Dataset Information

Urinary iodine concentration (UIC) could be a promising biomarker for predicting goiter among school-age children: A systematic review and meta-analysis.

ABSTRACT:

Objectives

To evaluate whether urinary iodine concentration (UIC) can predict goiter among school-age children, and to assess the association between UIC and goiter prevalence.

Methods

We searched the MEDLINE, EMBASE, Cochrane Library (Cochrane Database of Systematic Reviews), Web of Science, CNKI, VIP, and Wan Fang databases for relevant reports in both English and Chinese up to August 25, 2016. The mean differences (MD) and 95% confidence intervals (CI) were calculated for the UIC and goiter prevalence assessments. Pooled odds ratios and 95% CIs were used to compare the prevalences of goiter in the different UIC groups.

Results

We identified 11 case-control studies, and found that children with goiter had lower UIC values, compared to children without goiter (MD: -1.82, 95% CI: -3.24, -0.40, p < 0.05). An increased risk of goiter was associated with UIC values of < 20 ?g/L or > 200 ?g/L.

Conclusion

The results of our meta-analysis suggest that lower UIC values were associated with an increased risk of goiter, and that iodine deficiency may lead to an increased risk of goiter. Furthermore, we observed U-shaped relationships between UIC and the prevalence of goiter, which suggests that both severe iodine deficiency and excessive iodine intake may lead to increased risks of goiter.

SUBMITTER: Xiu L

PROVIDER: S-EPMC5362073 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Publications

Urinary iodine concentration (UIC) could be a promising biomarker for predicting goiter among school-age children: A systematic review and meta-analysis.

Xiu Linlin L Zhong Gansheng G Ma Xueman X

PloS one 20170322 3

<h4>Objectives</h4>To evaluate whether urinary iodine concentration (UIC) can predict goiter among school-age children, and to assess the association between UIC and goiter prevalence.<h4>Methods</h4>We searched the MEDLINE, EMBASE, Cochrane Library (Cochrane Database of Systematic Reviews), Web of Science, CNKI, VIP, and Wan Fang databases for relevant reports in both English and Chinese up to August 25, 2016. The mean differences (MD) and 95% confidence intervals (CI) were calculated for the U ...[more]

PMID: 28328929

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Project description:Background:Iodine deficiency is a public health problem. The universal salt iodization (USI) program is the main, simple, and cost-effective intervention strategy to control iodine deficiency. The study examined the iodine status in school-aged children in Ashanti region, Ghana, using thyroid volumes along with urinary iodine concentrations, the methods recommended by the WHO/ICCIDD for monitoring the sustained impact of USI programs. Methods:This cross-sectional study was conducted among school-aged children (6-12 years) from randomly selected schools in the central and northern part of the Ashanti region, Kumasi Metropolis, and Ejura-Sekyedumase Municipality, respectively. A total of 852 children were enrolled in the study. Thyroid volume and urinary iodine concentrations of the children were determined using the standardized methods recommended by WHO/ICCIDD. Anthropometric measurements were also evaluated. Results:The mean values of thyroid volume in female and male school-aged children were 3.53?±?0.09 and 3.32?±?0.07, respectively. The thyroid size was significantly associated with age (P < 0.0001), weight (P < 0.0001), height (P < 0.0001), BMI (P < 0.05), and BSA (P < 0.0001) by Pearson's correlation in both males and females. The P50 (median) thyroid volumes of school children investigated in this study were generally larger compared to the WHO/ICCIDD reference data by age and body surface area. The median value of urinary iodine concentration was 201.85??g/L, which showed significant sex difference (P value <0.0001). Excessive iodine nutrition (?300??g/L) was observed among 34.4% of male children and 27.6% of female children. Also, 12.8% of the male and 19.5% of the female children had UIC below requirement (<100??g/L). The criteria of thyroid volume per age yielded a goitre prevalence of 2.2%. In contrast, the criteria of thyroid volume by body surface area yielded a goitre prevalence of 0.9%. Conclusion:The study clearly indicated that adequate iodine nutrition exists generally among the school children. However, insufficient and excessive iodine intakes still persist among some of the children. The establishment of local reference values for thyroid volume that might be applicable to precisely define goitre prevalence in the Ghanaian context is highly recommended.

Project description:Background:Universal salt iodization (USI) is the most feasible and cost-effective, and equitable, approach to prevent iodine deficiency. Severe maternal iodine deficiency during pregnancy is associated with serious adverse gestational and birth outcomes. Objectives:The aim was to assess iodine status and identify independent factors associated with urinary iodine concentration (UIC) among women of reproductive age in Tanzania. Methods:This was a weighted, population-based, cross-sectional study in 2985 women of reproductive age (20-49 y) in Tanzania who participated in the Demographic and Health Surveys in 2015-2016 (DHS 2015-2016) and had measured UIC. Multivariable generalized linear regression was used to identify potential factors that were associated with UIC. Results:The median UICs among women consuming inadequately iodized salt (93.6 ?g/L; 25th and 75th percentiles: 43.1, 197.9 ?g/L) and women in the lowest socioeconomic status (92.3 ?g/L; 45.6, 194.4 ?g/L) were below the WHO-recommended ranges (?150 ?g/L for pregnant women and ?100 ?g/L for nonpregnant women). The results of multivariable models indicated that pregnant women had 1.21 ?g/L lower UIC than nonpregnant women (? = -1.21; 95% CI: -3.42, -0.12), breastfeeding women had 1.02 ?g/L lower UIC than nonbreastfeeding women (? = -1.02; 95% CI: -2.25, -0.27), and women with no education had a 1.88 ?g/L lower UIC compared with those with secondary/highest education (? = -1.88; 95% CI: -4.58, -0.36). Women consuming inadequately iodized salt had 6.55 ?g/L lower UIC than those consuming adequately iodized salt (? = -6.55; 95% CI: -9.24, -4.33). The median UIC varied substantially across geographic zones, ranging from 83.2 ?g/L (45.9, 165.3) in the Western region to 347.8 ?g/L (185.0, 479.8) in the Eastern region. Conclusions:Our findings indicated a great heterogeneity in median UIC across regions of Tanzania among women of reproductive age. Poverty, consuming inadequately iodized salt, and lack of education appeared to be the driving factors for lower UIC in Tanzania.

Project description:ObjectiveReports from populations with an insufficient iodine intake suggest that children of mothers with mild iodine deficiency during pregnancy are at risk for cognitive impairments. However, it is unknown whether, even in iodine-sufficient areas, low levels of iodine intake occur that influence cognitive development in the offspring. This study investigated the association between maternal low urinary iodine concentration (UIC) in pregnancy and children's cognition in a population-based sample from a country with an optimal iodine status (the Netherlands).Setting and participantsIn 1525 mother-child pairs in a Dutch multiethnic birth cohort, we investigated the relation between maternal UIC<150 μg/g creatinine, assessed <18 weeks gestation and children's cognition.Outcomes measuresNon-verbal IQ and language comprehension were assessed during a visit to the research centre using Dutch test batteries when the children were 6 years.ResultsIn total, 188 (12.3%) pregnant women had UIC<150 μg/g creatinine, with a median UIC equal to 119.3 μg/g creatinine. The median UIC in the group with UIC>150 μg/g creatinine was 322.9 μg/g and in the whole sample 296.5 μg/g creatinine. There was a univariate association between maternal low UIC and children's suboptimum non-verbal IQ (unadjusted OR=1.44, 95% CI 1.02 to 2.02). However, after adjustment for confounders, maternal low UIC was not associated with children's non-verbal IQ (adjusted OR=1.33, 95% CI 0.92 to 1.93). There was no relation between maternal UIC in early pregnancy and children's language comprehension at 6 years.ConclusionsThe lack of a clear association between maternal low UIC and children's cognition probably reflects that low levels of iodine were not frequent and severe enough to affect neurodevelopment. This may result from the Dutch iodine fortification policy, which allows iodised salt to be added to almost all processed food and emphasises the monitoring of iodine intake in the population.

Dataset Information

Urinary iodine concentration (UIC) could be a promising biomarker for predicting goiter among school-age children: A systematic review and meta-analysis.

Objectives

Methods

Results

Conclusion

Publications

Urinary iodine concentration (UIC) could be a promising biomarker for predicting goiter among school-age children: A systematic review and meta-analysis.

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