Sara Stinca1, Maria Andersson1, Sandra Weibel1, Isabelle Herter-Aeberli1, Ralph Fingerhut2, Sueppong Gowachirapant3, Sonja Y Hess4, Nidhi Jaiswal5, Tomislav Jukic6, Zvonko Kusic6, Ngoako Solomon Mabapa7, Ashwini Kumar Nepal8, Teofilo O L San Luis9, Jia Qing Zhen10, Michael Bruce Zimmermann1. 1. Human Nutrition Laboratory, Institute of Food Nutrition and Health, ETH Zurich, Zurich 8092, Switzerland. 2. Swiss Newborn Screening Laboratory, Children's Research Center (CRC), University Children's Hospital of Zurich, Zurich 8032, Switzerland. 3. Institute of Nutrition, Mahidol University, Nakhon Pathom 73170, Thailand. 4. Department of Nutrition, University of California, Davis, Davis, California 95616. 5. St. John's Research Institute, St. John's National Academy of Health Sciences, Bangalore 560034, India. 6. Department of Oncology and Nuclear Medicine, University of Zagreb School of Medicine, Sisters of Charity University Hospital Centre, Zagreb 10,000, Croatia. 7. Department of Nutrition, University of Venda, Thohoyandou 0950, South Africa. 8. Department of Biochemistry, B.P. Koirala Institute of Health Sciences, Ghopa, Dharan 56700, Nepal. 9. Iodine Global Network (IGN), Manila 1102, Philippines; and. 10. Shanxi Institute for Endemic Disease Prevention and Treatment, LinFen 041000, China.
Abstract
Context: Thyroglobulin (Tg) could be a sensitive biomarker of iodine nutrition in pregnant women (PW). A dried blood spot (DBS) assay would simplify collection and transport in field studies. Objectives: Our aims were to (1) establish and test a reference range for DBS-Tg in PW; (2) determine whether co-measurement of Tg antibodies (Abs) is necessary to define population iodine status. Design, Setting, and Participants: Standardized cross-sectional studies of 3870 PW from 11 countries. For the DBS-Tg reference range, we included TgAb-negative PW (n = 599) from 3 countries with sufficient iodine intake. Main Outcome Measures: We measured the urinary iodine concentration and DBS thyroid-stimulating hormone, total thyroxin, Tg, and TgAb. Results: In the reference population, the median DBS-Tg was 9.2 μg/L (95% confidence interval, 8.7 to 9.8 μg/L) and was not significantly different among trimesters. The reference range was 0.3 to 43.5 μg/L. Over a range of iodine intake, the Tg concentrations were U-shaped. Within countries, the median DBS-Tg and the presence of elevated DBS-Tg did not differ significantly between all PW and PW who were TgAb-negative. Conclusions: A median DBS-Tg of ∼10 μg/L with <3% of values ≥44 μg/L indicated population iodine sufficiency. Concurrent measurement of TgAb did not appear necessary to assess the population iodine status.
Context:Thyroglobulin (Tg) could be a sensitive biomarker of iodine nutrition in pregnant women (PW). A dried blood spot (DBS) assay would simplify collection and transport in field studies. Objectives: Our aims were to (1) establish and test a reference range for DBS-Tg in PW; (2) determine whether co-measurement of Tg antibodies (Abs) is necessary to define population iodine status. Design, Setting, and Participants: Standardized cross-sectional studies of 3870 PW from 11 countries. For the DBS-Tg reference range, we included TgAb-negative PW (n = 599) from 3 countries with sufficient iodine intake. Main Outcome Measures: We measured the urinary iodine concentration and DBS thyroid-stimulating hormone, total thyroxin, Tg, and TgAb. Results: In the reference population, the median DBS-Tg was 9.2 μg/L (95% confidence interval, 8.7 to 9.8 μg/L) and was not significantly different among trimesters. The reference range was 0.3 to 43.5 μg/L. Over a range of iodine intake, the Tg concentrations were U-shaped. Within countries, the median DBS-Tg and the presence of elevated DBS-Tg did not differ significantly between all PW and PW who were TgAb-negative. Conclusions: A median DBS-Tg of ∼10 μg/L with <3% of values ≥44 μg/L indicated population iodine sufficiency. Concurrent measurement of TgAb did not appear necessary to assess the population iodine status.
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