Methods: Data were acquired from a Chinese nationally representative cross-sectional study of 78,470 participants (TIDE study). The total study population were participants from the TIDE program, and the reference population was a subset of the total population defined by the National Academy of Clinical Biochemistry (NACB) guidelines. Serum concentrations of thyroid hormones, TSH, thyroid antibodies, and urine iodine concentration (UIC) were measured. Results: The geometric mean serum TSH (2.5th-97.5th) for the reference population (defined by the NACB) and total population was 2.28 mIU/L (0.74-7.04 mIU/L) and 2.34 mIU/L (0.61-8.33 mIU/L), respectively. In the reference population, increase in UIC was significantly associated with increase in the 50th and 97.5th centiles and decrease in the 2.5th centile of TSH. The median TSH was significantly higher in women than in men (2.41 mIU/L vs. 2.16 mIU/L, p-value <0.001). Increased age was significantly associated with an increased TSH, 97.5th centile. For each 10-year increase in the population age, the TSH 97.5th centile increased by 0.534 mIU/L. The prevalence of subclinical hypothyroidism diagnosed according to the assay-recommended interval (Roche 0.27-4.2 mIU/L) and NACB standard interval in the TIDE study (0.74-7.04 mIU/L) differed significantly (Roche 13.61% vs. TIDE 3.00%, p < 0.05). However, there was no significant difference in future cardiovascular disease, reflected by the Framingham risk score, between the 0.27-4.2 and 4.2-7.04 mIU/L TSH groups. Conclusions: Serum TSH concentration significantly increased with increase in iodine intake. Thus, iodine intake must be considered in establishing TSH reference intervals. To avoid overdiagnosis and overtreatment of subclinical hypothyroidism, different areas should use individual serum TSH reference intervals.
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Affiliation(s)
- Lei Zhao
- Department of Endocrinology and Metabolism and The Institute of Endocrinology, The First Hospital of China Medical University, Shenyang, P.R. China
| | - Di Teng
- Department of Endocrinology and Metabolism and The Institute of Endocrinology, The First Hospital of China Medical University, Shenyang, P.R. China
| | - Xiaoguang Shi
- Department of Endocrinology and Metabolism and The Institute of Endocrinology, The First Hospital of China Medical University, Shenyang, P.R. China
| | - Yongze Li
- Department of Endocrinology and Metabolism and The Institute of Endocrinology, The First Hospital of China Medical University, Shenyang, P.R. China
| | - Jianming Ba
- Department of Endocrinology, Chinese PLA General Hospital, Beijing, P.R. China
| | - Bing Chen
- Department of Endocrinology, Southwest Hospital, Third Military Medical University, Chongqing, P.R. China
| | - Jianling Du
- Department of Endocrinology, The First Affiliated Hospital of Dalian Medical University, Dalian, P.R. China
| | - Lanjie He
- Department of Endocrinology, Cardiovascular and Cerebrovascular Disease Hospital of Ningxia Medical University, Yinchuan, P.R. China
| | - Xiaoyang Lai
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Nanchang University, Nanchang, P.R. China
| | - Yanbo Li
- Department of Endocrinology, The First Affiliated Hospital of Harbin Medical University, Harbin, P.R. China
| | - Haiyi Chi
- Department of Endocrinology, Hohhot First Hospital, Hohhot, P.R. China
| | - Eryuan Liao
- Department of Endocrinology and Metabolism, The Second Xiangya Hospital, Central South University, Changsha, P.R. China
| | - Chao Liu
- Research Center of Endocrine and Metabolic Diseases, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, P.R. China
| | - Libin Liu
- Department of Endocrinology and Metabolism, Fujian Institute of Endocrinology, Fujian Medical University Union Hospital, Fuzhou, P.R. China
| | - Guijun Qin
- Division of Endocrinology, Department of Internal Medicine, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, P.R. China
| | - Yingfen Qin
- Department of Endocrine, First Affiliated Hospital of Guangxi Medical University, Nanning, P.R. China
| | - Huibiao Quan
- Department of Endocrinology, Hainan General Hospital, Haikou, P.R. China
| | - Bingyin Shi
- Department of Endocrinology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, P.R. China
| | - Hui Sun
- Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Xulei Tang
- Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, P.R. China
| | - Nanwei Tong
- Department of Endocrinology and Metabolism, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, P.R. China
| | - Guixia Wang
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, P.R. China
| | - Jin-An Zhang
- Department of Endocrinology, Shanghai University of Medicine & Health Science Affiliated Zhoupu Hospital, Shanghai, P.R. China
| | - Youmin Wang
- Department of Endocrinology, The First Hospital of An Hui Medical University, Hefei, P.R. China
| | - Yuanming Xue
- Department of Endocrinology, The First People's Hospital of Yunnan Province, Kunming, P.R. China
| | - Li Yan
- Department of Endocrinology and Metabolism, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, P.R. China
| | - Jing Yang
- Department of Endocrinology, The First Hospital of Shanxi Medical University, Taiyuan, P.R. China
| | - Lihui Yang
- Department of Endocrinology and Metabolism, People's Hospital of Tibet Autonomous Region, Lhasa, P.R. China
| | - Yongli Yao
- Department of Endocrinology, Qinghai Provincial People's Hospital, Xining, P.R. China
| | - Zhen Ye
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, P.R. China
| | - Qiao Zhang
- Department of Endocrinology and Metabolism, Affiliated Hospital of Guiyang Medical University, Guiyang, P.R. China
| | - Lihui Zhang
- Department of Endocrinology, Second Hospital of Hebei Medical University, Shijiazhuang, P.R. China
| | - Jun Zhu
- Department of Endocrinology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, P.R. China
| | - Mei Zhu
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, P.R. China
| | - Zhongyan Shan
- Department of Endocrinology and Metabolism and The Institute of Endocrinology, The First Hospital of China Medical University, Shenyang, P.R. China
| | - Weiping Teng
- Department of Endocrinology and Metabolism and The Institute of Endocrinology, The First Hospital of China Medical University, Shenyang, P.R. China
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