Spectrophotometric determination of urinary iodine by the Sandell-Kolthoff reaction subsequent to dry alkaline ashing. Results from the Czech Republic in the period 1994–2002

In-line spectroscopy for iodine quantification in dynamic contrast-enhanced dedicated breast CT

BACKGROUND

In 4D dynamic contrast-enhanced dedicated breast computed tomography (4D DCE-bCT), the functional properties of the breast will be characterized by monitoring the uptake and washout of iodine-based contrast agents over time. This information could be valuable in breast cancer treatment. However, prior to clinical implementation, it is crucial to validate the quantitative estimates of iodine concentrations at each time point during acquisition.

PURPOSE

To develop an in-line spectroscopy system capable of measuring iodine concentrations in a dynamic x-ray breast phantom in real-time.

METHODS

Potassium iodide served as the contrast agent. The system was set-up at both the entrance and exit of the phantom. It comprises a fiber-coupled green LED and collimator, which together ensure that a parallel beam passes through the sample holder. Transmitted light is captured by a collimator on the opposite side and directed through a fiber optic cable to a photodetector for intensity measurement. The relationship between 13 iodine concentrations (0-6 mg I/mL) and light transmission was tested, and the system's repeatability and accuracy were determined.

RESULTS

The system exhibited a strong correlation between iodine concentration and transmission values, achieving a root-mean-square error of 0.007. The repeated measurements had relative standard deviations of 0.04% and 0.1% for repeated water measurements at the phantom's entrance and exit, respectively. Furthermore, the accuracy measurements gave a mean error of fitting of 0.008 (± 0.07) mg I/mL.

CONCLUSION

The in-line spectroscopy system can effectively monitor iodine concentrations in a dynamic breast phantom, providing a reliable method for quantitative validation of 4D DCE-bCT.

Protocol for a community-based, household-randomised, dose-response trial to assess the acceptability, nutritional effects and safety of double-fortified salt containing iodine and folic acid compared with iodised salt among non-pregnant Ethiopian women of reproductive age (DFS-IoFA)

INTRODUCTION

The prevalence of neural tube defects (NTDs) is higher in Ethiopia than most other countries, and ~84% of Ethiopian women of reproductive age (WRA) have folate insufficiency, a major risk factor for NTDs. Salt fortification with folic acid is a potential strategy to improve women's folate status, but data are needed on the acceptability, nutritional impact and safety of folic acid fortification of iodised salt.

METHODS AND ANALYSIS

The study is designed as a community-based, household-randomised, dose-response trial. A total of 360 non-pregnant WRA 18-49 years of age will be randomly assigned to one of three intervention arms: (1) iodised salt fortified with 30 ppm folic acid to provide ~200 µg folic acid/day; (2) iodised salt fortified with 90 ppm folic acid to provide ~600 µg folic acid/day; or (3) iodised salt (comparator). The preweighed salts will be delivered to participants' homes biweekly for 26 weeks; unused salt will be collected and weighed. Fasting, venous blood samples will be collected at baseline, end line and a randomly assigned intermediate time point for assessment of folate, iodine, vitamin B12 and other micronutrient status biomarkers. Women's dietary intakes, including discretionary salt consumption, will be measured using weighed food records; 24-hour urine specimens will be analysed for sodium and iodine excretion. Primary outcomes are women's consumption of study salts, change in biomarkers of folate and iodine status and prevalence of adverse events. Results will be analysed using analysis of covariance models to estimate group mean differences for continuous outcomes, controlling for baseline measurements, and log-binomial or modified Poisson regressions for categorical outcomes. Prespecified effect modifications will be explored.

ETHICS AND DISSEMINATION

The study has been approved by the Ethiopian Public Health Institute's Institutional Review Board, and the protocol has been registered with ClinicalTrials.gov (registration number NCT06223854). Study results will be published in open access scientific journals and disseminated nationally in Ethiopia.

TRIAL REGISTRATION NUMBER

NCT06223854.

Iodine, Thyroglobulin and Thyroid Gland

Iodine is essential in the biosynthesis of thyroid hormones that affect metabolic processes in the organism from the prenatal state to the elderly. The immediate indicator of iodine intake is the concentration of iodine in urine, but the indicator of iodine intake in the longer term of several months is thyroglobulin (Tg). Tg negatively correlated with increasing intake of iodine in population that do not suffer from thyroid disease, while a more than adequate to excessive iodine intake leads to an increase in Tg. The dependence of Tg on iodine can be described by a U-shaped curve. Thyroglobulin in serum is elevated in thyroid disease mainly in hyperthyroidism (diagnosis E05 of WHO ICD-10 codes) and in goiter (diagnosis E04 of WHO ICD-10 codes). Tg values decrease below 20 µg/l after effective treatment of patients with thyroid disease. Thyroglobulin may thus be an indicator of thyroid stabilization and the success of the thyroid gland treatment.

The Relationship Between Iodine Intake and Serum Thyroglobulin in the General Population

The relationship is shown between a concentration of urinary iodine and serum thyroglobulin in population studies carried out on a general population that was randomly selected from the registry of the General Health Insurance Company (individuals aged 6-98 years, 1751 males, 2420 females). The individuals were divided into subgroups with a urinary iodine concentration of <50, 50-99, 100-199, 200-299 and ≥300 μg/l. The mean and median of thyroglobulin were calculated in these subgroups. Tg concentrations were dependent on gender (males<females), age (thyroglobulin increased with age) and statistically significant negative relationship was observed between thyroglobulin and urinary iodine in individuals with urinary iodine <300 μg/l and the age under 65 years. Upper nonparametric tolerance limits of thyroglobulin in relation to iodine intake were calculated in subgroup of normal individuals (n=1858, thyroglobulin, urinary iodine, thyrotropin and free thyroxine were within the normal reference range). Upper limits were dependent on gender and age. The total value of upper limits is 44 μg/l; for individuals aged 6-17 years it is 39.1 μg/l; 18-65 years = 51.4 μg/l and 66-98 years = 60.6 μg/l. In general, thyroglobulin serum concentrations higher than 40 μg/l should be an indicator for determining urinary iodine.

[Iodine intake during pregnancy: effects on thyroid function in mother and child]

INTRODUCTION

Recent studies in Spain have shown an inadequate iodine intake in a significant proportion of pregnant women. Pregnancy increases thyroid hormone requirements, and adequate iodine intake is therefore needed.

MATERIAL AND METHODS

One hundred and forty-seven women in their third trimester (week 37) of pregnancy provided a blood sample and a 24-hour urine sample to test serum and urine iodine levels and completed a food frequency questionnaire to assess iodine intake during pregnancy. Serum TSH levels were measured in the babies born to the 140 mothers in the postpartum group.

RESULTS

Only 10.9% of pregnant women consumed more than 250 μg iodine daily, and 24.4% of them consumed less than 100 μg daily. Mean free T4 levels were 9.37 pmol/L, and 74 women (54.41%) had levels below the hypothyroxinemia threshold. TSH levels were normal in 135 newborns (96.4%), while 5 (3.6%) had levels higher than 5 μU/mL.

Hypothyroxinemia during pregnancy: the effect on neurodevelopment in the child

CONTEXT

Experimental studies have shown that maternal hypothyroxinemia during early pregnancy is associated with poor neurodevelopment in affected offspring.

OBJECTIVE

The aim of this study was to assess the impact of maternal serum free T4 on psychomotor development of offspring.

MATERIALS AND METHODS

The study involved 147 women in the third trimester (week 37) of pregnancy. TSH and free T4 serum levels were measured at 37 week gestation. The children were evaluated between 38 and 60 months of age by the McCarthy Scales of Children's Abilities.

RESULTS

54.4% of the women had a free T4 below the threshold of hypothyroxinemia. We find a significant effect of maternal hypothyroxinemia on the general cognitive index, and on perceptual-manipulative and memory coefficients.