Iodine intake is still inadequate among pregnant women eight years after mandatory iodination of salt in Turkey

Kut, Altuğ; Gürsoy, Alptekin; Şenbayram, Şilan; Bayraktar, Nilüfer; Budakoğlu, Işıl İrem; Akgün, Hediye

doi:10.1007/bf03346625

Cited by 26 publications

(33 citation statements)

References 12 publications

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“…Nevertheless, many studies have shown an inverse relationship between neonatal TSH and maternal urinary iodine concentration, supporting the notion that the frequency of neonatal TSH concentrations >5 µU/mL was a sensitive indicator of iodine nutrition during pregnancy (39,40,41). In recent years, several studies have already demonstrated insufficient iodine intake of pregnant women living in different regions of Turkey (17,18), including apparently iodine-sufficient areas (19). As a result, the finding of the high frequency of transient CH is in line with the high recall rate in the NNSP.…”

Section: Discussionmentioning

confidence: 99%

“…The prevalence of transient CH in Turkey is much higher than the expected rate of 5-10% reported for iodine-sufficient populations (14). Numerous studies carried out in newborns (15,16,17) and pregnant women (18,19,20) have already demonstrated that iodine deficiency is a continuing problem of Turkey. Also, a recent study revealed that iodine excess could be a problem in newborns due to use of iodine-containing antiseptics during delivery despite maternal iodine deficiency (20).…”

Section: Introductionmentioning

confidence: 99%

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Transient Congenital Hypothyroidism in Turkey: An Analysis on Frequency and Natural Course

Kara

Gunindi²,

Yılmaz³

et al. 2016

Jcrpe

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Objective: Prevalence of congenital hypothyroidism (CH) in Turkey at birth was reported to be as high as 1:650 in 2008-2010. Incidence rates of permanent and transient CH separately are unknown due to lack of follow-up data. We aimed to evaluate the impact of transient hypothyroidism on increasing incidence of CH and to determine the natural course and the clinical, biochemical, and imaging characteristics of transient CH.Methods: Baseline and follow-up data of the infants with CH detected at screening in six provinces in the Black Sea Region were analyzed retrospectively during a time period covering the years 2008-2010.Results: Among 138 cases (48% female), 16 (12%) showed transient hyperthyrotropinemia which resolved without intervention. Of the treated 122 cases, 63 (52%) had transient CH. While its frequency was 35% in 2008, it increased to 56% in 2009-2010, following a lowering of the thyroid stimulating hormone cutoff value. The frequency was higher in inland provinces than in coast (67% vs. 43%; p=0.01).Clinical characteristics of permanent and transient cases were similar except female-to-male sex ratios (1.5:1 vs. 0.6:1; p=0.02). L-thyroxine was discontinued in 70% of transient cases before 3 years of age at a median age of 19 (2-36) months. The only indication for early discontinuation of treatment was a low L-thyroxine dose, which was 1.25±0.27 µg/kg/day at withdrawal time.Conclusion: Our regional follow-up data showed that more than half of newborns with primary CH had transient thyroid dysfunction. In the majority of cases, discrimination between transient and permanent CH can be made before age 3 years, as indicated by cessation of L-thyroxine treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Transient Congenital Hypothyroidism in Turkey: An Analysis on Frequency and Natural Course

Kara

Gunindi²,

Yılmaz³

et al. 2016

Jcrpe

View full text Add to dashboard Cite

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“…The public health strategy to minimize iodine deficiency is salt iodization; in Turkey salt iodization become mandatory in 1998 [13], [14]. Despite these efforts to fortify the population through iodized salt, some populations in Turkey appear to remain iodine deficient [15], [16]. For example, a recent study found low iodine intakes in two cities in Turkey (Burdur [near Isparta] and Kayseri) [16], [17].…”

Section: Introductionmentioning

confidence: 99%

Iodine Status in Turkish Populations and Exposure to Iodide Uptake Inhibitors

et al. 2014

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Perchlorate, nitrate, and thiocyanate are competitive inhibitors of the sodium iodide symporter of the thyroid membrane. These inhibitors can decrease iodine uptake by the symporter into the thyroid gland and may disrupt thyroid function. This study assesses iodine status and exposure to iodide uptake inhibitors of non-pregnant and non-lactating adult women living in three different cities in Turkey (Istanbul, Isparta and Kayseri). We measured iodine and iodide uptake inhibitors in 24-hr urines collected from study participants (N = 255). All three study populations were mildly iodine deficient, with median urinary iodine (UI) levels of 77.5 µg/L in Istanbul, 58.8 µg/L in Isparta, and 69.8 µg/L in Kayseri. Perchlorate doses were higher in the study population (median 0.13 µg/kg/day), compared with a reference population (median 0.059 µg/kg/day), but lower than the U.S. EPA reference dose (0.7 µg/kg/day). Urinary thiocyanate levels increased with increasing exposure to tobacco smoke, with non-smokers (268 µg/L) significantly lower than light smokers (1110 µg/L), who were significantly lower than heavy smokers (2410 µg/L). This pilot study provides novel data indicating that study participants were moderately iodine deficient and had higher intakes of the iodide uptake inhibitor perchlorate compared with a reference population. Further investigation is needed to characterize the thyroid impact resulting from iodine deficiency coupled with exposure to iodide uptake inhibitors such as perchlorate, thiocyanate and nitrate.

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“…Erdogan MF et al [15] found median UIC 89 μg/L in nonsurgical hospital stuff in in Ankara in a recent study. Kut A et al [16] found iodine deficiency in 49, 6% of Turkish first trimester pregnant women in Adana. Oguz Kutlu A, et al [17] found iodine deficiency in 72, 8% of Turkish second trimester pregnant women in Ankara.…”

Section: Discussionmentioning

confidence: 98%

Iodine deficiency has recurred in Istanbul, Turkey

Gökçel¹

2017

EMIJ

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Background: Iodine status of Turkish people improved after mandatory iodination of table salt; however there is a contrary results and difference between regions and age groups. Aim:The aim of the present study was to assess iodine status in people living in Istanbul, Turkey.Methods: This was a single center, retrospective study on subjects who attended to Acibadem Labmed Clinical Laboratories between January 2009 and December 2013 for the measurement of urinary iodine concentration (UIC). Subjects with UI and thyroid stimulating hormone (TSH) levels were included. Data on UIC was available for 1933 subjects (1629 women and 304 men).Results: Mean UIC was 123, 2 µg/g creatinine (µg/gCr) and mean age of the subjects was 36, 58 ± 0, 33 years. Mean UIC of men were lower than women (101, 55 ± 3, 95 vs 127, 24 ± 2, 22 µg/gCr; p<0.001). Totally 917 (47, 4%) of the subjects were iodine deficient (UIC < 100 µg/gCr). Men were more iodine deficient than women (59, 5% vs 45, 2%; p<0.001). Younger subjects were more iodine deficient than the older ones (p<0.001). TSH levels of iodine deficient and sufficient subjects were not different (3, 34 ± 0, 24 vs 3, 19 ± 0, 22 mIU/L; p>0, 05). There was a positive correlation between iodine level and age (r = 0, 149; p<0.03), but there was no correlation between iodine and TSH levels (p>0.05). Conclusion:A considerable number of subjects in our study had UIC below the normal ranges for adults, demonstrating that iodine deficiency continues to be a major healthcare concern in Turkey. At least, mild iodine deficiency has recurred in people living in Istanbul. The results emphasize the need for continuous monitoring in all regions, even in a country with iodine sufficiency. Keywords: Material and MethodsThis was a single center, retrospective study on subjects who attended to Acibadem Labmed Clinical Laboratories between January 2009 and December 2013 for the measurement of UIC. The Acibadem University Ethics Committee for Human Studies approved the study protocol. Subjects with urinary iodine (UI) and thyroid stimulating hormone (TSH) levels were included.Data on UIC was available for 1933 subjects (1629 women and 304 men). Data on UIC and TSH were available for 212 of these subjects. UIC were determined according to previously described method [5]. UI levels greater than 700 µg/g creatinine were eliminated from analysis because it was unclear if these samples were a result of contamination or toxicity. TSH levels were measured in C8000 Modular Analytics by using reagents from Roche Diagnostics. Repeatability CV and intermediate precision CV were determined to be ≤3,0 % and ≤ 7,2 % respectively by the manufacturer.Descriptive statistics were presented as mean ± standard error mean (SEM) for normally distributed data, and as counts and percentages for categorical data. The relationship between the categorical variables was examined using the Pearson Chisquare test; otherwise Fisher's exact test was used. The t-test or one-way Anova test was used to compare independent variables ...

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Iodine intake is still inadequate among pregnant women eight years after mandatory iodination of salt in Turkey

Abstract: Our study revealed that iodine deficiency still remains a serious problem for pregnant women. Based on our results, antenatal follow-up protocols in the primary care setting in Turkey must include iodine supplementation.

Cited by 26 publications

References 12 publications

Transient Congenital Hypothyroidism in Turkey: An Analysis on Frequency and Natural Course

Transient Congenital Hypothyroidism in Turkey: An Analysis on Frequency and Natural Course

Iodine Status in Turkish Populations and Exposure to Iodide Uptake Inhibitors

Iodine deficiency has recurred in Istanbul, Turkey

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