Case–Control Study of Papillary Thyroid Carcinoma on Urinary and Dietary Iodine Status in South Korea

Lee, Joon Hyop; Song, Ra Yeong; Yi, Jin Wook; Yu, Hyeong Won; Kwon, Hyungju; Kim, Sujin; Chai, Young Jun; Choi, June Young; Moon, Jae Hoon; Lee, Kyu Eun; Park, Young Joo; Park, Sue Kyung

doi:10.1007/s00268-017-4287-x

Cited by 20 publications

(24 citation statements)

References 53 publications

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“…A number of epidemiological studies have attempted to elucidate the association between excessive iodine intake and the risk of developing PTC. For example, Lee et al (4) found that the median urinary iodine concentration (UIC) and food frequency questionnaire score in patients with PTC were significantly higher compared with those in healthy control subjects. Zhou et al (5) discovered that UIC was higher in patients with nodular goiter and PTC compared with the general population.…”

Section: Introductionmentioning

confidence: 99%

Association between excessive chronic iodine exposure and the occurrence of papillary thyroid carcinoma

et al. 2020

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The aim of the present study was to elucidate the association between excessive chronic iodine exposure and the risk of developing papillary thyroid carcinoma (PTC). The demographic information and pathological characteristics of patients with thyroid nodules were retrieved from medical records at The Second Hospital of Shandong University. A fasting urine specimen was collected, and creatinine and urinary iodine concentration (UIC) were determined. The water iodine data from the domicile districts of these patients were collated from published reports. The results revealed that almost half of the patients with PTC (44.3%) also exhibited a high UIC (≥300 µg/l). Multivariate analysis revealed that the adjusted odds ratio for high UIC was 3.987 (95% CI: 1.355-11.736) and the adjusted area under the receiver operating characteristic curve was 0.776 (95% CI: 0.687-0.864), which was associated with PTC risk in patients with thyroid nodules. Integrated ecological assessment of chronic iodine exposures demonstrated that >80% (81.4%) of the patients with PTC who also exhibited a high UIC were from historically non-iodine-deficient regions, and 66.7% of patients with PTC who resided in historically iodine-excessive regions were characterized by high UICs. Importantly, a high UIC was significantly associated with capsular invasion and extrathyroid metastasis (P<0.05). Moreover, self-matching results indicated that, in patients with PTC, there were no significant differences in UIC grading between the pre-and postoperative specimens. In conclusion, excessive chronic iodine exposure is significantly associated with the risk of PTC, which contributes to increased capsular invasion and extrathyroid metastases. However, further research is required to validate these findings and to elucidate the potential molecular mechanisms involved.

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Section: Introductionmentioning

confidence: 99%

Association between excessive chronic iodine exposure and the occurrence of papillary thyroid carcinoma

et al. 2020

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“…The present results that the level of urinary iodine was increased during PTC were consisted with the reports from mainly epidemiological studies. Based on this appearance, many observers dogmatically considered that excessive iodine intake induced the incidence of PTC and iodine intake was a risk factor for the disease [7,16,22,[24][25][26]. In fact, there were two issues: one was the ambiguity of urinary iodine and iodine intake, and the other was the confusion of cause-effect relationship.…”

Section: High Urinary Iodine May Be a Specific Characteristic Of Ptcmentioning

confidence: 99%

“…It has been confirmed that iodine excess-induced thyroid dysfunction may lead to benign thyroid disease, such as autoimmune thyroiditis, benign thyroid nodules (BTN), hypothyroidism and hyperthyroidism [3]. But, it remains considerable controversy about the relationship between high iodine intake and thyroid cancers (TC) risk [4][5][6][7][8][9][10][11][12][13].…”

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confidence: 99%

“…Over the past few decades, TC incidence has rapidly increased, PTC predominated in the histological types of TC after universal salt iodization (USI) [4][5][6]14]. It is considered that increasing iodine intake has contributed to the increase in PTC incidence, whereas it is debatable [4][5][6][7][8][9][10][11][12][13].…”

mentioning

confidence: 99%

“…As such, urinary iodine is considered a sensitive marker of current iodine intake and can reflect recent changes in iodine status [15]. Several studies have explored the association of high urinary iodine with TC; however, the results are inconsistent: some studies reported a strong association between high urinary iodine and TC [7,[16][17][18][19][20][21][22][23][24][25], whereas other studies reported no association [26][27][28].…”

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confidence: 99%

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Urinary iodine is increased in papillary thyroid carcinoma but is not altered by regional population iodine intake status: a meta-analysis and implications

Yan

Zhang²,

Shen

et al. 2019

Endocr J

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Excessive iodine intake has been associated with increased risk of thyroid cancer (TC) in many studies, but the results have not been consistent. Since it was common knowledge that urinary iodine (UI) is considered a sensitive marker of current iodine intake, we conducted a meta-analysis to clarify the association between high UI and TC. We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, and the Cochrane Collaboration. Betweengroup meta-analyses were performed to compare UI between TC patients and the healthy/euthyroid subjects in local residents and benign thyroid nodules (BTN) patients. Then, between-group meta-analyses to compare the incidence rate of iodine excess were also conducted. The 22 case-control studies included in the meta-analyses represented 15,476 participants. It is the first time to clarify that UI was increased in PTC patients, but was not altered by regional population iodine intake status. Compared with BTN patients, PTC patients exhibited both higher UIC and higher odds ratio of iodine excess only in adequate iodine intake status subgroup; UIC, not the odds ratio of iodine excess, was higher in patients with PTC than those with BTN in above requirements iodine intake subgroup. A novel insight is offered that high UI in PTC patients was less influenced by regional population iodine intake status. It is indicted that high iodine intake is not a risk factor for PTC and high urinary iodine is just a specific characteristic of the disease.

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Papillary Thyroid Carcinoma: Current Position in Epidemiology, Genomics, and Classification

Lam

2022

Methods in Molecular Biology

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Case–Control Study of Papillary Thyroid Carcinoma on Urinary and Dietary Iodine Status in South Korea

Abstract: Our results indicate that iodine status differs significantly between patients with PTC and healthy controls, suggesting that iodine may be involved in the occurrence of PTC, although the association between iodine levels and BRAF mutational status did not reach statistical significance.

Cited by 20 publications

References 53 publications

Association between excessive chronic iodine exposure and the occurrence of papillary thyroid carcinoma

Association between excessive chronic iodine exposure and the occurrence of papillary thyroid carcinoma

Urinary iodine is increased in papillary thyroid carcinoma but is not altered by regional population iodine intake status: a meta-analysis and implications

Papillary Thyroid Carcinoma: Current Position in Epidemiology, Genomics, and Classification

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