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Kapper C, Oppelt P, Ganhör C, Gyunesh AA, Arbeithuber B, Stelzl P, Rezk-Füreder M. Minerals and the Menstrual Cycle: Impacts on Ovulation and Endometrial Health. Nutrients 2024; 16:1008. [PMID: 38613041 PMCID: PMC11013220 DOI: 10.3390/nu16071008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 04/14/2024] Open
Abstract
The role of minerals in female fertility, particularly in relation to the menstrual cycle, presents a complex area of study that underscores the interplay between nutrition and reproductive health. This narrative review aims to elucidate the impacts of minerals on key aspects of the reproductive system: hormonal regulation, ovarian function and ovulation, endometrial health, and oxidative stress. Despite the attention given to specific micronutrients in relation to reproductive disorders, there is a noticeable absence of a comprehensive review focusing on the impact of minerals throughout the menstrual cycle on female fertility. This narrative review aims to address this gap by examining the influence of minerals on reproductive health. Each mineral's contribution is explored in detail to provide a clearer picture of its importance in supporting female fertility. This comprehensive analysis not only enhances our knowledge of reproductive health but also offers clinicians valuable insights into potential therapeutic strategies and the recommended intake of minerals to promote female reproductive well-being, considering the menstrual cycle. This review stands as the first to offer such a detailed examination of minerals in the context of the menstrual cycle, aiming to elevate the understanding of their critical role in female fertility and reproductive health.
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Affiliation(s)
- Celine Kapper
- Experimental Gynaecology, Obstetrics and Gynaecological Endocrinology, Johannes Kepler University Linz, Altenberger Strasse 69, 4040 Linz, Austria; (C.K.); (P.O.); (B.A.)
| | - Peter Oppelt
- Experimental Gynaecology, Obstetrics and Gynaecological Endocrinology, Johannes Kepler University Linz, Altenberger Strasse 69, 4040 Linz, Austria; (C.K.); (P.O.); (B.A.)
- Department for Gynaecology, Obstetrics and Gynaecological Endocrinology, Kepler University Hospital, Johannes Kepler University Linz, 4020 Linz, Austria
| | - Clara Ganhör
- Division of Pathophysiology, Institute of Physiology and Pathophysiology, Medical Faculty, Johannes Kepler University Linz, 4020 Linz, Austria
- Clinical Research Institute for Cardiovascular and Metabolic Diseases, Medical Faculty, Johannes Kepler University Linz, 4020 Linz, Austria
| | - Ayberk Alp Gyunesh
- Experimental Gynaecology, Obstetrics and Gynaecological Endocrinology, Johannes Kepler University Linz, Altenberger Strasse 69, 4040 Linz, Austria; (C.K.); (P.O.); (B.A.)
| | - Barbara Arbeithuber
- Experimental Gynaecology, Obstetrics and Gynaecological Endocrinology, Johannes Kepler University Linz, Altenberger Strasse 69, 4040 Linz, Austria; (C.K.); (P.O.); (B.A.)
| | - Patrick Stelzl
- Department for Gynaecology, Obstetrics and Gynaecological Endocrinology, Kepler University Hospital, Johannes Kepler University Linz, 4020 Linz, Austria
| | - Marlene Rezk-Füreder
- Experimental Gynaecology, Obstetrics and Gynaecological Endocrinology, Johannes Kepler University Linz, Altenberger Strasse 69, 4040 Linz, Austria; (C.K.); (P.O.); (B.A.)
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Mathews DM, Peart JM, Sim RG, Johnson NP, O'Sullivan S, Derraik JGB, Hofman PL. Response to Letter to the Editor From Marin et al: "The SELFI Study: Iodine Excess and Thyroid Dysfunction in Women Undergoing Oil-Soluble Contrast Hysterosalpingography". J Clin Endocrinol Metab 2023; 108:e902-e903. [PMID: 36948881 PMCID: PMC10438866 DOI: 10.1210/clinem/dgad169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 03/17/2023] [Indexed: 03/24/2023]
Affiliation(s)
- Divya M Mathews
- Liggins Institute, University of Auckland, Auckland 1142, New Zealand
| | - Jane M Peart
- Department of Radiology, Auckland Radiology Group, Auckland 1050, New Zealand
| | - Robert G Sim
- Department of Radiology, Auckland Radiology Group, Auckland 1050, New Zealand
| | - Neil P Johnson
- Department of Obstetrics and Gynecology, Robinson Research Institute, University of Adelaide, Adelaide, South Australia 5006, Australia
- Department of Reproductive Endocrinology and Fertility, Repromed Auckland and Auckland Gynecology Group, Auckland 1050, New Zealand
| | - Susannah O'Sullivan
- Department of Endocrinology, Greenlane Clinical Centre, Auckland District Health Board, Auckland 1051, New Zealand
| | - José G B Derraik
- Liggins Institute, University of Auckland, Auckland 1142, New Zealand
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland 1023, New Zealand
| | - Paul L Hofman
- Liggins Institute, University of Auckland, Auckland 1142, New Zealand
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Optimizing Growth: The Case for Iodine. Nutrients 2023; 15:nu15040814. [PMID: 36839172 PMCID: PMC9959690 DOI: 10.3390/nu15040814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/29/2023] [Accepted: 02/03/2023] [Indexed: 02/08/2023] Open
Abstract
Iodine is an essential micronutrient and component of thyroid hormone. An adequate dietary iodine intake is critical to maintain and promote normal growth and development, especially during vulnerable life stages such as pregnancy and early infancy. The role of iodine in cognitive development is supported by numerous interventional and observational studies, and when iodine intake is too low, somatic growth is also impaired. This can be clearly seen in cases of untreated congenital hypothyroidism related to severe iodine deficiency, which is characterized, in part, by a short stature. Nevertheless, the impact of a less severe iodine deficiency on growth, whether in utero or postnatal, is unclear. Robust studies examining the relationship between iodine and growth are rarely feasible, including the aspect of examining the effect of a single micronutrient on a process that is reliant on multiple nutrients for optimal success. Conversely, excessive iodine intake can affect thyroid function and the secretion of optimal thyroid hormone levels; however, whether this affects growth has not been examined. This narrative review outlines the mechanisms by which iodine contributes to the growth process from conception onwards, supported by evidence from human studies. It emphasizes the need for adequate iodine public health policies and their robust monitoring and surveillance, to ensure coverage for all population groups, particularly those at life stages vulnerable for growth. Finally, it summarizes the other micronutrients important to consider alongside iodine when seeking to assess the impact of iodine on somatic growth.
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Deepak Kumar K, Huntriss R, Green E, Bora S, Pettitt C. Development of a nutrition screening tool to identify need for dietetic intervention in female infertility. J Hum Nutr Diet 2023; 36:154-168. [PMID: 35762584 PMCID: PMC10087620 DOI: 10.1111/jhn.13055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 06/11/2022] [Accepted: 06/13/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND One in seven couples are impacted by infertility in the UK, and female infertility is often associated with several health conditions impacted by nutrition. Despite many studies aimed at identifying the critical role of nutrition in infertility, there is currently no screening tool that identifies nutritional risk factors for infertility. AIM To propose a self-administered screening tool to identify women who would benefit from nutritional intervention to promote fertility. METHODS A narrative review was carried out to identify and summarise modifiable nutritional risk factors that can influence female fertility, including comorbidities that can influence nutrition intake, absorption, and metabolism. KEY FINDINGS A nutrition screening tool outlining modifiable nutrition risk factors potentially improving female fertility has been proposed, comprising of BMI, medical history and quality of diet and lifestyle which would aid in designing evidence based dietetic services for female infertility.
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Affiliation(s)
| | | | | | | | - Claire Pettitt
- Nutrition and Dietetic Research Group, Faculty of Medicine, Imperial College London, UK
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Cannas A, Rayman MP, Kolokotroni O, Bath SC. Iodine status of pregnant women from the Republic of Cyprus. Br J Nutr 2023; 129:126-134. [PMID: 35236523 PMCID: PMC9816652 DOI: 10.1017/s0007114522000617] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 02/08/2022] [Accepted: 02/18/2022] [Indexed: 01/21/2023]
Abstract
Iodine supply is crucial during pregnancy to ensure that the proper thyroid function of mother and baby support fetal brain development. Little is known about iodine status or its dietary determinants in pregnant women in the Republic of Cyprus. We therefore recruited 128 pregnant women at their first-trimester ultrasound scan to a cross-sectional study. We collected spot-urine samples for the measurement of urinary iodine concentration (UIC, µg/l) and creatinine concentration (Creat, g/l), the latter of which allows us to correct for urine dilution and to compute the iodine-to-creatinine ratio (UI/Creat). Women completed a FFQ and a general questionnaire. We used a General Linear model to explore associations between maternal and dietary characteristics with UI/Creat. The median UIC (105 µg/l) indicated iodine deficiency according to the WHO criterion (threshold for adequacy = 150 µg/l), and the UI/Creat was also low at 107 µg/g. Only 32 % (n 45) of women reported the use of iodine-containing supplements; users had a higher UI/Creat than non-users (131 µg/g v. 118 µg/g), though this difference was NS in the adjusted analysis (P = 0·37). Of the dietary components, only egg intake was significantly associated with a higher UI/Creat in adjusted analyses (P = 0·018); there was no significant association with milk, dairy products or fish intake. Our results suggest that pregnant women in Cyprus have inadequate iodine status and are at risk of mild-to-moderate iodine deficiency. Further research on dietary sources in this population is required.
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Affiliation(s)
- Andrea Cannas
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, GU2 7XH, UK
| | - Margaret P. Rayman
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, GU2 7XH, UK
| | - Ourania Kolokotroni
- Department of Primary Care and Population Health, University of Nicosia, Medical School, Nicosia, 1700, Cyprus
| | - Sarah C. Bath
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, GU2 7XH, UK
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Ku CW, Ku CO, Tay LPC, Xing HK, Cheung YB, Godfrey KM, Colega MT, Teo C, Tan KML, Chong YS, Shek LPC, Tan KH, Chan SY, Lim SX, Chong MFF, Yap F, Chan JKY, Loy SL. Dietary Supplement Intake and Fecundability in a Singapore Preconception Cohort Study. Nutrients 2022; 14:nu14235110. [PMID: 36501137 PMCID: PMC9739604 DOI: 10.3390/nu14235110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/21/2022] [Accepted: 11/30/2022] [Indexed: 12/03/2022] Open
Abstract
Subfertility is a global problem affecting millions worldwide, with declining total fertility rates. Preconception dietary supplementation may improve fecundability, but the magnitude of impact remains unclear. This prospective cohort study aimed to examine the association of preconception micronutrient supplements with fecundability, measured by time to pregnancy (TTP). The study was conducted at KK Women's and Children's Hospital, Singapore, between February 2015 and October 2017, on 908 women aged 18-45 years old, who were trying to conceive and were enrolled in the Singapore PREconception Study of long-Term maternal and child Outcomes (S-PRESTO). Baseline sociodemographic characteristics and supplement intake were collected through face-to-face interviews. The fecundability ratio (FR) was estimated using discrete-time proportional hazard modelling. Adjusting for potentially confounding variables, folic acid (FA) (FR 1.26, 95% confidence interval 1.03-1.56) and iodine (1.28, 1.00-1.65) supplement users had higher fecundability compared to non-users. Conversely, evening primrose oil supplement users had lower fecundability (0.56, 0.31-0.99) than non-users. In this study, preconception FA and iodine supplementation were associated with shortened TTP, while evening primrose oil use was associated with longer TTP. Nonetheless, the association between supplement use and the magnitude of fecundability changes will need to be further confirmed with well-designed randomised controlled trials.
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Affiliation(s)
- Chee Wai Ku
- Department of Reproductive Medicine, KK Women’s and Children’s Hospital, Singapore 229899, Singapore
- Duke-NUS Medical School, Singapore 169857, Singapore
| | - Chee Onn Ku
- Faculty of Science, National University of Singapore, Singapore 117546, Singapore
| | - Liza Pui Chin Tay
- Department of Obstetrics and Gynaecology, KK Women’s and Children’s Hospital, Singapore 229899, Singapore
| | - Hui Kun Xing
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Yin Bun Cheung
- Program in Health Services & Systems Research and Center for Quantitative Medicine, Duke-NUS Medical School, Singapore 169857, Singapore
- Tampere Center for Child, Adolescent and Maternal Health Research, Tampere University, 33014 Tampere, Finland
| | - Keith M. Godfrey
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton SO16 6YD, UK
- National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton SO16 6YD, UK
| | - Marjorelee T. Colega
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore 117609, Singapore
| | - Cherlyen Teo
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore 117609, Singapore
| | - Karen Mei Ling Tan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore 117609, Singapore
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore 117609, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore 119228, Singapore
| | - Lynette Pei-Chi Shek
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore 117609, Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore 119228, Singapore
- Khoo Teck Puat-National University Children’s Medical Institute, National University Hospital, National University Health System, Singapore 119074, Singapore
| | - Kok Hian Tan
- Duke-NUS Medical School, Singapore 169857, Singapore
- Department of Maternal Fetal Medicine, KK Women’s and Children’s Hospital, Singapore 229899, Singapore
| | - Shiao-Yng Chan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore 117609, Singapore
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore 119228, Singapore
| | - Shan Xuan Lim
- Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore 117549, Singapore
| | - Mary Foong-Fong Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore 117609, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore 117549, Singapore
| | - Fabian Yap
- Duke-NUS Medical School, Singapore 169857, Singapore
- Department of Paediatrics, KK Women’s and Children’s Hospital, Singapore 229899, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 636921, Singapore
| | - Jerry Kok Yen Chan
- Department of Reproductive Medicine, KK Women’s and Children’s Hospital, Singapore 229899, Singapore
- Duke-NUS Medical School, Singapore 169857, Singapore
- Correspondence:
| | - See Ling Loy
- Department of Reproductive Medicine, KK Women’s and Children’s Hospital, Singapore 229899, Singapore
- Duke-NUS Medical School, Singapore 169857, Singapore
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Konishi S, Mizuno Y. Pre-Conceptional Anti-Thyroid Antibodies and Thyroid Function in Association with Natural Conception Rates. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13177. [PMID: 36293757 PMCID: PMC9603695 DOI: 10.3390/ijerph192013177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023]
Abstract
Thyroid functioning is an integral part of the endocrine system that supports conception and pregnancy. Frequent consumption of seafood and iodine by Japanese people may adversely affect their thyroid function. Thus, in this study, we aimed to analyze the associations between iodine intake, thyroid hormones, autoimmunity, and natural conception rates in Japanese women trying to conceive their first child. A prospective study of 24 weeks targeted 80 women with no history of infertility, who did not plan to undergo fertility treatment. Concentrations of urinary iodine concentration and thyroid biomarkers in the serum at enrollment were measured. Thirty-five women naturally conceived during the follow-up. The median (inter-quartile range) urinary concentration of iodine was 297 (165, 500) μg/L. Free triiodothyronine (T3) and free thyroxin (T4) negatively correlated with urinary iodine concentrations. Women with anti-thyroid peroxidase (anti-TPO) ≥ 16 IU/mL had lower conception rates (hazard ratio: 0.28, 95% confidence interval, 0.08-0.92) compared with those with anti-TPO < 16 IU/mL, after adjusting for age and coital frequency. None of anti-thyroglobulin antibody, free T3, free T4, or thyroid-stimulating hormone showed significant associations with conception rate after adjusting for age and coital frequency. The negative association between thyroid autoimmunity and natural conception rates warrants further investigation.
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Cui X, Yu H, Wang Z, Wang H, Shi Z, Jin W, Song Q, Guo C, Tang H, Zang J. No Association Was Found Between Mild Iodine Deficiency During Pregnancy and Pregnancy Outcomes: a Follow-up Study Based on a Birth Registry. Biol Trace Elem Res 2022; 200:4267-4277. [PMID: 34988930 PMCID: PMC9439975 DOI: 10.1007/s12011-021-03028-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 11/11/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Severe iodine deficiency during gestation is associated with adverse pregnancy outcomes; however, the impact of mild-to-moderate iodine deficiency, though prevalent in pregnancy, remains unclear. METHODS We extracted follow-up data for 7435 pregnant women from a national iodine deficiency disorders monitoring program from 2016 to 2018 and a mother-child cohort study in 2017 based on a birth registry in Shanghai. Birth outcomes were collected from the registry. Spot urine and household salt samples were collected for iodine testing. Single-factor analysis and logistic regression were used to evaluate the association between maternal iodine status and pregnancy outcomes. RESULTS The median urine iodine level in pregnant women was 137.5 μg/L (interquartile range 82.4-211.5), suggesting mild deficiency according to WHO standards. The incidence of pregnancy termination, preterm birth, congenital malformations, low birth weight, and cesarean section was 3.2%, 4.3%, 1.4%, 2.7%, and 45.2% in the mildly iodine-deficient group and 3.4%, 4.5%, 1.4%, 2.7%, and 44.5% in the normal group, respectively. After adjusting for maternal age and education, trimesters, and preterm birth rate in the general population, the odds ratios for any outcome did not differ significantly between the two groups. CONCLUSION The present study suggests that mild maternal iodine deficiency is not associated with adverse pregnancy outcomes.
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Affiliation(s)
- Xueying Cui
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336 China
| | - Huiting Yu
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336 China
| | - Zhengyuan Wang
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336 China
| | - Hai Wang
- Shanghai University of Traditional Chinese Medicine, Shanghai, 201203 China
| | - Zehuan Shi
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336 China
| | - Wei Jin
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336 China
| | - Qi Song
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336 China
| | - Changyi Guo
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336 China
| | - Hongmei Tang
- Minhang District Center for Disease Control and Prevention, Shanghai, 201101 China
| | - Jiajie Zang
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336 China
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Roest I, Hajiyavand AM, Bongers MY, Mijatovic V, Mol BWJ, Koks CAM, Dearn KD. What is the fertility-enhancing effect of tubal flushing? A hypothesis article. J OBSTET GYNAECOL 2022; 42:1619-1625. [DOI: 10.1080/01443615.2022.2054679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Inez Roest
- Department of Obstetrics and Gynaecology, Máxima MC, Veldhoven, Eindhoven, The Netherlands
- Department of Reproductive Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Reproduction and Development, Amsterdam, The Netherlands
- Grow Research School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
| | - Amir M. Hajiyavand
- Department of Mechanical Engineering, School of Engineering, Mechanical Innovation and Tribology Group, University of Birmingham, Birmingham, UK
| | - Marlies Y. Bongers
- Department of Obstetrics and Gynaecology, Máxima MC, Veldhoven, Eindhoven, The Netherlands
- Grow Research School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
| | - Velja Mijatovic
- Department of Reproductive Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Reproduction and Development, Amsterdam, The Netherlands
| | - Ben Willem J. Mol
- Department of Obstetrics and Gynaecology, University of Monash, Melbourne, Australia
| | - Carolien A. M. Koks
- Department of Obstetrics and Gynaecology, Máxima MC, Veldhoven, Eindhoven, The Netherlands
| | - Karl D. Dearn
- Department of Mechanical Engineering, School of Engineering, Mechanical Innovation and Tribology Group, University of Birmingham, Birmingham, UK
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Essentiality of Trace Elements in Pregnancy, Fertility, and Gynecologic Cancers-A State-of-the-Art Review. Nutrients 2021; 14:nu14010185. [PMID: 35011060 PMCID: PMC8746721 DOI: 10.3390/nu14010185] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 12/23/2021] [Accepted: 12/28/2021] [Indexed: 12/18/2022] Open
Abstract
Gynecological neoplasms pose a serious threat to women's health. It is estimated that in 2020, there were nearly 1.3 million new cases worldwide, from which almost 50% ended in death. The most commonly diagnosed are cervical and endometrial cancers; when it comes to infertility, it affects ~48.5 million couples worldwide and the number is continually rising. Ageing of the population, environmental factors such as dietary habits, environmental pollutants and increasing prevalence of risk factors may affect the reproductive potential in women. Therefore, in order to identify potential risk factors for these issues, attention has been drawn to trace elements. Trace mineral imbalances can be caused by a variety of causes, starting with hereditary diseases, finishing with an incorrect diet or exposure to polluted air or water. In this review, we aimed to summarize the current knowledge regarding trace elements imbalances in the case of gynecologic cancers as well as female fertility and during pregnancy.
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Galvão VE, Cavalli RC, Sandrim VC. Preeclampsia and Gestational Hypertension: Biochemical and Antioxidant Features in Vitro Might Help Understand Different Outcomes. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2021; 43:894-903. [PMID: 34933382 PMCID: PMC10183867 DOI: 10.1055/s-0041-1740270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE Gestational hypertension (GH) is characterized by increased blood pressure after the 20th gestational week; the presence of proteinuria and/or signs of end-organ damage indicate preeclampsia (PE). Heme oxygenase-1 (HO-1) is an antioxidant enzyme with an important role in maintaining endothelial function, and induction of HO-1 by certain molecules shows potential in attenuating the condition's effects over endothelial tissue. HO-1 production can also be stimulated by potassium iodide (KI). Therefore, we evaluated the effects of KI over HO-1 expression in human umbilical vein endothelial cells (HUVECs) incubated with plasma from women diagnosed with GH or PE. METHODS Human umbilical vein endothelial cells were incubated with a pool of plasma of healthy pregnant women (n = 12), pregnant women diagnosed with GH (n = 10) or preeclamptic women (n = 11) with or without the addition of KI for 24 hours to evaluate its effect on this enzyme expression. Analysis of variance was performed followed by Dunnet's test for multiple comparisons between groups only or between groups with addition of KI (p ≤ 0.05). RESULTS KI solution (1,000 µM) reduced HO-1 in the gestational hypertension group (p = 0.0018) and cytotoxicity in the preeclamptic group (p = 0.0143); treatment with KI reduced plasma cytotoxicity but did not affect the preeclamptic group's HO-1 expression. CONCLUSION Our findings suggest that KI alleviates oxidative stress leading to decreased HO-1 expression; plasma from preeclamptic women did not induce the enzyme's expression in HUVECs, and we hypothesize that this is possibly due to inhibitory post-transcriptional mechanisms in response to overexpression of this enzyme during early pregnancy.
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Affiliation(s)
- Victoria Elizabeth Galvão
- Department of Pharmacology, Instituto de Biociências, Universidade Estadual Paulista, Botucatu, SP, Brazil
| | - Ricardo Carvalho Cavalli
- Department of Obstetrics and Gynecology, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Valeria Cristina Sandrim
- Department of Pharmacology, Instituto de Biociências, Universidade Estadual Paulista, Botucatu, SP, Brazil.,Center for Toxicological Assistance, Instituto de Biociências, Universidade Estadual Paulista, Botucatu, SP, Brazil
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Sorrenti S, Baldini E, Pironi D, Lauro A, D’Orazi V, Tartaglia F, Tripodi D, Lori E, Gagliardi F, Praticò M, Illuminati G, D’Andrea V, Palumbo P, Ulisse S. Iodine: Its Role in Thyroid Hormone Biosynthesis and Beyond. Nutrients 2021; 13:nu13124469. [PMID: 34960019 PMCID: PMC8709459 DOI: 10.3390/nu13124469] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/13/2021] [Accepted: 12/14/2021] [Indexed: 11/16/2022] Open
Abstract
The present review deals with the functional roles of iodine and its metabolism. The main biological function of iodine concerns its role in the biosynthesis of thyroid hormones (THs) by the thyroid gland. In addition, however, further biological roles of iodine have emerged. Precisely, due to its significant action as scavenger of reactive oxygen species (ROS), iodine is thought to represent one of the oldest antioxidants in living organisms. Moreover, iodine oxidation to hypoiodite (IO−) has been shown to possess strong bactericidal as well as antiviral and antifungal activity. Finally, and importantly, iodine has been demonstrated to exert antineoplastic effects in human cancer cell lines. Thus, iodine, through the action of different tissue-specific peroxidases, may serve different evolutionarily conserved physiological functions that, beyond TH biosynthesis, encompass antioxidant activity and defense against pathogens and cancer progression.
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Skoracka K, Ratajczak AE, Rychter AM, Dobrowolska A, Krela-Kaźmierczak I. Female Fertility and the Nutritional Approach: The Most Essential Aspects. Adv Nutr 2021; 12:2372-2386. [PMID: 34139003 PMCID: PMC8634384 DOI: 10.1093/advances/nmab068] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/19/2021] [Accepted: 05/05/2021] [Indexed: 12/17/2022] Open
Abstract
Infertility is an increasing problem that affects couples attempting pregnancy. A growing body of evidence points to a link between diet and female fertility. In fact, data show that a diet high in trans fats, refined carbohydrates, and added sugars can negatively affect fertility. Conversely, a diet based on the Mediterranean dietary patterns, i.e., rich in dietary fiber, omega-3 (ɷ-3) fatty acids, plant-based protein, and vitamins and minerals, has a positive impact on female fertility. An unhealthy diet can disrupt microbiota composition, and it is worth investigating whether the composition of the gut microbiota correlates with the frequency of infertility. There is a lack of evidence to exclude gluten from the diet of every woman trying to become pregnant in the absence of celiac disease. Furthermore, there are no data concerning adverse effects of alcohol on female fertility, and caffeine consumption in the recommended amounts also does not seem to affect fertility. On the other hand, phytoestrogens presumably have a positive influence on female fertility. Nevertheless, there are many unanswered questions with regard to supplementation in order to enhance fertility. It has been established that women of childbearing age should supplement folic acid. Moreover, most people experience vitamin D and iodine deficiency; thus, it is vital to control their blood concentrations and consider supplementation if necessary. Therefore, since diet and lifestyle seem to be significant factors influencing fertility, it is valid to expand knowledge in this area.
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Affiliation(s)
- Kinga Skoracka
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, the Heliodor Swiecicki Hospital, Poznan, Poland
| | - Alicja Ewa Ratajczak
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, the Heliodor Swiecicki Hospital, Poznan, Poland
| | - Anna Maria Rychter
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, the Heliodor Swiecicki Hospital, Poznan, Poland
| | - Agnieszka Dobrowolska
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, the Heliodor Swiecicki Hospital, Poznan, Poland
| | - Iwona Krela-Kaźmierczak
- Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, the Heliodor Swiecicki Hospital, Poznan, Poland
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14
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Low Iodine Intake May Decrease Women's Fecundity: A Population-Based Cross-Sectional Study. Nutrients 2021; 13:nu13093056. [PMID: 34578933 PMCID: PMC8467427 DOI: 10.3390/nu13093056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 08/20/2021] [Accepted: 08/26/2021] [Indexed: 12/27/2022] Open
Abstract
Salt iodization is one of the most cost-effective strategies to eliminate iodine deficiency disorders (IDD). However, China’s dismantling of salt monopoly has reduced the availability of iodized salt in the susceptible population in pregnancy, which might cause IDD and have adverse health effects on both themselves and their offspring. The aim of our study was therefore to explore the association between IDD and women’s reproductive health. This is a population-based cross-sectional study conducted in 2018 in Zhejiang Province, China. A total of 1653 pregnant women participated in this study. Median urinary iodine concentration (UIC) in the population was used to assess iodine intake. Cox regression analyses were used to estimate the association between iodine intake and time to pregnancy, which was indicated with fecundability ratio (FR) and 95% confidence interval (CI). The percentage of participants with iodine deficiency who had been waiting longer than 13 months to get pregnant (20%; median UIC 119.6 μg/L) was significantly higher than those with iodine sufficiency (14%; median UIC 147.1 μg/L). A significant decrease in fecundity was observed in participants with iodine deficiency (FR, 0.820; 95% CI, 0.725−0.929) than those with iodine sufficiency. These findings indicate the importance of ongoing monitoring of iodine nutrition in women of reproductive age. Keeping a safe and optimal level of iodine nutrition during pregnancy should be emphasized.
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Deischinger C, Deischinger D, Gessl I, Krebs M, Marculescu R, Kautzky-Willer A, Kosi-Trebotic L. Oral Contraceptive Intake and Iodine Status in Young Women. ANNALS OF NUTRITION AND METABOLISM 2021; 77:231-235. [PMID: 34350850 DOI: 10.1159/000518135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 06/15/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Similar to pregnant women, women taking an oral contraceptive (OC) might have elevated iodine requirements due to the altered hormonal state. This is the first study aimed at investigating the prevalence of iodine deficiency and possible influences of OC intake on urine creatinine and iodine levels in young women. METHODS One hundred fifty-five women between the age of 18 and 35 years (62 taking an OC and 93 controls) participated in a cross-sectional pilot study at the Medical University of Vienna, which included a 1-spot urine sample and a questionnaire on OC intake as well as a food questionnaire. RESULTS The median urinary iodine concentration (UIC) in this study was 68 μg/L (41, 111 μg/L) suggesting an inadequate iodine status in the women according to the WHO guidelines. Median UIC (OC: 89 μg/L, IQR 55-120; control: 59 μg/L, IQR 39-91, p = 0.010) and urine creatinine (OC: median = 99.0 μg/L, IQR 74.9-175.5; control: 77.0 μg/L, IQR 49.6-147.2, p = 0.030) levels were significantly higher in OC women than in the control group. UIC corrected for urine creatinine was comparable between both groups. CONCLUSION With similar creatinine-corrected UICs in both groups, OC intake might not have a significant impact on iodine status. However, the low median UIC in a vulnerable group of young women potentially conceiving in the following years points at the necessity of optimizing the iodine intake in the Austrian population and reiterates the insufficiency of the current iodine supplementation measures.
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Affiliation(s)
- Carola Deischinger
- Clinical Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Unit of Gender Medicine, Vienna, Austria
| | - Doris Deischinger
- Clinical Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Unit of Gender Medicine, Vienna, Austria
| | - Irina Gessl
- Clinical Division of Rheumatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Michael Krebs
- Clinical Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Unit of Gender Medicine, Vienna, Austria
| | - Rodrig Marculescu
- Clinical Institute for Medical and Chemical Laboratory Diagnostics, Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Alexandra Kautzky-Willer
- Clinical Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Unit of Gender Medicine, Vienna, Austria
| | - Lana Kosi-Trebotic
- Clinical Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Unit of Gender Medicine, Vienna, Austria
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16
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Iron, iodine and vitamin D deficiencies during pregnancy: epidemiology, risk factors and developmental impacts. Proc Nutr Soc 2021; 80:290-302. [PMID: 33988109 DOI: 10.1017/s0029665121001944] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Micronutrient deficiency persists throughout the world, and although the burden is higher in low-resource settings, it is also prevalent in wealthy countries, a phenomenon termed 'hidden hunger'. Due to their high requirements for vitamins and minerals relative to their energy intake, young women and children are particularly vulnerable to hidden hunger. As they share several risk factors and impact on overlapping outcomes, we consider how deficiency of iron, iodine and vitamin D can have profound impacts on perinatal health and infant development. We review the epidemiology of these micronutrient deficiencies during pregnancy, including social, environmental and dietary risk factors. We identify the main challenges in defining nutritional status of these nutrients using validated diagnostic criteria linked with meaningful clinical outcomes. Public health strategies are urgently required to improve the overall health and nutritional status of women of reproductive age. Obesity prevention and early detection of malnutrition with standardised screening methods would detect pregnant women at increased risk of iron deficiency. Development of sensitive, individual biomarkers of iodine status is required to protect maternal health and fetal/infant brain development. Risk assessments of vitamin D requirements during pregnancy need to be revisited from the perspective of fetal and neonatal requirements. International consensus on standardised approaches to micronutrient assessment, analysis and reporting as well as sensitive, clinically validated infant and child neuro-behavioural outcomes will enable progression of useful observational and intervention studies.
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17
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Mathews DM, Johnson NP, Sim RG, O'Sullivan S, Peart JM, Hofman PL. Iodine and fertility: do we know enough? Hum Reprod 2021; 36:265-274. [PMID: 33289034 DOI: 10.1093/humrep/deaa312] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 09/30/2020] [Indexed: 02/01/2023] Open
Abstract
Iodine is a vital micronutrient and its importance in thyroid function is well established. However, abnormalities in iodine intake may also have other effects. In particular, iodine is taken up avidly by the ovary and endometrium. Iodine deficiency is associated with reduced fertility. The use of high iodine concentration contrast media has recently been shown to improve conception rates in couples with unexplained infertility (UI). We hypothesize that this improvement could be related to the iodine excess and mechanisms independent of its action on thyroid. In this article, the metabolism of iodine and its potential role in fertility will be discussed, including the impact of both iodine deficiency and excess states and the importance of iodine in normal fetal development. This will include insights from animal studies on the effect of iodine in the uterine and ovarian structural environment, hormonal milieu and immunological factors affecting implantation. We speculate that iodine may well have a role as a potential therapy for UI.
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Affiliation(s)
- Divya M Mathews
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Neil P Johnson
- Robinson Research Institute, University of Adelaide, Australia and University of Auckland & Repromed Auckland, Auckland, New Zealand
| | | | - Susannah O'Sullivan
- Endocrinology, Greenlane Clinical Centre, Auckland District Health Board, Auckland, New Zealand
| | | | - Paul L Hofman
- Liggins Institute, University of Auckland, Auckland, New Zealand
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18
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Luo J, Li C, Zhang X, Shan Z, Teng W. Reference Intervals of the Ratio of Urine Iodine to Creatinine in Pregnant Women in an Iodine-Replete Area of China. Biol Trace Elem Res 2021; 199:62-69. [PMID: 32249377 DOI: 10.1007/s12011-020-02133-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 03/25/2020] [Indexed: 11/28/2022]
Abstract
The assessment method of iodine nutrition for pregnant women lacks strong evidence-based medicine. The prevalence of iodine deficiency in pregnant women may be overestimated using urinary iodine concentration (UIC). The reference intervals of UIC-to-urinary creatinine concentration ratio (UIC/UCr) were established using a self-sequential longitudinal study of pregnant women with singleton gestation who were recruited using the criteria of the National Academy of Clinical Biochemistry in Dandong City, which is a long-term iodine-replete area. Nine thousand one hundred sixty-four pregnant women in the first trimester from Dalian City, Dandong City, and Shenyang City were included to verify our proposed reference intervals. UIC and concentrations of urinary creatinine, serum iodine, TSH, FT4, TPOAb, and TgAb were measured. The reference intervals of UIC/UCr were 38.63-489.46 μg/g for the first trimester, 58.48-644.03 μg/g for the second trimester, and 56.27-644.93 μg/g for the third trimester. The prevalence of iodine deficiency was 49.50% using UIC as the indicator (< 150 μg/L), while the prevalence was 3.28% using UIC/UCr (< 38.63 μg/g). The prevalence of iodine excess was 3.21% using UIC as the indicator (> 500 μg/L) while the prevalence was 1.45% using UIC/UCr (> 489.46 μg/g). The highest prevalence of overt hypothyroidism and positive thyroid antibodies was in the group with UIC/UCr < 38.63 μg/g. In contrast to the place of residence and age, BMI was an influencing factor for UIC/UCr. The reference intervals of UIC/UCr were established. UIC/UCr may eliminate the effect of urine volume and reflect the actual prevalence of iodine deficiency in pregnant women.
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Affiliation(s)
- Jingyi Luo
- Department of Endocrinology and Metabolism and the Institute of Endocrinology, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China
| | - Chenyan Li
- Department of Endocrinology and Metabolism and the Institute of Endocrinology, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China
| | - Xiaomei Zhang
- Department of Endocrinology and Metabolism, Peking University International Hospital, Beijing, 100000, People's Republic of China
| | - Zhongyan Shan
- Department of Endocrinology and Metabolism and the Institute of Endocrinology, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China
| | - Weiping Teng
- Department of Endocrinology and Metabolism and the Institute of Endocrinology, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China.
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19
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Abel MH, Caspersen IH, Sengpiel V, Jacobsson B, Meltzer HM, Magnus P, Alexander J, Brantsæter AL. Insufficient maternal iodine intake is associated with subfecundity, reduced foetal growth, and adverse pregnancy outcomes in the Norwegian Mother, Father and Child Cohort Study. BMC Med 2020; 18:211. [PMID: 32778101 PMCID: PMC7418397 DOI: 10.1186/s12916-020-01676-w] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 06/23/2020] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Severe iodine deficiency impacts fertility and reproductive outcomes. The potential effects of mild-to-moderate iodine deficiency are not well known. The aim of this study was to examine whether iodine intake was associated with subfecundity (i.e. > 12 months trying to get pregnant), foetal growth, and adverse pregnancy outcomes in a mild-to-moderately iodine-deficient population. METHODS We used the Norwegian Mother, Father and Child Cohort Study (MoBa) and included 78,318 pregnancies with data on iodine intake and pregnancy outcomes. Iodine intake was calculated using an extensive food frequency questionnaire in mid-pregnancy. In addition, urinary iodine concentration was available in a subsample of 2795 pregnancies. Associations were modelled continuously by multivariable regression controlling for a range of confounding factors. RESULTS The median iodine intake from food was 121 μg/day and the median urinary iodine was 69 μg/L, confirming mild-to-moderate iodine deficiency. In non-users of iodine supplements (n = 49,187), low iodine intake (< 100-150 μg/day) was associated with increased risk of preeclampsia (aOR = 1.14 (95% CI 1.08, 1.22) at 75 vs. 100 μg/day, p overall < 0.001), preterm delivery before gestational week 37 (aOR = 1.10 (1.04, 1.16) at 75 vs. 100 μg/day, p overall = 0.003), and reduced foetal growth (- 0.08 SD (- 0.10, - 0.06) difference in birth weight z-score at 75 vs. 150 μg/day, p overall < 0.001), but not with early preterm delivery or intrauterine death. In planned pregnancies (n = 56,416), having an iodine intake lower than ~ 100 μg/day was associated with increased prevalence of subfecundity (aOR = 1.05 (1.01, 1.09) at 75 μg/day vs. 100 μg/day, p overall = 0.005). Long-term iodine supplement use (initiated before pregnancy) was associated with increased foetal growth (+ 0.05 SD (0.03, 0.07) on birth weight z-score, p < 0.001) and reduced risk of preeclampsia (aOR 0.85 (0.74, 0.98), p = 0.022), but not with the other adverse pregnancy outcomes. Urinary iodine concentration was not associated with any of the dichotomous outcomes, but positively associated with foetal growth (n = 2795, p overall = 0.017). CONCLUSIONS This study shows that a low iodine intake was associated with restricted foetal growth and a higher prevalence of preeclampsia in these mild-to-moderately iodine-deficient women. Results also indicated increased risk of subfecundity and preterm delivery. Initiating iodine supplement use in pregnancy may be too late.
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Affiliation(s)
- Marianne Hope Abel
- Department of Chronic Diseases and Ageing, Division of Mental and Physical Health, Norwegian Institute of Public Health, P.O. Box 222, Skøyen, NO-0213, Oslo, Norway
| | - Ida Henriette Caspersen
- Department of Environmental Health, Division of Infection Control, Environment and Health, Norwegian Institute of Public Health, P.O. Box 222, Skøyen, NO-0213, Oslo, Norway
| | - Verena Sengpiel
- Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, SE 416 85, Gothenburg, Sweden
| | - Bo Jacobsson
- Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, SE 416 85, Gothenburg, Sweden
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, University of Gothenburg, SE 416 85, Gothenburg, Sweden
- Department of Genetics and Bioinformatics, Division of Health Data and Digitalisation, Institute of Public Health, P.O. Box 222, Skøyen, NO-0213, Oslo, Norway
| | - Helle Margrete Meltzer
- Division of Infection Control, Environment and Health, Norwegian Institute of Public Health, P.O. Box 222, Skøyen, NO-0213, Oslo, Norway
| | - Per Magnus
- Centre for Fertility and Health, Norwegian Institute of Public Health, P.O. Box 222, Skøyen, NO-0213, Oslo, Norway
| | - Jan Alexander
- Division of Infection Control, Environment and Health, Norwegian Institute of Public Health, P.O. Box 222, Skøyen, NO-0213, Oslo, Norway
| | - Anne Lise Brantsæter
- Department of Environmental Health, Division of Infection Control, Environment and Health, Norwegian Institute of Public Health, P.O. Box 222, Skøyen, NO-0213, Oslo, Norway.
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20
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Rodriguez-Diaz E, Pearce EN. Iodine status and supplementation before, during, and after pregnancy. Best Pract Res Clin Endocrinol Metab 2020; 34:101430. [PMID: 32792134 DOI: 10.1016/j.beem.2020.101430] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Iodine intake is essential for the production of thyroid hormone. Iodine deficiency remains a public health problem in many regions around the world. Iodine deficiency can present as a spectrum of disorders depending on the degree of severity. Pregnant and lactating women are particularly vulnerable to iodine deficiency disorders because of their increased iodine requirements. Severe maternal iodine deficiency has been associated with cretinism or impaired neurodevelopment in children as well as obstetric complications. Universal salt iodization has been shown to prevent these disorders in severely iodine deficient areas. Recently, observational studies have demonstrated an association between mild-to-moderate iodine deficiency and poorer cognitive outcomes in children. In this review, we describe the iodine requirements for pregnant and lactating women, how population iodine status can be assessed, the effects of maternal iodine deficiency and excess, and current data regarding efficacy of iodine supplementation for women who are pregnant or lactating.
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Affiliation(s)
- Eduardo Rodriguez-Diaz
- Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, 720 Harrison Avenue Suite 8100, Boston, MA 02118, USA.
| | - Elizabeth N Pearce
- Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, 720 Harrison Avenue Suite 8100, Boston, MA 02118, USA.
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21
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Chen Y, Chen W, Du C, Fan L, Wang W, Gao M, Zhang Y, Cui T, Hao Y, Pearce EN, Wang C, Zhang W. Iodine Nutrition and Thyroid Function in Pregnant Women Exposed to Different Iodine Sources. Biol Trace Elem Res 2019; 190:52-59. [PMID: 30280309 DOI: 10.1007/s12011-018-1530-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Accepted: 09/19/2018] [Indexed: 10/28/2022]
Abstract
Pregnant women are more vulnerable to iodine deficiency and iodine excess. The study aimed to assess the changes in iodine nutrition and thyroid function of pregnant women exposed to different iodine sources resulting in various iodine intakes during pregnancy. From 2016 to 2017, 2004 healthy pregnant women aged 20-35 years from Shandong and Tianjin, China, were enrolled. Urinary iodine concentration (UIC), drinking water iodine content (WIC), thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), free thyroid hormone (FT4), thyroglobulin (Tg), serum thyroid peroxidase antibody (TPOAb), and thyroglobulin antibody (TgAb) were measured. Pregnant women in both Shandong and Tianjin were iodine sufficient, but the median UIC in pregnant women was significantly higher in Shandong (244 μg/L) than that in Tianjin (159 μg/L). No differences were found in UIC over the course of gestation in Shandong. In Tianjin, the UIC decreased during 13-24 weeks and stabilized thereafter. Compared with Tianjin, TSH levels were higher and FT3 and FT4 levels were lower in Shandong. Both FT3 and FT4 significantly decreased during pregnancy in Shandong and Tianjin. TSH and Tg increased over the course of gestation in both Shandong and Tianjin. The iodine status of pregnant women in Tianjin and Shandong were sufficient, but different changing patterns in UIC and thyroid function during pregnancy were presented. More attention should be focused on iodine nutrition of pregnant women, even in iodine-sufficient areas.
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Affiliation(s)
- Yanting Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, #22 Qixiangtai Street, Heping District, Tianjin, 300070, China
| | - Wen Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, #22 Qixiangtai Street, Heping District, Tianjin, 300070, China
| | - Cong Du
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, #22 Qixiangtai Street, Heping District, Tianjin, 300070, China
| | - Lili Fan
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, #22 Qixiangtai Street, Heping District, Tianjin, 300070, China
| | - Wei Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, #22 Qixiangtai Street, Heping District, Tianjin, 300070, China
| | - Min Gao
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, #22 Qixiangtai Street, Heping District, Tianjin, 300070, China
| | - Yixin Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, #22 Qixiangtai Street, Heping District, Tianjin, 300070, China
| | - Tingkai Cui
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, #22 Qixiangtai Street, Heping District, Tianjin, 300070, China
| | - Yunmeng Hao
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, #22 Qixiangtai Street, Heping District, Tianjin, 300070, China
| | - Elizabeth N Pearce
- Section of Endocrinology, Diabetes and Nutrition, Boston University School of Medicine, Boston, USA
| | - Chongdan Wang
- Department of Obstetrics, Tanggu Maternity Hospital, Tianjin, China
| | - Wanqi Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, #22 Qixiangtai Street, Heping District, Tianjin, 300070, China.
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22
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Vila L, Lucas A, Donnay S, de la Vieja A, Wengrovicz S, Santiago P, Bandrés O, Velasco I, Garcia-Fuentes E, Ares S, Moreno Navarro JC, Espada M, Muñoz A, Galofré JC, Puig-Domingo M. Iodine nutrition status in Spain Needs for the future. ACTA ACUST UNITED AC 2019; 67:61-69. [PMID: 30962160 DOI: 10.1016/j.endinu.2019.02.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 02/14/2019] [Indexed: 10/27/2022]
Abstract
Although iodine nutrition in Spain has improved in recent years, the problem is not completely resolved. It is necessary that health institutions establish measures to ensure an adequate iodine nutrition of the population, especially among the highest risk groups (children and adolescents, women of childbearing age, pregnant women and nursing mothers). A low salt intake should be advised, but it should be iodized. It is also imperative that food control agencies establish effective control over adequate iodization of salt. Indicators on iodine nutrition should be included in future health surveys. The EUthyroid study and the Krakow Declaration on iodine nutrition provide an opportunity to set up a pan-European plan for the prevention of iodine deficiency that should be considered and used by health authorities.
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Affiliation(s)
- Lluís Vila
- Servicio de Endocrinología y Nutrición, Hospital de Sant Joan Despí Moisès Broggi, Barcelona, España; Grupo Nutrición de Yodo. Área de conocimiento de la Tiroides-Sociedad Española de Endocrinología y Nutrición.
| | - Anna Lucas
- Grupo Nutrición de Yodo. Área de conocimiento de la Tiroides-Sociedad Española de Endocrinología y Nutrición; Servicio de Endocrinología y Nutrición, Hospital Germans Trias i Pujol, Badalona, España
| | - Sergio Donnay
- Grupo Nutrición de Yodo. Área de conocimiento de la Tiroides-Sociedad Española de Endocrinología y Nutrición; Servicio de Endocrinología y Nutrición, Fundación Hospital Alcorcón, Madrid, España
| | - Antonio de la Vieja
- Grupo Nutrición de Yodo. Área de conocimiento de la Tiroides-Sociedad Española de Endocrinología y Nutrición; Unidad de Tumores Endocrinos. 53.03.020. Instituto de Salud Carlos III-UFIEC, Madrid, España
| | - Silvia Wengrovicz
- Grupo Nutrición de Yodo. Área de conocimiento de la Tiroides-Sociedad Española de Endocrinología y Nutrición; Instituto Catalán de Endocrinología, Clínica Tres Torres, Barcelona, España
| | - Piedad Santiago
- Grupo Nutrición de Yodo. Área de conocimiento de la Tiroides-Sociedad Española de Endocrinología y Nutrición; Servicio de Endocrinología y Nutrición, Complejo Hospitalario de Jaén, Jaén, España
| | - Orosia Bandrés
- Grupo Nutrición de Yodo. Área de conocimiento de la Tiroides-Sociedad Española de Endocrinología y Nutrición; Sección de Endocrinología y Nutrición, Hospital Royo Villanova, Zaragoza, España
| | - Inés Velasco
- Grupo Nutrición de Yodo. Área de conocimiento de la Tiroides-Sociedad Española de Endocrinología y Nutrición; Servicio de Obstetricia y Ginecología, Hospital Riotinto, Riotinto, Huelva, España
| | - Eduardo Garcia-Fuentes
- Grupo Nutrición de Yodo. Área de conocimiento de la Tiroides-Sociedad Española de Endocrinología y Nutrición; Unidad de Gestión Clínica de Aparato Digestivo/Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria/Universidad de Málaga, Málaga, España
| | - Susana Ares
- Grupo Nutrición de Yodo. Área de conocimiento de la Tiroides-Sociedad Española de Endocrinología y Nutrición; Servicio de Neonatología, Hospital Universitario La Paz, Madrid, España
| | - José Carlos Moreno Navarro
- Grupo Nutrición de Yodo. Área de conocimiento de la Tiroides-Sociedad Española de Endocrinología y Nutrición; Laboratorio de Tiroides Molecular, INGEMM-Instituto de Medicina y Genética Molecular, Hospital Universitario de La Paz, Madrid, España
| | - Mercedes Espada
- Grupo Nutrición de Yodo. Área de conocimiento de la Tiroides-Sociedad Española de Endocrinología y Nutrición; Unidad de Bioquímica Clínica, Laboratorio de Salud Pública de Bilbao, Gobierno Vasco, Parque Tecnológico de Bizkaia, Derio, España
| | - Antonio Muñoz
- Grupo Nutrición de Yodo. Área de conocimiento de la Tiroides-Sociedad Española de Endocrinología y Nutrición; Centro de Atención Primaria de la Seu d'Urgell, Lleida, España
| | - Juan Carlos Galofré
- Grupo Nutrición de Yodo. Área de conocimiento de la Tiroides-Sociedad Española de Endocrinología y Nutrición; Departamento de Endocrinología Clínica, Universidad de Navarra, Pamplona, España
| | - Manel Puig-Domingo
- Grupo Nutrición de Yodo. Área de conocimiento de la Tiroides-Sociedad Española de Endocrinología y Nutrición; Servicio de Endocrinología y Nutrición, Hospital Germans Trias i Pujol, Institut de Recerca Germans Trias i Pujol (IGTP), Badalona, España
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Pregnancy Loss and Iodine Status: The LIFE Prospective Cohort Study. Nutrients 2019; 11:nu11030534. [PMID: 30823683 PMCID: PMC6471412 DOI: 10.3390/nu11030534] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 02/21/2019] [Accepted: 02/26/2019] [Indexed: 12/12/2022] Open
Abstract
Iodine deficiency in pregnancy is a common problem in the United States and parts of Europe, but whether iodine deficiency is associated with increased pregnancy loss has not been well studied. The LIFE study provided an excellent opportunity to examine the relationship between iodine status and pregnancy loss because women were monitored prospectively to ensure excellent ascertainment of conceptions. The LIFE study, a population-based prospective cohort study, monitored 501 women who had discontinued contraception within two months to become pregnant; 329 became pregnant, had urinary iodine concentrations measured on samples collected at enrollment, and were followed up to determine pregnancy outcomes. Of the 329, 196 had live births (59.5%), 92 (28.0%) had losses, and 41 (12.5%) withdrew or were lost to follow up. Urinary iodine concentrations were in the deficiency range in 59.6% of the participants. The risk of loss, however, was not elevated in the mildly deficient group (hazard ratio 0.69, 95% confidence interval 0.34, 1.38), the moderately deficient group (hazard ratio 0.81, 95% confidence interval 0.43, 1.51), or the severely deficient group (hazard ratio 0.69, 95% confidence interval 0.32, 1.50). Iodine deficiency, even when moderate to severe, was not associated with increased rates of pregnancy loss. This study provides some reassurance that iodine deficiency at levels seen in many developed countries does not increase the risk of pregnancy loss.
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Panth P, Guerin G, DiMarco NM. A Review of Iodine Status of Women of Reproductive Age in the USA. Biol Trace Elem Res 2019; 188:208-220. [PMID: 30617900 PMCID: PMC6373336 DOI: 10.1007/s12011-018-1606-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 12/05/2018] [Indexed: 01/20/2023]
Abstract
Iodine, an essential micronutrient, is required to produce thyroid hormones. Iodine deficiency disorders (IDD) comprise a range of adverse maternal and fetal outcomes, with the most significant irreversible effect resulting from neurodevelopmental deficits in fetal brain caused by deficient iodine status during early pregnancy. The objective of this scoping review was to summarize the studies that assessed iodine status of women of reproductive age in the USA. A systematic review of literature using the PRISMA Extension for Scoping Reviews (PRISMA-ScR) statement was conducted. PubMed, Medline, CINAHL, EMBASE, EBSCOHost, Cochrane, ERIC, Google Scholar, and Web of Science databases were searched, 1652 records were identified. One thousand six hundred forty-one records that did not satisfy the inclusion/exclusion criteria and quality review were excluded, and 11 peer-reviewed articles were determined to be eligible for this scoping review. Despite the USA being considered iodine sufficient for the general population, the US dietary iodine intakes have decreased drastically since the 1970s, with iodine deficiency reemerging in vulnerable groups such as women of reproductive age. Although data to conduct a scoping review of iodine status among women of reproductive age in the USA was scarce, majority of the articles reviewed demonstrate emergent iodine deficiency in this population of women of reproductive age, indicating alarm for a public health concern needing immediate attention.
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Affiliation(s)
- Pallavi Panth
- Department of Nutrition and Food Sciences, College of Health Sciences, Texas Woman's University, P.O. Box 425888, Denton, TX, 76204-5876, USA.
- Institute for Women's Health, College of Health Sciences, Texas Woman's University, Denton, TX, 76204-5876, USA.
| | - Gena Guerin
- Department of Kinesiology, College of Health Sciences, Texas Woman's University, Denton, TX, 76204-5876, USA
| | - Nancy M DiMarco
- Department of Nutrition and Food Sciences, College of Health Sciences, Texas Woman's University, P.O. Box 425888, Denton, TX, 76204-5876, USA.
- Institute for Women's Health, College of Health Sciences, Texas Woman's University, Denton, TX, 76204-5876, USA.
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Ernährung und Nahrungsergänzungsmittel bei Kinderwunsch der Frau. GYNAKOLOGISCHE ENDOKRINOLOGIE 2019. [DOI: 10.1007/s10304-018-0229-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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26
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Pearce EN. Iodine nutrition: recent research and unanswered questions. Eur J Clin Nutr 2018; 72:1226-1228. [PMID: 30185854 DOI: 10.1038/s41430-018-0226-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 05/22/2018] [Indexed: 11/09/2022]
Affiliation(s)
- Elizabeth N Pearce
- Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, 720 Harrison Ave, Suite 8100, Boston, MA, 02118, USA.
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27
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Serafico ME, Ulanday JRC, Alibayan MV, Gironella GMP, Perlas LA. Iodine Status in Filipino Women of Childbearing Age. Endocrinol Metab (Seoul) 2018; 33:372-379. [PMID: 30229576 PMCID: PMC6145958 DOI: 10.3803/enm.2018.33.3.372] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 06/11/2018] [Accepted: 06/17/2018] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Iodine deficiency (ID) has become a concern not only among pregnant women, but in women of childbearing age as well. In fact, a recent report suggested that women with moderate to severe ID may experience a significantly longer time to conceive. This study aimed to investigate iodine status in Filipino women of childbearing age. METHODS The iodine status of 6,194 Filipino women aged 15 to 45 years old was assessed through urinary iodine analysis. A casual spot urine sample was collected from women in households participating in the eighth National Nutrition Survey conducted by the Food and Nutrition Research Institute. The sample was analyzed using ammonium persulfate digestion followed by the Sandell-Kolthoff colorimetric reaction. A median urinary iodine concentration (UIC) of less than 100 μg/L was used to define ID. RESULTS The median UIC was 123 μg/L, indicative of adequate iodine nutrition; however, 21.5% of participants had a UIC below 50 μg/L. The median UIC of women who lived in urban areas (142 μg/L), belonged to the middle to richest class (>124 μg/L), had reached a college education (136 μg/L), and used iodized salt (15 ppm and above; 148 to 179 μg/L) reflected adequate iodine nutrition. ID was found to have been eliminated in the regions of Central Luzon, Eastern Visayas, Calabarzon, Mimaropa, and the National Capital, while mild ID was identified in Western Visayas, Southern and Western Mindanao, and in the Autonomous Region in Muslim Mindanao. CONCLUSION Pockets of ID among women of childbearing age exist in the Philippines. Proper information through education and the use of adequately iodized salt are key measures for improving the iodine status of the studied population.
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Affiliation(s)
- Michael E Serafico
- Department of Science and Technology-Food and Nutrition Research Institute (DOST-FNRI), Taguig, Philippines.
| | - Joselita Rosario C Ulanday
- Department of Science and Technology-Food and Nutrition Research Institute (DOST-FNRI), Taguig, Philippines
| | - Marites V Alibayan
- Department of Science and Technology-Food and Nutrition Research Institute (DOST-FNRI), Taguig, Philippines
| | - Glen Melvin P Gironella
- Department of Science and Technology-Food and Nutrition Research Institute (DOST-FNRI), Taguig, Philippines
| | - Leah A Perlas
- Department of Science and Technology-Food and Nutrition Research Institute (DOST-FNRI), Taguig, Philippines
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28
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Chambers L. Are plant-based milk alternatives putting people at risk of low iodine intake? NUTR BULL 2018. [DOI: 10.1111/nbu.12305] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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