Saliva Iodine Concentration in Children and Its Association with Iodine Status and Thyroid Function
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Abstract Context The effectiveness of saliva iodine concentration (SIC) in evaluating iodine status in children is not clear. Objective We aimed to explore associations between SIC and assessed indicators of iodine status and thyroid function. Design Cross-sectional study. Setting Primary schools in Shandong, China. Participants Local children aged 8 to 13 years with no known thyroid disease were recruited to this study. Main outcome measures Blood, saliva, and urine samples were collected to evaluate thyroid function and iodine status. Results SIC positively correlated with spot urinary iodine concentration (r = 0.29, P < 0.0001), 24-hour urinary iodine concentration (r = 0.35, P < 0.0001), and 24-hour urinary iodine excretion (r = 0.40, P < 0.0001). The prevalence of thyroid nodules (TN) and goiter showed an upward trend with SIC quantiles (P for trend < 0.05). Children with SIC <105 μg/L had a higher risk of insufficient iodine status (OR = 4.18; 95% CI, 2.67-6.56) compared with those with higher SIC. Those having SIC >273 μg/L were associated with greater risks of TN (OR = 2.70; 95% CI, 1.38-5.26) and excessive iodine status (OR = 18.56; 95% CI, 5.66-60.91) than those with lower SIC values. Conclusions There is a good correlation between SIC and urinary iodine concentrations. It is of significant reference value for the diagnosis of iodine deficiency with SIC of less than 105 μg/L and for the diagnosis of iodine excess and TN with SIC of more than 273 μg/L. Given the sanitary nature and convenience of saliva iodine collection, SIC is highly recommended as a good biomarker of recent iodine status in school-aged children.Nutritional deficiency
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No less than 200 million members of the world’s human population have the thyroid enlargements known as goiters and associated disorders, resulting in a public health and socioeconomic problem of major proportions (1,2). It is clear that the greatest goitrogenic factor among the world’s population is iodine deficiency. Seventy-five percent of people with goiter live in less developed countries where iodine deficiency is prevalent. The role of iodine deficiency as an environmental determinant in the development of endemic goiter is firmly established. However, iodine deficiency does not always result in endemic goiter (3), and iodine supplementation does not always result in complete eradication and prevention of goiter (1,3–9). Even in the presence of extreme iodine deficiency there is an unequal geographic distribution of goiter.
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Objective To look into the current distribution of iodine deficiency area in Shandong province and to guide the re-defined iodine deficiency area and to supplement iodine scientifically. Methods In 2008, 100 iodine deficiency counties（cities, districts）, designated in Shandong province＇s ＂to supplement iodized salt to eliminate the hazard of iodine deficiency management regulations＂, were selected in the study. One to three samples were collected from water source which was used by the majority of local residents in the 100 iodine deficiency places and iodine concentration was tested by As3＋-Ce4＋ catalyzing spectrophotometry. Results A total of 65 716 water samples were collected. Sample recovery efficiency reached 99.8%（65 572/65 716）. The median water iodine was 5.57 μg/L, with 82.05%（ 1097/1337 ） of the township（town） met criteria for the classification of iodine deficiency areas（water iodine 〈 10 μg/L）, 17.43%（233/1337） of the township （town） water iodine moderate（water iodine 10 - 150 μg/L）, and 0.52%（7/1337）of the township（town） should be defined high iodine areas（water iodine 〉 150 - 300 μg/L）. Conclusions The iodine deficiency areas should be redefined because water iodine concentrations of iodine deficiency areas have changed. We suggest that the smallest place to supply salt with different range of iodine content is set to the township（town）.
Key words:
Iodine; Deficiency diseases; Drinking; Data collection
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Severe iodine deficiency causes hypothyroidism that results in impaired somatic growth and motor development in children. Mild and moderate iodine deficiencies cause multifocal autonomous growth of thyroid, which results in thyrotoxicosis. On the other hand, iodine excess is associated with the development of hypothyroidism and thyroid autoimmunity. In areas of iodine deficiency, a sudden increase in iodine intake is associated with transient hyperthyroidism. Recent studies demonstrated that long-term thyroid function of subjects who experienced both iodine deficiency and iodine excess during childhood tended to be abnormal despite optimization of their current iodine intake. Iodine status in the Korean Peninsula is very unique because people in the Republic of Korea have been shown to have predominantly excessive iodine levels, whereas the Democratic People's Republic of Korea is known to be an iodine-deficient area. Further research is warranted to verify the optimal ranges of iodine intake and to clarify the effects of iodine intake on thyroid disorders in the Korean Peninsula. Keywords: Thyroid, Iodine, Hypothyroidism
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Iodine deficiency remains a considerable challenge worldwide, even after decades of efforts to address the problem. The aim of this review is to present the current situation in historically iodine-deficient Pakistan regarding iodine nutritional status and place it in a global perspective. We collected relevant articles from online bibliographic databases and websites of concerned organizations that addressed prevalence of goiter/iodine deficiency and barriers to sustainable control. We divided the studies into pre- and post-1994, a landmark year when Pakistan formally adopted the universal salt iodization (USI) programme. Overall, 56 studies reported goiter/iodine deficiency prevalence in Pakistan. Before 1994, six studies (30%) reported a goiter prevalence ≥70%, while nine studies (45%) reported a goiter prevalence between 30% and 70%. Only five studies (25%) found a goiter prevalence less than 30%, of which only two studies reported prevalence <10%. From 1994 onwards, 15 studies (41.7%) reported a goiter/iodine deficiency (ID) prevalence ≥50%, of which seven studies reported prevalence ≥70%, while three studies (8.3%) found a goiter prevalence of 30%-49%, nine studies (25%) found a goiter prevalence of 10%-29%, and five studies (13.9%) reported prevalence of <10%. Four studies (11.1%) reported lower goiter prevalence but higher prevalence of iodine deficiency. The efforts in the past two decades resulted in up to a 50% decline in iodine deficiency disorders (IDD). Variable remaining factors and the recent results, however, indicate that this decline may be non-uniform and even over-estimated. Coordinated and regionally adopted efforts for eradication of IDD from all stakeholders should be pursued. Policy makers should take steps to protect future generations and alert concerned organizations about the importance of careful assessments and estimates of iodine nutritional status.
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According to the detection of hearings ability of children in iodine deficiency areas who was born before and after iodine supplement, the effects of iodine supplement on hearing system development was evaluated.Hearing was tested by AS-72 type pure zone diagnostic audiometer(made in Denmark). Hearing of 11-14 years old students were tested before iodine supplement in iodine deficiency areas in 1984, the control was students living in non-iodine deficiency areas. Iodine salt (50 mg/kg) were supplied by the end of 1984, the hearings of children born after one year of iodine supplied were tested in 1999. The result showed that the average hearing threshold of students before iodine supplied in iodine deficiency areas was significance higher than of non-iodine deficiency areas. The hearing of children born after one year of iodine salt supplied in deficient areas had no significant difference from that of normal areas. The development of hearing system might be deteriorated by iodine deficiency during pregnant. It was able to meet the need of iodine that pregnant women ate 1:20 thousands iodine salt.
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Purpose. Conducting a comparative analysis and assessment of the dynamics of endemic goiter and iodine deficiency in the population of boys of the Republic of Dagestan at the age of 11–13 years for the period 2002–2013, living in different ecological and geographical zones. Patients and methods. 3457 adolescent boys 11–13 years old, living in different ecological and geographical zones, were surveyed. Methods of investigation were: determination of daily excretion of iodine in urine, palpation and ultrasound examination of the thyroid gland. Results. It was revealed that during the period of preventive measures there was an improvement in iodine supply regardless of the area of residence. However, against the background of preventive measures in the lowland zone, iodine deficiency decreased not evenly, and in some cases the aggravation occured. Conclusion. The incidence of endemic goiter and the severity of iodine deficiency in boys aged 11–13 years in the mountain and foothill ecology and geographical zones of the Republic of Dagestan are generally comparable to those of iodine deficiency and endemic goiter in the general population of the Republic of Dagestan. On a flat ecogeographical zone, endemic goiter in boys 11-13 years is less common than in the general population in this region. Preventive measures to combat iodine deficiency have led to a decrease in the frequency of endemic goiter, but constant monitoring is required. As a result, there was no correlation between the incidence of endemic goiter and the severity of iodine deficiency.
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Objective To look into the current distribution of iodine deficiency areas in Zibo city and to guide the re-defined iodine deficiency areas in order to supplement iodine scientifically.Methods 8 iodine deficiency counties(cities,districts),and 1 high iodine counties(cities,districts) were investigated in Zibo city according toSupplement iodized salt to eliminate the hazard of iodine deficiency management regulations.One to three samples were collected from water source which was used by the majority of local residents in 8 iodine deficiency areas and iodine concentration was tested by As3+-Ce4+ catalyzing spectrophotometry.Results A total of 3 676 water samples were collected.The median water iodine was 2.0 μg/L,64.71%(88/136) of the township(town) met criteria for the classification of iodine deficiency areas(water iodine10 μg/L),26.47%(36/136)of the township(town) water iodine moderate(water iodine 10~150 μg/L),and 8.82%(12/136)of the township(town) should be defined as high iodine areas(water iodine150~300 μg/L).However,in high iodine areas,9.26%(5/54) township(town) met criteria for the classification of iodine deficiency areas,35.19%(19/54) of the township(town) water iodine moderate,55.56%(30/54) should be defined as high iodine areas.Conclusions The deficiency and high iodine areas should be taken appropriate measures.The township(town) should be set as the smallest place to supply salt with different range of iodine content.
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The main consequence of iodine deficiency in the environment is the development of goiter in people living in iodine-deficient regions (endemic goiter). In this regard, for a long time it was considered that goiter is the only manifestation of this condition. It has now been proven that, in addition to goiter, iodine deficiency also has other adverse effects on human health. In 1983, the term "endemic goiter" was replaced by the term "iodine deficiency diseases" (IDD). These diseases are caused by a decrease in the functional activity of the thyroid gland in response to iodine deficiency.
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