Optimal and Safe Upper Limits of Iodine Intake for Early Pregnancy in Iodine-Sufficient Regions: A Cross-Sectional Study of 7190 Pregnant Women in China
Context:The WHO Technical Consultation recommends urinary iodine concentrations (UIC) from 250 to 499 μg/L as more-than-adequate iodine intake and UIC ≥500 μg/L as excessive iodine for pregnant and lactating women, but scientific evidence for this is weak.Objective:We investigated optimal and safe r...
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| Published in | The journal of clinical endocrinology and metabolism Vol. 100; no. 4; pp. 1630 - 1638 |
|---|---|
| Main Authors | , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Oxford University Press
01.04.2015
Copyright by The Endocrine Society |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0021-972X 1945-7197 1945-7197 |
| DOI | 10.1210/jc.2014-3704 |
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| Abstract | Context:The WHO Technical Consultation recommends urinary iodine concentrations (UIC) from 250 to 499 μg/L as more-than-adequate iodine intake and UIC ≥500 μg/L as excessive iodine for pregnant and lactating women, but scientific evidence for this is weak.Objective:We investigated optimal and safe ranges of iodine intake during early pregnancy in an iodine-sufficient region of China.Method:Seven thousand one hundred ninety pregnant women at 4–8 weeks gestation were investigated and their UIC, serum thyroid stimulating hormone (TSH), free thyroxine (FT4), thyroid-peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb), and thyroglobulin (Tg) were measured.Results:The prevalence of overt hypothyroidism was lowest in the group with UIC 150–249 μg/L, which corresponded to the lowest serum Tg concentration (10.18 μg/L). Prevalences of subclinical hypothyroidism (2.4%) and isolated hypothyroxinemia (1.7%) were lower in the group with UIC 150–249 μg/L. Multivariate logistic regression indicated that more-than-adequate iodine intake (UIC 250–499 μg/L) and excessive iodine intake (UIC ≥ 500 μg/L) were associated with a 1.72-fold and a 2.17-fold increased risk of subclinical hypothyroidism, respectively. Meanwhile, excessive iodine intake was associated with a 2.85-fold increased risk of isolated hypothyroxinemia. Moreover, the prevalence of TPOAb positivity and TgAb positivity presented a U-shaped curve, ranging from mild iodine deficiency to iodine excess.Conclusion:The upper limit of iodine intake during early pregnancy in an iodine-sufficient region should not exceed UIC 250 μg/L, because this is associated with a significantly high risk of subclinical hypothyroidism, and a UIC of 500 μg/L should not be exceeded, as it is associated with a significantly high risk of isolated hypothyroxinemia. |
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| AbstractList | The WHO Technical Consultation recommends urinary iodine concentrations (UIC) from 250 to 499 μg/L as more-than-adequate iodine intake and UIC ≥ 500 μg/L as excessive iodine for pregnant and lactating women, but scientific evidence for this is weak.CONTEXTThe WHO Technical Consultation recommends urinary iodine concentrations (UIC) from 250 to 499 μg/L as more-than-adequate iodine intake and UIC ≥ 500 μg/L as excessive iodine for pregnant and lactating women, but scientific evidence for this is weak.We investigated optimal and safe ranges of iodine intake during early pregnancy in an iodine-sufficient region of China.OBJECTIVEWe investigated optimal and safe ranges of iodine intake during early pregnancy in an iodine-sufficient region of China.Seven thousand one hundred ninety pregnant women at 4-8 weeks gestation were investigated and their UIC, serum thyroid stimulating hormone (TSH), free thyroxine (FT4), thyroid-peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb), and thyroglobulin (Tg) were measured.METHODSeven thousand one hundred ninety pregnant women at 4-8 weeks gestation were investigated and their UIC, serum thyroid stimulating hormone (TSH), free thyroxine (FT4), thyroid-peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb), and thyroglobulin (Tg) were measured.The prevalence of overt hypothyroidism was lowest in the group with UIC 150-249 μg/L, which corresponded to the lowest serum Tg concentration (10.18 μg/L). Prevalences of subclinical hypothyroidism (2.4%) and isolated hypothyroxinemia (1.7%) were lower in the group with UIC 150-249 μg/L. Multivariate logistic regression indicated that more-than-adequate iodine intake (UIC 250-499 μg/L) and excessive iodine intake (UIC ≥ 500 μg/L) were associated with a 1.72-fold and a 2.17-fold increased risk of subclinical hypothyroidism, respectively. Meanwhile, excessive iodine intake was associated with a 2.85-fold increased risk of isolated hypothyroxinemia. Moreover, the prevalence of TPOAb positivity and TgAb positivity presented a U-shaped curve, ranging from mild iodine deficiency to iodine excess.RESULTSThe prevalence of overt hypothyroidism was lowest in the group with UIC 150-249 μg/L, which corresponded to the lowest serum Tg concentration (10.18 μg/L). Prevalences of subclinical hypothyroidism (2.4%) and isolated hypothyroxinemia (1.7%) were lower in the group with UIC 150-249 μg/L. Multivariate logistic regression indicated that more-than-adequate iodine intake (UIC 250-499 μg/L) and excessive iodine intake (UIC ≥ 500 μg/L) were associated with a 1.72-fold and a 2.17-fold increased risk of subclinical hypothyroidism, respectively. Meanwhile, excessive iodine intake was associated with a 2.85-fold increased risk of isolated hypothyroxinemia. Moreover, the prevalence of TPOAb positivity and TgAb positivity presented a U-shaped curve, ranging from mild iodine deficiency to iodine excess.The upper limit of iodine intake during early pregnancy in an iodine-sufficient region should not exceed UIC 250 μg/L, because this is associated with a significantly high risk of subclinical hypothyroidism, and a UIC of 500 μg/L should not be exceeded, as it is associated with a significantly high risk of isolated hypothyroxinemia.CONCLUSIONThe upper limit of iodine intake during early pregnancy in an iodine-sufficient region should not exceed UIC 250 μg/L, because this is associated with a significantly high risk of subclinical hypothyroidism, and a UIC of 500 μg/L should not be exceeded, as it is associated with a significantly high risk of isolated hypothyroxinemia. The WHO Technical Consultation recommends urinary iodine concentrations (UIC) from 250 to 499 μg/L as more-than-adequate iodine intake and UIC ≥ 500 μg/L as excessive iodine for pregnant and lactating women, but scientific evidence for this is weak. We investigated optimal and safe ranges of iodine intake during early pregnancy in an iodine-sufficient region of China. Seven thousand one hundred ninety pregnant women at 4-8 weeks gestation were investigated and their UIC, serum thyroid stimulating hormone (TSH), free thyroxine (FT4), thyroid-peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb), and thyroglobulin (Tg) were measured. The prevalence of overt hypothyroidism was lowest in the group with UIC 150-249 μg/L, which corresponded to the lowest serum Tg concentration (10.18 μg/L). Prevalences of subclinical hypothyroidism (2.4%) and isolated hypothyroxinemia (1.7%) were lower in the group with UIC 150-249 μg/L. Multivariate logistic regression indicated that more-than-adequate iodine intake (UIC 250-499 μg/L) and excessive iodine intake (UIC ≥ 500 μg/L) were associated with a 1.72-fold and a 2.17-fold increased risk of subclinical hypothyroidism, respectively. Meanwhile, excessive iodine intake was associated with a 2.85-fold increased risk of isolated hypothyroxinemia. Moreover, the prevalence of TPOAb positivity and TgAb positivity presented a U-shaped curve, ranging from mild iodine deficiency to iodine excess. The upper limit of iodine intake during early pregnancy in an iodine-sufficient region should not exceed UIC 250 μg/L, because this is associated with a significantly high risk of subclinical hypothyroidism, and a UIC of 500 μg/L should not be exceeded, as it is associated with a significantly high risk of isolated hypothyroxinemia. CONTEXT:The WHO Technical Consultation recommends urinary iodine concentrations (UIC) from 250 to 499 μg/L as more-than-adequate iodine intake and UIC ≥500 μg/L as excessive iodine for pregnant and lactating women, but scientific evidence for this is weak. OBJECTIVE:We investigated optimal and safe ranges of iodine intake during early pregnancy in an iodine-sufficient region of China. METHOD:Seven thousand one hundred ninety pregnant women at 4–8 weeks gestation were investigated and their UIC, serum thyroid stimulating hormone (TSH), free thyroxine (FT4), thyroid-peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb), and thyroglobulin (Tg) were measured. RESULTS:The prevalence of overt hypothyroidism was lowest in the group with UIC 150–249 μg/L, which corresponded to the lowest serum Tg concentration (10.18 μg/L). Prevalences of subclinical hypothyroidism (2.4%) and isolated hypothyroxinemia (1.7%) were lower in the group with UIC 150–249 μg/L. Multivariate logistic regression indicated that more-than-adequate iodine intake (UIC 250–499 μg/L) and excessive iodine intake (UIC ≥ 500 μg/L) were associated with a 1.72-fold and a 2.17-fold increased risk of subclinical hypothyroidism, respectively. Meanwhile, excessive iodine intake was associated with a 2.85-fold increased risk of isolated hypothyroxinemia. Moreover, the prevalence of TPOAb positivity and TgAb positivity presented a U-shaped curve, ranging from mild iodine deficiency to iodine excess. CONCLUSION:The upper limit of iodine intake during early pregnancy in an iodine-sufficient region should not exceed UIC 250 μg/L, because this is associated with a significantly high risk of subclinical hypothyroidism, and a UIC of 500 μg/L should not be exceeded, as it is associated with a significantly high risk of isolated hypothyroxinemia. Context:The WHO Technical Consultation recommends urinary iodine concentrations (UIC) from 250 to 499 μg/L as more-than-adequate iodine intake and UIC ≥500 μg/L as excessive iodine for pregnant and lactating women, but scientific evidence for this is weak.Objective:We investigated optimal and safe ranges of iodine intake during early pregnancy in an iodine-sufficient region of China.Method:Seven thousand one hundred ninety pregnant women at 4–8 weeks gestation were investigated and their UIC, serum thyroid stimulating hormone (TSH), free thyroxine (FT4), thyroid-peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb), and thyroglobulin (Tg) were measured.Results:The prevalence of overt hypothyroidism was lowest in the group with UIC 150–249 μg/L, which corresponded to the lowest serum Tg concentration (10.18 μg/L). Prevalences of subclinical hypothyroidism (2.4%) and isolated hypothyroxinemia (1.7%) were lower in the group with UIC 150–249 μg/L. Multivariate logistic regression indicated that more-than-adequate iodine intake (UIC 250–499 μg/L) and excessive iodine intake (UIC ≥ 500 μg/L) were associated with a 1.72-fold and a 2.17-fold increased risk of subclinical hypothyroidism, respectively. Meanwhile, excessive iodine intake was associated with a 2.85-fold increased risk of isolated hypothyroxinemia. Moreover, the prevalence of TPOAb positivity and TgAb positivity presented a U-shaped curve, ranging from mild iodine deficiency to iodine excess.Conclusion:The upper limit of iodine intake during early pregnancy in an iodine-sufficient region should not exceed UIC 250 μg/L, because this is associated with a significantly high risk of subclinical hypothyroidism, and a UIC of 500 μg/L should not be exceeded, as it is associated with a significantly high risk of isolated hypothyroxinemia. |
| Author | Xie, Xiaochen Shi, Xiaoguang Meng, Tao Du, Jianling Zhang, Xiaomei Fan, Chenling Teng, Weiping Li, Chenyan Li, Chenyang Xu, Bin Mao, Jinyuan Gao, Zhengnan Han, Cheng Wang, Weiwei Zhang, Shaowei Shan, Zhongyan |
| AuthorAffiliation | The Endocrine Institute and The Liaoning Provincial Key Laboratory of Endocrine Diseases, Departments of Endocrinology and Metabolism (X.S., C.H., C.L., J.M., W.W., X.X., C.F., Z.S., W.T.) and Obstetrics and Gynecology (T.M.), The First Hospital of China Medical University, Shenyang, China; Shenyang Womenʼs and Childrenʼs Hospital (C.L.), Shenyang, China; Departments of Obstetrics and Gynecology (B.X) and Endocrinology (S.Z.), No. 202 Hospital of Peopleʼs Liberation Army, Shenyang, China; Department of Endocrinology (J.D.), The First Affiliated Hospital of Dalian Medical University, Dalian, China; Department of Endocrinology (Z.G.), Dalian Municipal Central Hospital Affiliated of Dalian Medical University, Dalian, China; and Department of Endocrinology (X.Z.), The First Hospital of Dandong, Dandong, China |
| AuthorAffiliation_xml | – name: The Endocrine Institute and The Liaoning Provincial Key Laboratory of Endocrine Diseases, Departments of Endocrinology and Metabolism (X.S., C.H., C.L., J.M., W.W., X.X., C.F., Z.S., W.T.) and Obstetrics and Gynecology (T.M.), The First Hospital of China Medical University, Shenyang, China; Shenyang Womenʼs and Childrenʼs Hospital (C.L.), Shenyang, China; Departments of Obstetrics and Gynecology (B.X) and Endocrinology (S.Z.), No. 202 Hospital of Peopleʼs Liberation Army, Shenyang, China; Department of Endocrinology (J.D.), The First Affiliated Hospital of Dalian Medical University, Dalian, China; Department of Endocrinology (Z.G.), Dalian Municipal Central Hospital Affiliated of Dalian Medical University, Dalian, China; and Department of Endocrinology (X.Z.), The First Hospital of Dandong, Dandong, China |
| Author_xml | – sequence: 1 givenname: Xiaoguang surname: Shi fullname: Shi, Xiaoguang organization: 1The Endocrine Institute and The Liaoning Provincial Key Laboratory of Endocrine Diseases, Departments of Endocrinology and Metabolism (X.S., C.H., C.L., J.M., W.W., X.X., C.F., Z.S., W.T.), Shenyang, China – sequence: 2 givenname: Cheng surname: Han fullname: Han, Cheng organization: 1The Endocrine Institute and The Liaoning Provincial Key Laboratory of Endocrine Diseases, Departments of Endocrinology and Metabolism (X.S., C.H., C.L., J.M., W.W., X.X., C.F., Z.S., W.T.), Shenyang, China – sequence: 3 givenname: Chenyan surname: Li fullname: Li, Chenyan organization: 1The Endocrine Institute and The Liaoning Provincial Key Laboratory of Endocrine Diseases, Departments of Endocrinology and Metabolism (X.S., C.H., C.L., J.M., W.W., X.X., C.F., Z.S., W.T.), Shenyang, China – sequence: 4 givenname: Jinyuan surname: Mao fullname: Mao, Jinyuan organization: 1The Endocrine Institute and The Liaoning Provincial Key Laboratory of Endocrine Diseases, Departments of Endocrinology and Metabolism (X.S., C.H., C.L., J.M., W.W., X.X., C.F., Z.S., W.T.), Shenyang, China – sequence: 5 givenname: Weiwei surname: Wang fullname: Wang, Weiwei organization: 1The Endocrine Institute and The Liaoning Provincial Key Laboratory of Endocrine Diseases, Departments of Endocrinology and Metabolism (X.S., C.H., C.L., J.M., W.W., X.X., C.F., Z.S., W.T.), Shenyang, China – sequence: 6 givenname: Xiaochen surname: Xie fullname: Xie, Xiaochen organization: 1The Endocrine Institute and The Liaoning Provincial Key Laboratory of Endocrine Diseases, Departments of Endocrinology and Metabolism (X.S., C.H., C.L., J.M., W.W., X.X., C.F., Z.S., W.T.), Shenyang, China – sequence: 7 givenname: Chenyang surname: Li fullname: Li, Chenyang organization: 3Shenyang Women's and Children's Hospital (C.L.), Shenyang, China – sequence: 8 givenname: Bin surname: Xu fullname: Xu, Bin organization: 4Departments of Obstetrics and Gynecology (B.X), Shenyang, China – sequence: 9 givenname: Tao surname: Meng fullname: Meng, Tao organization: 2Obstetrics and Gynecology (T.M.), The First Hospital of China Medical University, Shenyang, China – sequence: 10 givenname: Jianling surname: Du fullname: Du, Jianling organization: 6Department of Endocrinology (J.D.), The First Affiliated Hospital of Dalian Medical University, Dalian, China – sequence: 11 givenname: Shaowei surname: Zhang fullname: Zhang, Shaowei organization: 5Endocrinology (S.Z.), No. 202 Hospital of People's Liberation Army, Shenyang, China – sequence: 12 givenname: Zhengnan surname: Gao fullname: Gao, Zhengnan organization: 7Department of Endocrinology (Z.G.), Dalian Municipal Central Hospital Affiliated of Dalian Medical University, Dalian, China – sequence: 13 givenname: Xiaomei surname: Zhang fullname: Zhang, Xiaomei organization: 8Department of Endocrinology (X.Z.), The First Hospital of Dandong, Dandong, China – sequence: 14 givenname: Chenling surname: Fan fullname: Fan, Chenling organization: 1The Endocrine Institute and The Liaoning Provincial Key Laboratory of Endocrine Diseases, Departments of Endocrinology and Metabolism (X.S., C.H., C.L., J.M., W.W., X.X., C.F., Z.S., W.T.), Shenyang, China – sequence: 15 givenname: Zhongyan surname: Shan fullname: Shan, Zhongyan email: shanzhongyan@medmail.com.cn organization: 1The Endocrine Institute and The Liaoning Provincial Key Laboratory of Endocrine Diseases, Departments of Endocrinology and Metabolism (X.S., C.H., C.L., J.M., W.W., X.X., C.F., Z.S., W.T.), Shenyang, China – sequence: 16 givenname: Weiping surname: Teng fullname: Teng, Weiping email: twp@vip.163.com organization: 1The Endocrine Institute and The Liaoning Provincial Key Laboratory of Endocrine Diseases, Departments of Endocrinology and Metabolism (X.S., C.H., C.L., J.M., W.W., X.X., C.F., Z.S., W.T.), Shenyang, China |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/25629356$$D View this record in MEDLINE/PubMed |
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| Snippet | Context:The WHO Technical Consultation recommends urinary iodine concentrations (UIC) from 250 to 499 μg/L as more-than-adequate iodine intake and UIC ≥500... CONTEXT:The WHO Technical Consultation recommends urinary iodine concentrations (UIC) from 250 to 499 μg/L as more-than-adequate iodine intake and UIC ≥500... The WHO Technical Consultation recommends urinary iodine concentrations (UIC) from 250 to 499 μg/L as more-than-adequate iodine intake and UIC ≥ 500 μg/L as... |
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| SubjectTerms | Adult China - epidemiology Cross-Sectional Studies Female Humans Hypothyroidism Hypothyroidism - epidemiology Iodine Iodine - administration & dosage Iodine - adverse effects Iodine - urine Lactation - metabolism Maternal Nutritional Physiological Phenomena Pregnancy Pregnancy Complications - epidemiology Pregnancy Complications - prevention & control Prevalence Recommended Dietary Allowances Thyroglobulin Thyroglobulin - blood Thyroid Thyroid gland Thyroid-stimulating hormone Thyrotropin - blood Thyroxine Thyroxine - blood Young Adult |
| Title | Optimal and Safe Upper Limits of Iodine Intake for Early Pregnancy in Iodine-Sufficient Regions: A Cross-Sectional Study of 7190 Pregnant Women in China |
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