Xiaoguang Shi1, Cheng Han, Chenyan Li, Jinyuan Mao, Weiwei Wang, Xiaochen Xie, Chenyang Li, Bin Xu, Tao Meng, Jianling Du, Shaowei Zhang, Zhengnan Gao, Xiaomei Zhang, Chenling Fan, Zhongyan Shan, Weiping Teng. 1. 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 Women's and Children's Hospital (C.L.), Shenyang, China; Departments of Obstetrics and Gynecology (B.X) and Endocrinology (S.Z.), No. 202 Hospital of People's 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.
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.
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.
Authors: M Gao; W Chen; S Dong; Y Chen; Q Zhang; H Sun; Y Zhang; W Wu; Z Pan; S Gao; L Lin; J Shen; L Tan; G Wang; W Zhang Journal: Eur J Nutr Date: 2020-06-23 Impact factor: 5.614