Till Ittermann1, Diana Albrecht1,2, Petra Arohonka3,4, Radovan Bilek5, Joao J de Castro6, Lisbeth Dahl7, Helena Filipsson Nystrom8,9, Simona Gaberscek10, Eduardo Garcia-Fuentes11, Monica L Gheorghiu12,13, Alicja Hubalewska-Dydejczyk14, Sandra Hunziker15, Tomislav Jukic16, Borislav Karanfilski17, Seppo Koskinen4, Zvonko Kusic16, Venjamin Majstorov18, Konstantinos C Makris19, Kostas B Markou20, Christa Meisinger21,22, Neda Milevska Kostova17, Karen R Mullen23, Endre V Nagy24, Valdis Pirags25, Gemma Rojo-Martinez11, Mira Samardzic26, Ljiljana Saranac27, Ieva Strele25, Michael Thamm28, Işık Top29, Malgorzata Trofimiuk-Müldner14, Belgin Ünal29, Seppo Koskinen4, Lluis Vila30, Paolo Vitti31, Benjamin Winter1, Jayne V Woodside32, Katja Zaletel10, Vaclav Zamrazil5, Michael Zimmermann15, Iris Erlund3,4, Henry Völzke1. 1. Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany. 2. Leibniz Institute for Plasma Science and Technology (INP), Greifswald, Germany. 3. Department of Government Services, Finnish Institute for Health and Welfare, Helsinki, Finland. 4. Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland. 5. Institute of Endocrinology, Prague, Czech Republic. 6. Department of Endocrinology, Hospital das Forças Armadas, Lisbon, Portugal. 7. Food Security and Nutrition, Institute of Marine Research (IMR), Bergen, Norway. 8. Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 9. Department of Endocrinology, Sahlgrenska University Hospital, Göteborg, Sweden. 10. Department of Nuclear Medicine, University Medical Centre, Ljubljana, Slovenia. 11. Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga, IBIMA, Málaga, Spain. 12. Carol Davila University of Medicine and Pharmacy, Bucharest, Romania. 13. C.I. Parhon National Institute of Endocrinology, Bucharest, Romania. 14. Department of Endocrinology, Jagiellonian University Medical College, Krakow, Poland. 15. Department of Health Sciences and Technology, ETH, Zürich, Switzerland. 16. Department of Oncology and Nuclear Medicine, Sestre Milosrdnice University Hospital Centre, Zagreb, Croatia. 17. Centre for Regional Policy Research and Cooperation "Studiorum", Skopje, North Macedonia. 18. Institute of Pathophysiology and Nuclear Medicine, Ss. Cyril and Methodius University, Skopje, Former Yougoslavian Rebublic of Macedonia. 19. Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus. 20. Department of Endocrinology, Institute University of Patras Medical School, Patras, Greece. 21. Chair of Epidemiology, Ludwig-Maximilians Universität Munich, UNIKA-T Augsburg, Augsburg, Germany. 22. Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany. 23. Belfast Health and Social Care Trust, Belfast, United Kingdom. 24. Division of Endocrinology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary. 25. Department of Internal Medicine, University of Latvia, Riga, Latvia. 26. Department of Endocrinology and Diabetes, Institute for Sick Children, Podgorica, Montenegro. 27. Department of Pediatrics, Faculty of Medicine, University of Niš, Niš, Serbia. 28. Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany. 29. Department of Public Health, Dokuz Eylul University Medical Faculty, İzmir, Turkey. 30. Department of Endocrinology and Nutrition, Hospital de Sant Joan Despi Moisès Broggi, Barcelona, Spain. 31. Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy. 32. Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom.
Abstract
Background: Knowledge about the population's iodine status is important, because it allows adjustment of iodine supply and prevention of iodine deficiency. The validity and comparability of iodine-related population studies can be improved by standardization, which was one of the goals of the EUthyroid project. The aim of this study was to establish the first standardized map of iodine status in Europe by using standardized urinary iodine concentration (UIC) data. Materials and Methods: We established a gold-standard laboratory in Helsinki measuring UIC by inductively coupled plasma mass spectrometry. A total of 40 studies from 23 European countries provided 75 urine samples covering the whole range of concentrations. Conversion formulas for UIC derived from the gold-standard values were established by linear regression models and were used to postharmonize the studies by standardizing the UIC data of the individual studies. Results: In comparison with the EUthyroid gold-standard, mean UIC measurements were higher in 11 laboratories and lower in 10 laboratories. The mean differences ranged from -36.6% to 49.5%. Of the 40 postharmonized studies providing data for the standardization, 16 were conducted in schoolchildren, 13 in adults, and 11 in pregnant women. Median standardized UIC was <100 μg/L in 1 out of 16 (6.3%) studies in schoolchildren, while in adults 7 out of 13 (53.8%) studies had a median standardized UIC <100 μg/L. Seven out of 11 (63.6%) studies in pregnant women revealed a median UIC <150 μg/L. Conclusions: We demonstrate that iodine deficiency is still present in Europe, using standardized data from a large number of studies. Adults and pregnant women, particularly, are at risk for iodine deficiency, which calls for action. For instance, a more uniform European legislation on iodine fortification is warranted to ensure that noniodized salt is replaced by iodized salt more often. In addition, further efforts should be put on harmonizing iodine-related studies and iodine measurements to improve the validity and comparability of results.
Background: Knowledge about the population's iodine status is important, because it allows adjustment of iodine supply and prevention of iodine deficiency. The validity and comparability of iodine-related population studies can be improved by standardization, which was one of the goals of the EUthyroid project. The aim of this study was to establish the first standardized map of iodine status in Europe by using standardized urinary iodine concentration (UIC) data. Materials and Methods: We established a gold-standard laboratory in Helsinki measuring UIC by inductively coupled plasma mass spectrometry. A total of 40 studies from 23 European countries provided 75 urine samples covering the whole range of concentrations. Conversion formulas for UIC derived from the gold-standard values were established by linear regression models and were used to postharmonize the studies by standardizing the UIC data of the individual studies. Results: In comparison with the EUthyroid gold-standard, mean UIC measurements were higher in 11 laboratories and lower in 10 laboratories. The mean differences ranged from -36.6% to 49.5%. Of the 40 postharmonized studies providing data for the standardization, 16 were conducted in schoolchildren, 13 in adults, and 11 in pregnant women. Median standardized UIC was <100 μg/L in 1 out of 16 (6.3%) studies in schoolchildren, while in adults 7 out of 13 (53.8%) studies had a median standardized UIC <100 μg/L. Seven out of 11 (63.6%) studies in pregnant women revealed a median UIC <150 μg/L. Conclusions: We demonstrate that iodine deficiency is still present in Europe, using standardized data from a large number of studies. Adults and pregnant women, particularly, are at risk for iodine deficiency, which calls for action. For instance, a more uniform European legislation on iodine fortification is warranted to ensure that noniodized salt is replaced by iodized salt more often. In addition, further efforts should be put on harmonizing iodine-related studies and iodine measurements to improve the validity and comparability of results.
Authors: Mia Stråvik; Klara Gustin; Malin Barman; Helena Skröder; Anna Sandin; Agnes E Wold; Ann-Sofie Sandberg; Maria Kippler; Marie Vahter Journal: Front Nutr Date: 2021-12-17
Authors: Aniceta A Mikulska; Dorota Filipowicz; Franciszek K Główka; Ewelina Szczepanek-Parulska; Marek Ruchała; Michał Bartecki; Marta Karaźniewicz-Łada Journal: Molecules Date: 2021-11-10 Impact factor: 4.411