Can Neonatal TSH Screening Reflect Trends in Population Iodine Intake?

Burns, Robert; Mayne, Philip; O’Herlihy, Colm; Smith, Damian; Higgins, Mary; Staines, Anthony; Smyth, P. P. A.

doi:10.1089/thy.2008.0036

Cited by 42 publications

(40 citation statements)

References 29 publications

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“…In mild iodine deficiency the frequency may be 3.0–19.9%, and the frequencies of 20.0–39.9% and above 40.0% are found in countries with moderate and severe iodine deficiency, respectively [22]. Although the cutoff TSH level in neonates of 5 mU/L, as set by the WHO, has been criticized [23–25], it has already been used for assessing the prevalence of iodine deficiency [26,27]. However, the Republic of Macedonia including the Prilep region has certified iodine sufficiency [18,19].…”

Section: Discussionmentioning

confidence: 99%

High Incidence of Congenital Hypothyroidism in One Region of the Republic of Macedonia

Anastasovska

Koviloska²,

Kočova

2014

Balkan Journal of Medical Genetics

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Congenital hypothyroidism (CH) is the most common preventable cause of mental retardation in children. Diagnosis is difficult at birth without neonatal screening. Neonatal thyroid screening was established in Prilep, Republic of Macedonia as an integral part of the nationwide screening program. To estimate the prevalence of CH in this region, neonatal thyroid screening was performed on 9757 newborns, during the period 2002–2011. The DELFIA method was applied to measure the thyroid-stimulating hormone (TSH) concentration in dried blood spot samples on standard filter paper taken 48 hours after birth by heel-stick. The TSH cut-off level was 10 mU/L.The neonatal thyroid screening coverage was 93.4%. Eight newborns with CH were detected, with an incidence of 1:1220 live births, significantly higher compared to the nationwide results 1:2602. The TSH level was not significantly dependent on the gender of the newborn. There was a statistically significant difference between the TSH level and the timing of newborn screening sampling (p <0.05) and between the TSH level and the newborn birth weight (p = 0.01). One point ninety-two percent of newborns with TSH levels above 5 mU/L indicated an iodine sufficiency in Prilep. The incidence of CH in Prilep, which is higher when compared with that reported in surrounding countries, might be a consequence of the higher percentage of the Romany population in this region. Further analysis of this population in other regions is warranted.

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Section: Discussionmentioning

confidence: 99%

High Incidence of Congenital Hypothyroidism in One Region of the Republic of Macedonia

Anastasovska

Koviloska²,

Kočova

2014

Balkan Journal of Medical Genetics

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“…Several reports coincide on the utility of neonatal TSH levels >5.0 mU/l assessed with a sensitive monoclonal antibody assay for iodine supply supervision [13,20,21,22]. …”

Section: Discussionmentioning

confidence: 99%

Prevalence and Etiology of Congenital Hypothyroidism Detected through an Argentine Neonatal Screening Program (1997-2010)

et al. 2013

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Introduction: We retrospectively assessed the incidence of congenital hypothyroidism (CH) detected through our neonatal screening program between 1997 and 2010. We describe the diagnostic characteristics of the detected population and verify the impact of a TSH cutoff (CO) change. Patients and Methods: Screening was based on TSH determination on dried blood spot on filter paper samples (IFMA) using a 15 mU/l blood CO until 12/2002 (P1) and 10 mU/l thereafter (P2). Patients were classified as having transient or permanent CH (athyreotic, ectopic, eutopic, with goiter and unknown etiology). Global and diagnostic-related incidences were calculated for the whole studied period with the same CO, and P1 and P2 were compared. Results: Incidences of permanent CH were 1:3,108 (P1) and 1:2,367 (P2). The lower CO detected 22 extra CH, 13 of them definitive (70% with eutopic glands). Only a significant increase (p < 0.05) in eutopic CH was found, partially related to the lower CO applied. A statistically significant association with time was seen for total definitive and ectopic cases (p < 0.05). Conclusion: Our findings revealed some changes in the detected population partially related to the CO applied, with only eutopic dysfunctional disorders being more prevalent in the later years. Total permanent CH and ectopic thyroid disorders showed a trend toward higher detection over time, but their prevalence has not changed significantly in our screening program.

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“…The increasing contribution of milk iodine is likely to be a major reason why estimated dietary iodine intakes in the UK increased between 1952 and 1982 from 80 mg to 255 mg/d (76) . However, several UK authors have suggested that the increasing trend to replace iodine compounds used in the dairy and baking industries with non-iodine alternatives may be decreasing iodine intakes, similar to the situation that has occurred in Australia (77)(78)(79)(80)(81)(82) . If adventitious dietary iodine falls, the population may be vulnerable to iodine deficiency because iodised salt makes up < 5% of all salt consumed in the UK and the Republic of Ireland (77) .…”

Section: The Uk and The Republic Of Irelandmentioning

confidence: 97%

Symposium on ‘Geographical and geological influences on nutrition’ Iodine deficiency in industrialised countries

Zimmermann

2009

Proc. Nutr. Soc.

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Iodine deficiency is not only a problem in developing regions; it also affects many industrialised countries. Globally, two billion individuals have an insufficient iodine intake, and approximately 50% of continental Europe remains mildly iodine deficient. Iodine intakes in other industrialised countries, including the USA and Australia, have fallen in recent years. Iodine deficiency has reappeared in Australia, as a result of declining iodine residues in milk products because of decreased iodophor use by the dairy industry. In the USA, although the general population is iodine sufficient, it is uncertain whether iodine intakes are adequate in pregnancy, which has led to calls for iodine supplementation. The few available data suggest that pregnant women in the Republic of Ireland and the UK are now mildly iodine deficient, possibly as a result of reduced use of iodophors by the dairy industry, as observed in Australia. Representative data on iodine status in children and pregnant women in the UK are urgently needed to inform health policy. In most industrialised countries the best strategy to control iodine deficiency is carefully-monitored salt iodisation. However, because approximately 90% of salt consumption in industrialised countries is from purchased processed foods, the iodisation of household salt only will not supply adequate iodine. Thus, in order to successfully control iodine deficiency in industrialised countries it is critical that the food industry use iodised salt. The current push to reduce salt consumption to prevent chronic diseases and the policy of salt iodisation to eliminate iodine deficiency do not conflict; iodisation methods can fortify salt to provide recommended iodine intakes even ifper capitasalt intakes are reduced to <5 g/d.

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Can Neonatal TSH Screening Reflect Trends in Population Iodine Intake?

Cited by 42 publications

References 29 publications

High Incidence of Congenital Hypothyroidism in One Region of the Republic of Macedonia

High Incidence of Congenital Hypothyroidism in One Region of the Republic of Macedonia

Prevalence and Etiology of Congenital Hypothyroidism Detected through an Argentine Neonatal Screening Program (1997-2010)

Symposium on ‘Geographical and geological influences on nutrition’ Iodine deficiency in industrialised countries

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