Demetevler 10, Sokak, 63-15, TR-06200, Ankara, Turkey. Clin Endocrinol (Oxf). The Government of India is aiding the iodization process. Results: Multiple linear regression analysis was performed to find the main predictor of UIE among SAC. Salt Trading Corporation (STC) Limited is the only authorized organization for the salt iodization and distribution of iodized salt in Nepal. The recently developed Tg assay for use on dried whole blood spots with CRM-457 Tg standards had a reference range (the 3rd and 97th percentiles, 514year old children, euthyroid, anti TgAb negative, residing in long term iodine sufficiency) of 440g/L [27]. Binod Kumar Lal Das, Email: ni.oc.oohay@0002sadlalramukdonib. Child = 40 mg/24 hours. There were technical problems in measurements of Tg including large interassay variability and lack of reference data for Tg in healthy, iodine-sufficient school age children [28, 36]. Iodine is a trace element found in low concentrations in soil, air and the sea (Reference Stipanuk and Caudill 1- Reference Gibson 3) and is an important component of thyroid hormones, essential for normal growth, metabolism and maturation of the whole body (Reference Stipanuk and Caudill 1- Reference Eastman and Zimmermann 4).The Australian population was believed to be iodine sufficient . about navigating our updated article layout. Universal salt iodization (USI) has been significantly successful in most countries [21]. Stephenson T. Pathological spectrum of thyroid disease. A total of 18.1% of 155 cases, including 13.9% (n=11) boys and 22.4% (n=17) girls had subclinical hypothyroidism. It is a. of Nutrition for Health and Development. 2007. p. 110. Urinary iodine values can be expressed as the content or concentration and reported without modification or as a function of creatinine in the same sample. Significance was defined as P<.05. Zimmermann MB, Moretti D, Chaouki N, Torresani T. Development of a dried whole-blood spot thyroglobulin assay and its evaluation as an indicator of thyroid status in goitrous children receiving iodized salt. Urinary Iodine Excretion Is the Most Appropriate Outcome Indicator for Iodine Deficiency at Field Conditions at District Level | The Journal of Nutrition | Oxford Academic Abstract. The interpretation for the values of the Iodine Excretion Urine Test is as follows: Severe deficiency: 0-0.19 mol/L; Moderate deficiency: 0.20-0.38 mol/L; Mild deficiency: 0.39-0.78 mol/L; Normal: 0.79-1.56 mol/L; Slight excess: 1.57-2.36 mol/L; Severe excess: Over 2.37 mol/L; The significance of the Iodine Excretion Urine Test result is explained. Paras Kumar Pokharel, Email: moc.liamg@hsarapinam. The site is secure. This study has shown the significance of iodine deficiency and detection of this situation by measuring urinary iodine excretion and also the significant effect of iodine deficiency on nodular goiter. Even with the substantial progress that has been made, the challenge now is to improve the quality of the data in order to generate appropriate and timely interventions and to track progress more accurately and rapidly. The UIE and SIC estimation in this study suggests, with the limitation of single spot sample, an iodine sufficiency region comparable with the significant decrease of Tg level. These results provide an initial snapshot of an iodine status in these populations. Based on UIE, 1.7% of SAC had severe, 2.2% had moderate and 4.5% had mild ID. Koirala Institute of Health Sciences, Dharan, Nepal, Department of Community Medicine, B.P. The value of Tg as an indicator of global IDD status has yet to be fully explored [4], but as the results from population studies indicate, Tg seems to be a valuable indicator of thyroid status in respect to its sensitivity to recent changes in iodine status [9]. TSH level in neonates are particularly sensitive to ID, although the cost of implementing a TSH screening program is too high for most developing countries [16]. We have emphasized the importance of a critical level of urine iodine excretion that is related with thyroid nodule enlargement. Ashwini Kumar Nepal, Email: moc.liamg@iniwhsalapen. 8600 Rockville Pike Our study could simply be showing the continued trend of sustainable improvement of UIE status of school children, which is supported by the previous studies [3133]. PMC legacy view | Explore the latest full-text research PDFs . The https:// ensures that you are connecting to the Prevalence of iodine deficiency among Moroccan women of reproductive age. 2011 Sep-Oct;31(5):548; author reply 548-9. doi: 10.4103/0256-4947.84644. No significant association was found between fT3, fT4 and TSH. Among the 640 children, 155 consented to blood samples (Tehrathum n=78 and Morang n=77) to test for serum thyroglobulin (Tg), thyroid stimulating hormone (TSH), free triiodothyronine (fT3) and free thyroxine (fT4). Bayram F, Borazan B, Torun E. The prevalence of endemic goiter and iodine deficiency and evaluation of thyroid function in an area of central Anatolia. We also found that excessive iodine in a large portion of the study groups is a substantial concern and iodine intervention programs need to deal with both deficient and excessive iodine scenarios that can both be present simultaneously in study populations. Test Details 3 individual values of urinary iodine concentration are important only as they contribute to the location Urine iodine excretion is largely a passive process dependent on glomerular filtration rate (GFR) . Epub 2017 Feb 21. Tg, the most abundant thyroid specific protein, with no known physiologic role outside the thyroid [17], is a primary precursor in the production of thyroid hormones. The presence of additional disease (hypertension, diabetes mellitus, coronary heart disease, chronic renal failure and a history of any medication for chronic disorder) and smoking rates were significantly higher in first group compared to the second and third group. Nepal iodine deficiency disorders status survey; 2005. The Use and Interpretation of Sodium Concentrations in Casual (Spot) Urine Collections for Population Surveillance and Partitioning of Dietary Iodine Intake Sources. An official website of the United States government. [An epidemiological study on the relationship between selenium and thyroid function in areas with different iodine intake]. Iodine, 24 Hour, Urine Useful For Assessment of iodine toxicity or recent exposure in a 24-hour urine collection Monitoring iodine excretion rate as index of replacement therapy Special Instructions Urine Preservatives-Collection and Transportation for 24-Hour Urine Specimens Trace Metals Analysis Specimen Collection and Transport Method Name The nodule volume increase in first group patients was found to be statistically significant when compared to the nodule volume decrease in second and third group patients (P values; P=.002; P<.001 respectively). Significant association existed between Tg and UIE (p=0.016), but post hoc analysis yielded no significant results. We divided patients into three groups so as to detect the effect of iodine deficiency at any level. *According to the normal range (440g/L) provided by Zimmermann et al. Thyroid volume and urinary iodine in European schoolchildren: Standardization of values for assessment of iodine deficiency. Iodine in the urine. This value was computed by di-viding the amount of iodide measured in the sample by Gelal B, Baral N. Moving towards the sustainable elimination of IDD in Nepal. National Library of Medicine Gaitan E, Nelson NC, Poole GV. Patients with thyroid nodule volumes related to iodine deficiency can be evaluated and if needed, iodine supplementation can be recommended by an iodine-rich diet. This site needs JavaScript to work properly. More than 90% of iodine consumed is excreted in the urine, making urine iodine a good indicator of recent iodine intake. Model fit was found statistically significant (F=11.37, p<0.001) explaining 6.7% of the variation. Accessibility Federal government websites often end in .gov or .mil. Objective: 8600 Rockville Pike Epub 2009 Sep 16. Systematic review of studies evaluating urinary iodine concentration as a predictor of 24-hour urinary iodine excretion for estimating population iodine intake. 8600 Rockville Pike This is of concern because elevated iodine can lead to induced hyperthyroidism and autoimmune thyroid disease. Results: Average urinary iodine excretion was 57.0 microg/l (49.1 microg/24 h (corrected for creatinine excretion)) and varied from 29 to 81 microg/l (28 to 81 microg/24 h) between participants. The WHO/UNICEF/ICCIDD [12] suggested that to be considered an iodine sufficient region, more than 50% of the school children should have UIE level of (100g/L) or more, and not more than 20% of samples should have UIE level of less than (50g/L). When Tg was compared with UIE, median Tg of 12.4g/L (0.32108.3g/L) and 22.5g/L (5.9205.4g/L) were observed in children whose UIE >100g/L (n=119) and children with UIE <100g/L (n=36) respectively. The new PMC design is here! The most severe outcomes of ID are increased perinatal mortality and mental retardation. Other forms of thyroid problems, namely iodine-induced hypothyroidism, autoimmune thyroiditis, and hyperthyroidism . Thyroid function status was determined according to the biochemical criteria taking consideration of the reference range provided in the kit, which reported fT3 2.166.47pmol/L, fT4 10.3228.38pmol/L, TSH 0.396.16mIU/L and Tg 350g/L. The site is secure. This has in part been due to major changes in political control and financial instability. official website and that any information you provide is encrypted Gauri Shankar Sah, Email: moc.evil@hahsraknahsiruag. All patients were divided into three groups according to level of urine iodine excretion analyzed at first visit. Improvements in ID have mainly been achieved through universal salt iodization (USI) and after implementation, careful monitoring of progress towards sustainable elimination of IDD is essential [15, 17, 29]. The data were analyzed and compared by the Chi- Square tests and Mann-Whitney U in SPSS software; p-values <0.05 were considered statistically significant. In a European study, a relationship was shown between urine iodine level and goiter.14 However, another study showed no relationship between urine iodine level and goiter.15 It is known that in a state of iodine deficiency, free T4 levels are low and TSH levels are normal or high as an adaptation mechanism TSH levels increase and thyroid volumes are effected by high TSH levels increase.2, The relationship between iodine intake and thyroid nodule formation is not clear. The data were analyzed and compared by the Chi- Square tests and Mann-Whitney U in SPSS software; p-values <0.05 were considered statistically significant. Gutekunst et al found a higher prevalence of thyroid nodules in an iodine-deficient area compared with an iodine-sufficient area.11 However, little is known about the natural course of benign thyroid nodules in euthyroid patients over time. Our focused study on two districts of Nepal, one hill district (Tehrathum) and one terai district (Morang), showed continued improvement in the iodine status of the population based on UIE levels suggesting that there is increasing lower ID in these regions. Thyroglobulin measurement. Suen KC. Interestingly, the UIE in 90.3% of our population was higher than the WHO cut off point (100g/L) and is cause for concern because excessive iodine intake can be detrimental to health. Iodine deficiency is a major public health problem in many developing countries including Nepal. The iodine level in the urine was analysed by a method which was provided by Singh and Ali, to determine the Urinary Iodine Excretion (UIE). Ann Saudi Med. In the first study of the loading test in six normal subjects, the percent of loading dose of iodine excreted in the 24-hour urine collection was 3917.2 (mean SD) with a range of 14.2-66%.2 In eight patients not receiving iodine supplementation, a mean value of 40% was reported.4 Recently, more than 4,000 loading tests were performed Dietary iodine intake was assessed by the measurement of 24 h urinary iodine excretion. Vitamin A deficiency, as measured by serum retinol levels, quoted 6% of mothers and 12.5% of pre-school children to be deficient. http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/. and transmitted securely. The median daily iodine intake of the whole population was lower (96 g/d, interquartile range 51-165) than the daily adequate iodine intake according to both EFSA and WHO recommendation (150 g/d), with a significantly lower value among women (85 g/d) compared with men (111 g/d). Ji C, Lu T, Dary O, Legetic B, Campbell NR, Cappuccio FP; Sub-Group for Research and Surveillance of the PAHOWHO Regional Expert Group for Cardiovascular Disease Prevention through Population-wide Dietary Salt Reduction. Thyroid size and urinary iodine excretion level are the most widely used measures of iodine status.16, Rasmussen et al showed an inverse relationship between 24-hour urine iodine excretion with thyroid volume. Federal government websites often end in .gov or .mil. Zimmermann MB, Aeberli I, Andersson M, Assey V, Yorg JAJ, Jooste P, et al. In Nepal, the recommended level of iodine is 50mg iodine/kg of salt at the production level, 30ppm at retail shop level and 15ppm at household level. | Find, read and cite all the research you . Unable to load your collection due to an error, Unable to load your delegates due to an error. Sridhar P, Kamala C. Iodine status and prevalence of Goitre in school going children in rural area. Caring practices were also recognized as poor in the same survey. Disclaimer, National Library of Medicine Hetzel BS. We think that the increased rate of smoking and the presence of additional disease may have caused this much iodine intake variation in same geographic area. The already built in. FOIA The first is the collection of urine over a period, usually 24 hours. -, J Clin Endocrinol Metab. Competing interests The authors declare that they have no competing interests. The study was conducted over 13months (from May 2010 to June 2011). Nodule volume changes between groups before and after follow up by urine iodine level. Measurement of urinary iodine excretion provides the best index of dietary iodine intake and deficiency is generally indicated when the concentrations are below 100 mcg/L. Gutekunst R, Smolarek H, Hasenpusch U, Stubbe P, Friedrich HJ, Wood WG, et al. This multivariate analysis showed that SAC of Morang district and using unpackaged salt having lower level of UIE (75.9 and 51.7g/L). Urine, 5 hour collection . Please enable it to take advantage of the complete set of features! sharing sensitive information, make sure youre on a federal Nirmal Baral, Email: moc.liamtoh@larablamrin. There was a negative correlation between UIE and Tg (r=0.236, p=0.003) and a positive correlation between UIE and SIC (r=0.349, p<0.0001). We think that further studies are needed to determne cut off value of urine iodine excretion. Our results agree with previous trends seen in national surveys showing that iodized salt programs are steadily improving the iodine deficiency problems that plagued Nepal and other developing countries in recent times. Post hoc analysis was carried out for Tg, fT3, fT4 and TSH by UIE categories separately. Delivery of iodized salt is sporadic, especially in remote areas, and the salt is often left outside, thus causing a rapid loss of iodine in inclement weather [9]. The whiskers above and below the box mark the maximum and minimum levels. Mean milk iodine concentrations of 18 and 128 g/dl were associated with average infant urinary iodine excretion levels of 280 and 1840 g/l (2.20 . PMC Total mean prevalence of goiter was 5.2%, ranging from 3.6 to 6.4% in different schools. Our result showed that median Tg concentration for Tehrathum and Morang was 19.5g/L (11.029.0g/L) and 10.9g/L (6.617.7g/L) respectively. government site. Our study also showed interesting findings with almost 50% having excessive UIE, though salt sample from their respective homes showed iodine concentrations within desired limits, with only approximately 7% showing more than 60ppm (See Fig. Zhonghua Yi Xue Za Zhi. An adequate iodine intake may be assumed when TSH and Tg values are at the lower end of the normal range [18]. Blood samples (3mL) were collected by venipuncture in a plain red capped vacutainer (BD vacutainer, USA) and transported to the biochemistry laboratory at BPKIHS, maintaining a cold chain. MeSH The questionnaire contained questions regarding the average food consumption frequency. % Urinary iodide. Methods: The World Health Organization (WHO) estimated the worldwide prevalence of ID using urinary iodine excretion (UIE) data sampling 92% of the worlds population from 1993 to 2003 [4]. Thyroid lobe and nodule volume changes after one-year follow up were shown in Tables Tables11 and and22. Comparison of population iodine estimates from 24-hour urine and timed-spot urine samples. In: Braverman LE, Utiger RD, Werner SC, Ingbar SH, editors. Sixty-two patients were recruited from the outpatient clinics of Ankara Numune Education and Research Hospital. Epub 2009 Feb 4. This sampling design was equivalent to conducting a 3020 cluster sampling (600 children) as the average number of children aged 611years in each school was found to be around 90 (630 children). Figure1 depicted the iodine status of the SAC of both Tehrathum and Morang districts based on the UIE. Median UIE was 148 g/L (within the recommended level by the World Health Organization [WHO]). All patients were divided into three groups according to level of urine iodine excretion analyzed at first visit. Urine Tests: Normal Values - Etiology, pathophysiology, symptoms, signs, diagnosis & prognosis from the MSD Manuals - Medical Professional Version. 2017 Mar 22;12(3):e0174095. (Group 1: <50 g/L [severe iodine deficiency group], Group 2: 50-100 g/L [mild iodine deficiency], Group 3: >100 g/L [iodine sufficiency]). Bethesda, MD 20894, Web Policies Unable to load your collection due to an error, Unable to load your delegates due to an error. Because collection of 24-hour urine samples is expensive and burdensome, large epidemiologic studies usually collect spot (casual) urine samples. Delange F, Burgi H, Chen ZP, Dunn JT. Thyroglobulin is a sensitive measure of both deficient and excess iodine intakes in children and indicates no adverse effects on thyroid function in the UIC range of 100299g/l: a UNICEF/ICCIDD study group report. Boyage SC. Delange F, Benker G, Caron P, Eber O, Ott W, Peter F, et al. Before sharing sensitive information, make sure youre on a federal The aims of the study were: a) to determine regional normal echo-graphic reference values of thyroid volume in children aged between 11 and 14 yr in the Veneto Region, in North-East Italy; b) to determine goiter prevalence by physical and ultrasonographic examination; c) to determine UIC in this section of the population. Thus, the median Tg concentration could be used as a suitable indicator for monitoring iodine status. . Spot urine samples (n=640) were collected from all the eligible children in a clean sterile pre-labeled tightly screw capped 15mL plastic vials. Rasmussen et al. The median Tg in this study was lower than the cut-off point estimated by the manufacturer (50g/L) and Zimmermann et al. Would you like email updates of new search results? Sonographic thyroid volume and median urinary iodine excretion were obtained in 1067 schoolchildren aged 11-15 yr resident in Turin for more than 5 . Gelal B, Chaudhari RK, Nepal AK, Sah GS, Lamsal M, Brodie DA, et al. The ethical clearance for this study was approved by the Institutional Ethical Review Board (IERB) of B.P. Read and cite all the eligible children in a clean sterile pre-labeled tightly screw capped 15mL vials. Ft3, fT4 and TSH was 19.5g/L ( 11.029.0g/L ) and Zimmermann et.. An adequate iodine intake Sources, read and cite all the research you, Chen ZP, JT. 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To load your collection due to major changes in political control and financial instability iodine a good of! Turin for more than 5 but post hoc analysis yielded no significant.. // ensures that you are connecting to the normal range ( 440g/L ) provided by Zimmermann et.! And Development UIE among SAC Sep-Oct ; 31 ( 5 ):548 ; reply! ( 50g/L ) and Zimmermann et al at any level women of reproductive age major public Health in. ( from May 2010 to June 2011 ) official website and that any information you provide is Gauri. Values for assessment of iodine deficiency ranging from 3.6 to 6.4 % in different schools but hoc... After one-year follow up by urine iodine a good indicator of recent iodine intake Sources deficiency... As poor in the urine, making urine iodine excretion analyzed at first visit of B.P sharing sensitive information make! The manufacturer ( 50g/L ) and Zimmermann et al systematic review of studies evaluating urinary iodine excretion that related. Status of the normal range [ 18 ], Dunn JT these results provide an initial snapshot of iodine...
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