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Iodine is a key micronutrient essential for the synthesis of thyroid hormone, which regulates metabolic processes and maintains overall health. Despite its importance, iodine deficiency is a global health issue, leading to disorders such as goiter, hypothyroidism, and developmental abnormalities. Biofortification of crops with iodine is a promising strategy to enhance the dietary iodine intake, providing an alternative to iodized salt. Curly kale (Brassica oleracea var. sabellica) is a nutrient-rich vegetable high in vitamins A, C, K; minerals; fiber; and bioactive compounds with antioxidant, anti-inflammatory, and detoxifying properties. This study evaluates the effects of diets containing iodine-biofortified curly kale ('Oldenbor F1' and 'Redbor F1') on iodine content, tissue iodine levels, and various biochemical parameters in laboratory rats. The biofortified curly kale was enriched with 5,7-diiodo-8-quinolinol. The iodine content in the AIN-93G (control) diet and the non-biofortified curly kale diets did not differ significantly. However, diets with 5,7-diiodo-8-quinolinol biofortified kale showed significantly higher iodine levels compared with the control diets. Tissue analysis revealed the highest iodine concentrations in the liver and kidneys of rats fed diets with biofortified curly kale, indicating better iodine bioavailability. Biochemical analysis showed that rats fed the biofortified kale diet had lower total cholesterol (TC) and triglyceride (TG) levels compared with rats fed the control diet. Additionally, the biofortified diet improved the liver function markers (ALAT, ASAT) and reduced oxidative stress markers (TBARS). The study also investigated the expression of thyroid-related genes (Slc5A5, Tpo, Dio1, Dio2) in response to diets containing biofortified kale. The results demonstrated significant changes in gene expression, indicating adaptive mechanisms to dietary iodine levels and the presence of bioactive compounds in the biofortified kale. The study also observed variations in uric acid levels, with lower concentrations in rats fed a diet with biofortified curly kale. Biofortified curly kale supports thyroid function and improves liver and kidney health by reducing oxidative stress and modulating key biochemical and genetic markers. These findings suggest that biofortified curly kale can effectively increase dietary iodine intake as a nutritional intervention to address iodine deficiency and promote overall health. [ABSTRACT FROM AUTHOR]

Objective: To assess pre-term birth, low birth-weight and growth restriction according to maternal thyroid screening results and subsequent treatment. Methods: This is a nonintervention nested case-control study derived from 10,052 asymptomatic women previously screened during the first trimester marker with anti-thyroid peroxidase antibodies, serum thyroid stimulating hormone, and free thyroxine. Screening results had been classified as positive with one or more markers outside the normal range and referred to an endocrinologist. Cases were 512 women with positive results and information on recommended treatment: 204 thyroxine, propylthiouracil or surgery, and 308 no treatment or only iodine. Controls were a sequential sample of 1292 women with negative results. All cases and controls had information on gestation at delivery or birth-weight. Outcome measures were pre-term birth (<37 weeks), low birth-weight (<2.5 kg) and, for singletons, small for gestational age (SGA; <10th percentile). Results: Among singleton pregnancies, there was a higher prevalence of both pre-term birth (risk ratio (RR) 1.69, 95% confidence interval (CI) 1.21–2.36, p <.002) and low birth-weight (RR 1.72, 95% CI 1.13–2.62, p <.02) in cases compared with controls. An increase in low birth-weight was also present in term pregnancies, but not significant (RR 1.80, 95% CI 0.78–4.14, p =.16), and there was no difference in SGA prevalence (1.24, 95% CI 0.93–1.65, p =.14). Among cases there was no significant difference in these rates according to treatment even after logistic regression, allowing for the individual screening marker levels and maternal weight. Conclusions: Women with positive thyroid screening results are at increased risk of pre-term birth regardless of thyroid dysfunction or subsequent treatment. An association with low birth-weight is probably secondary to early delivery. [ABSTRACT FROM AUTHOR]

Iodine is a micronutrient that is required for thyroid hormone synthesis. The iodide cycle in thyroid hormone synthesis consists of a series of transport, oxidation, organification, and binding/coupling steps in thyroid follicular cells. Common sources of iodine include the consumption of an iodine-rich diet or iodine-fortified foods, the administration of amiodarone, iodine-containing supplements, or iodinated contrast media, and other miscellaneous sources. Methods to assess population iodine status include the measurement of urinary iodine concentrations, blood thyroglobulin levels, prevalence of elevated neonatal thyrotropin levels, and thyroid volume. Although excessive iodine intake or exposure is generally well tolerated, an acute iodine load may result in thyroid dysfunction (hypothyroidism or hyperthyroidism) in certain susceptible individuals due to the failure to escape from the Wolff–Chaikoff effect and to the Jod–Basedow phenomenon, respectively. In this review, we discuss the associations between excessive iodine intake or exposure, with particular focus on iodinated contrast media as a common source of excess iodine in health care settings, and risks of incident thyroid dysfunction. We also summarize the risks of iodine excess in vulnerable populations and review current guidelines regarding the screening and monitoring of iodinated contrast–induced thyroid dysfunction. Finally, we discuss the long-term potential nonthyroidal health risks associated with iodine excess and suggest the need for more data to define safe upper limits for iodine intake, particularly in high-risk populations. [ABSTRACT FROM AUTHOR]

Thyroid hormones (THs) require iodine for biosynthesis and play critical roles in brain development. Perchlorate is an environmental contaminant that reduces serum THs by blocking the uptake of iodine from the blood to the thyroid gland. Using a pregnant rodent model, we examined the impact of maternal exposure to perchlorate under conditions of dietary iodine deficiency (ID) on the brain and behavior of offspring. We observed modest reductions in thyroxine (T4) in the serum of dams and no effect on T4 in pup serum in response to maternal exposure to 300 ppm of perchlorate in the drinking water. Likewise, serum T4 was reduced in ID dams, but, as with perchlorate, no effects were evident in the pup. However, when ID was coupled with perchlorate, reductions in pup serum THs and transcriptional alterations in the thyroid gland and pup brain were detected. These observations were accompanied by reductions in the number of cortical inhibitory interneurons containing the calcium-binding protein parvalbumin (Pvalb). Alterations in Pvalb expression in the neonatal brain were associated with deficits in the prepulse inhibition of acoustic startle in adult male offspring and enhanced fear conditioning in females. These findings support and extend structural defects in the brain previously reported in this model. Further, they underscore the critical need to consider additional non-chemical stressors in the determination of hazards and risks posed by environmental contaminants that affect the thyroid system. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to assess the knowledge, attitudes, and practices (KAPs) regarding iodine deficiency among the population of Kyrgyzstan, with a focus on pregnant women, and to correlate these factors with the urinary iodine concentration (UIC). Methods: A cross-sectional study was conducted using structured questionnaires and urine sample analysis to evaluate iodine status. A multistage stratified sampling method ensured a representative sample from both urban and rural areas. Descriptive statistics were used to summarize demographic characteristics and KAP variables, whereas chi-square tests and multivariate logistic regression analysis were used to identify predictors of KAP outcomes. Results: The study included 690 participants, with balanced representation from both urban and rural areas. The mean knowledge score was moderate, with significant gaps in the understanding of iodine deficiency. The participants generally had positive attitudes toward iodine intake but exhibited suboptimal practices, especially in rural areas. Pregnant women demonstrated greater knowledge, but fewer practical behaviors related to iodine intake. Compared with rural participants, urban participants had higher UIC levels, indicating better iodine nutrition. Multivariate regression analysis revealed that residence, knowledge, attitudes, and practices significantly influenced UIC levels. Conclusion: Despite existing iodization programs, significant gaps remain in the knowledge and practices related to iodine intake, particularly in rural areas. This study highlights the need for targeted public health interventions to improve iodine nutrition and reduce the burden of iodine deficiency disorders in Kyrgyzstan. Enhancing public health education, improving the accessibility and affordability of iodized salt, and regularly monitoring the iodine status are essential strategies for addressing these issues. [ABSTRACT FROM AUTHOR]

Iodized salt serves as an effective intervention strategy, combating iodine deficiency disorders (IDD) and promoting overall health. This study aimed to assess the household salt consumption status and its relationship with urinary iodine (UI) levels among school-aged children. This is a descriptive-cross-sectional study that was selected by cluster-random sampling from 5 girls' schools (182) and 5 boys' schools (169), with a total of 351 primary school students (8–10 years old) of Darab. To explore the relationship between independent variables and dependent variable, urinary iodine (UI) levels, linear regression model was applied. A significance level of 0.05 was adopted for all analyses. The median UI level was 138 µg/L (IQR = 111). Our findings revealed that 66% of used iodized salt. A significant majority of participants properly stored their salt in containers with lids. Nearly half of the students in Darab have insufficient iodine intake. Despite controlling for the effect of iodized foods consumption, no significant association (P-value = 0.693) was observed between the storage method and iodized foods. Our study showed that students do not receive enough iodine or have received more than the required amount of iodine. Therefore, efforts should be focused on increasing awareness of diseases caused by iodine deficiency. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions The aim of this study was to validate in 20‐year follow‐up (FU) the outcomes reported in World J Surg 2010; 34(6):1232–8 on recurrent nodular goiter in the contralateral thyroid lobe among patients after thyroid lobectomy (TL) for multinodular goiter (MNG) receiving versus not receiving postoperative prophylactic levothyroxine (LT4) treatment.Some 150 consenting patients underwent TL for MNG in 2000–2003. They were randomized to two groups, 75 patients each: (a) receiving prophylactic LT4 treatment postoperatively (dose range 75–125 microg/day to maintain thyroid‐stimulating hormone values within 0.27–1.0 mU/L), and (b) not receiving LT4. Sixty‐month FU was extended to 240 months for all the consenting patients. The primary outcome was prevalence of recurrent goiter. The secondary outcome was re‐intervention rate for recurrent goiter. The outcomes were stratified according to individual iodine metabolism status assessed by urinary iodine excretion.During the 5‐year FU (5 patients were lost) recurrent goiter was found in patients receiving versus not receiving LT4 in 1.4% versus 16.7% (p = 0.001) whereas during 20‐year FU (29 patients were lost) it was 3.3% versus 30.0% of patients, respectively (p = 0.031). During 20‐year FU 4.9% versus 30.0%, respectively, of patients receiving versus not receiving LT4 required contralateral thyroid lobe treatment/surgery (p = 0.028). LT4 decreased recurrence rate among iodine‐deficient patients (10.0% vs. 70.0%, respectively; p = 0.037) but not among iodine‐sufficient patients (0.0% vs. 10.0%, respectively; p = 0.056).Twenty‐year FU data confirmed that prophylactic LT4 treatment significantly decreased the recurrence of nodular goiter and the need for completion intervention/surgery, mostly among patients with iodine deficiency. [ABSTRACT FROM AUTHOR]

Background/Objectives: The management of differentiated thyroid cancer (DTC) patients has undergone a major paradigm shift in past years, especially regarding the role of a careful postoperative disease assessment both in deciding for or against the use of iodine-131 therapy (i.e., patients' selection) and in selecting the correct goal of the treatment: ablative, adjuvant or therapeutic. Furthermore, diagnostic and risk-oriented uses of iodine isotopes (i.e., 123/124/131I) should always be considered during both postoperative assessment and follow-up of DTC patients to improve early staging and response assessment to initial treatments, respectively. The present review summarizes current (and real-life-related) evidence and the emerging perspectives on the therapeutic, diagnostic, and theragnostic use of radioiodine isotopes. Methods: A review of the pertinent literature was performed in PubMed, Web of Science, and Scopus without language restrictions or time limits and using one or more fitting search criteria and terms. Results: According to the literature evidence and real-life clinical practice, a risk-oriented postoperative iodine-131 therapy remains pivotal for most DTC patients and improves early disease staging through post-therapy functional imaging (i.e., theragnostic aim). Accordingly, the goal of iodine-131 therapy, the optimal strategy (empiric vs. dosimetric approach), the appropriate stimulation method [i.e., levothyroxine (L-T4) withdrawal vs. recombinant human thyrotropin (rhTSH) administration] and, finally, the suggested radioiodine activity to deliver for iodine-131 therapy (RIT) should be personalized, especially in metastatic DTC patients. Conclusions: The evidence related to the diagnostic and theragnostic use of iodine isotopes leads to a significant improvement in the postoperative risk stratification and staging of DTC patients in addition to a more accurate assessment of the response to initial treatments. In conclusion, radioiodine is really an oldie but goldie radiotracer. It has both a current fundamental role and a future perspective for the more careful management of DTC patients. [ABSTRACT FROM AUTHOR]

Thyroid syndrome, a complex endocrine disorder, involves the dysregulation of the thyroid gland, impacting vital physiological functions. Common causes include autoimmune disorders, iodine deficiency, and genetic predispositions. The effects of thyroid syndrome extend beyond the thyroid itself, affecting metabolism, energy levels, and overall well-being. Thyroid syndrome is associated with severe cases of thyroid dysfunction, highlighting the potentially life-threatening consequences of untreated or inadequately managed thyroid disorders. This research aims to propose an advanced meta-learning approach for the timely detection of Thyroid syndrome. We used a standard thyroid-balanced dataset containing 7,000 patient records to apply advanced machine-learning methods. We proposed a novel meta-learning model based on a unique stack of K-Neighbors (KN) and Random Forest (RF) models. Then, a meta-learning Logistic Regression (LR) model is built based on the collective experience of stacked models. For the first time, the novel proposed KRL (KN-RF-LR) method is employed for the effective diagnosis of Thyroid syndrome. Extensive research experiments illustrated that the novel proposed KRL outperformed state-of-the-art approaches, achieving an impressive performance accuracy of 98%. We vindicated the performance scores through k-fold cross-validation and enhanced performance using hyperparameter tuning. Our research revolutionized the timely detection of thyroid syndrome, contributing to the enhancement of human life by reducing thyroid mortality rates. [ABSTRACT FROM AUTHOR]

Objective: Acute or chronic exposure to excess iodine has detrimental effects on thyroid physiology; therefore, this study aimed to determine the prevalence of overt hypothyroidism (OH) and subclinical hypothyroidism (SCH) in an elderly population residing in geographical areas with chronic exposure to excess iodine intake and to analyse contributing risk factors. Design: This cross‐sectional study was conducted from 2016 to 2017 in areas of Jiangsu Province that have documented chronic exposure to high iodine intake. Patients: We enroled 2559 adult participants using a multistage, stratified sampling method. Measurements: Urinary iodine concentration (UIC), serum thyroid‐stimulating hormone (TSH) level and other relevant parameters were measured. Demographic information was recorded using a standardized questionnaire. The age‐specific TSH references were determined by the National Academy of Clinical Biochemistry guidelines. Univariate and multivariate logistic regression analyses were performed to identify risk factors for hypothyroidism in the study population. Results: The median UIC of participants was 307.3 µg/L (interquartile range: 200.7, 469.8 μg/L). The prevalence of OH in subjects ≥70 years using laboratory reference ranges was 2.37%; however, it decreased to 1.78% with the use of an age‐specific reference range. Similarly, the prevalence of SCH also declined drastically from 29.59% to 2.96% with the application of an age‐specific reference range. In both univariate and multivariate models, advanced age, female gender and high UIC were identified as risk factors for hypothyroidism. Conclusions: Usage of age‐specific TSH reference ranges led to a significantly lower prevalence of OH and SCH in the study population, thus preventing unnecessary over‐diagnosis and over‐treatment. [ABSTRACT FROM AUTHOR]

An investigation was conducted at the Veterinary Clinical Complex, College of Veterinary Science, COVS, GADVASU Rampura Phul, Punjab, India during May, 2023 to study the pathomorphological alterations of Hyperplastic and Colloidal Goiter in a beetal. Two new born kids were considered that included one dead and other with history of no suckling, lassitude, not able to rise its head and swelling in cranioventral neck region. Post mortem examination of dead kid showed markedly swollen thyroid gland and samples collected from them were subjected to routine H&E examination. Histopathological examination revealed extensive hyperplasia of the thyroid follicles along with follicles filled with varying amount of colloid suggesting hyperplastic and colloidal goitre. Areas of Hyperplastic follicles showed cuboidal to tall columnar follicular epithelial cells with highly vacoular cytoplasm whereas follicles with colloidal deposition showed flattened epithelium. Hemato-biochemical examination of samples collected from live kid showed moderate anaemia with decreased leucocyte count. There was macrocytic hypochromic anaemia. T4 was significantly lower and there was significant rise in TSH levels when compared to reference values. The kid born co-twin with the dead kid survived after treatment and showed significant improvement in clinical condition after 5 days of treatment. Based on the gross and histopathological examination the cause of death was confirmed to be congenital hyperplastic and colloid goitre which is usually a non-inflammatory and non-neoplastic enlargement of the thyroid caused due to iodine deficiency is most common in new-born animals in iodine-deficient areas. [ABSTRACT FROM AUTHOR]

As a component of thyroid hormones, iodine is essential for brain development in the fetus and in young children. Some evidence suggests that pregnant and lactating women who consume a vegan diet may be at risk for iodine deficiency. Iodine sources for vegans include supplements, iodized salt, and seaweed. However, because the iodine content of seaweed is variable, with some types providing amounts that may lead to excessive intake, recommendations for consumption of these foods during pregnancy and breastfeeding should be specific regarding types and amounts. Pregnant and lactating women who choose a vegan diet should include a supplement of potassium iodide in their diet and should follow advice about the types of seaweed to avoid or limit. [ABSTRACT FROM AUTHOR]

Context Iodine is necessary for proper brain development. The prevalence of iodine deficiency in Portuguese pregnant women led the health authorities, in 2013, to recommend iodine supplementation for women in preconception, throughout pregnancy, and during lactation. Objective This work aimed to assess the effect of iodine supplementation initiated in the preconception or the first trimester of pregnancy on the prevalence of iodine deficiency and maternal thyroid status. Methods An observational prospective cohort study was conducted that followed the thyroid function and iodine status of women recruited during preconception or in the first trimester of pregnancy. Results Median urinary iodine concentration (UIC) was significantly higher among women taking iodine supplements (no-supplement group UIC = 63 µg/L; supplement group UIC = 100 µg/L; P =.002) but still below the levels recommended by the World Health Organization. Only 15% of pregnant women had adequate iodine status and 17% showed a UIC of less than 50 µg/L. There was no influence whether iodine supplementation was started during preconception or during the first trimester of gestation (UIC preconception group: 112 µg/L vs UIC pregnancy group: 91 µg/L; P =.569). In the first trimester of pregnancy, total thyroxine levels were lower and free triiodothyronine levels were higher in nonsupplemented women. Thyroglobulin levels were lower in women who started iodine supplementation during preconception compared to nonsupplemented women and women who started iodine supplementation during gestation. Conclusion In the Minho region of Portugal, fertile women have insufficient iodine intake. Additional public health measures are needed since the current recommendations for iodine supplementation for pregnancy are unsatisfactory to achieve adequate iodine status. [ABSTRACT FROM AUTHOR]

Background: Iodine is one of the essential trace elements for human life. The main objective of the biofortification of plants with iodine is to obtain food with a higher content of this element compared to conventional food. Biofortification of plants with iodine can increase the intake of this trace element by different populations. In addition, it may reduce the risk of iodine deficiency diseases. Objectives: The aim of the study was to investigate the effect of kale biofortified with 8-hydroxy-7-iodo-5-quinolinesulfonic acid (8-OH-7-I-5QSA) on iodine bioavailability and biochemical effects in Wistar rats. Methods: Kale biofortified with (8-OH-7-I-5QSA) was tested for iodine levels in urine, feces, and selected tissues using the ICP-MS/MS technique. The feeding experiment was designed to investigate potential changes in selected thyroid-regulated biochemical parameters in blood serum of Wistar rats. Results: The dietary intake of Wistar rats fed kale biofortified with (8-OH-7-I-5QSA) from both the "Oldenbor F1" and "Redbor F1" cultivars for 8 weeks resulted in significantly (p ≤ 0.05) higher iodine concentrations in the urine and kidneys of rats, which proves iodine bioavailability. Rats' diets with "Oldenbor F1" and "Redbor F1" kale non- and -biofortified with 8-OH-7-I-5QSA had a significantly (p ≤ 0.05) lower or a tendency for lower concentration of TSH, triglyceride, total and direct bilirubin, TBARs, uric acid, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) concentrations in serum. Dietary intake of "Oldenbor F1" and "Redbor F1" kale biofortified with 8-OH-7-I-5QSA significantly (p ≤ 0.05) increased the total antioxidant status (TAS). Conclusions: Our study confirms that kale biofortified with iodine in organic form iodoquinoline 8-OH-7-I-5QSA is bioavailable and well absorbed by the Wistar rat and has a positive effect on selected biochemical parameters. The results obtained in this study may be highly predictive for further studies in humans. [ABSTRACT FROM AUTHOR]

Background/Objective: Iodine deficiency hypothyroidism is an important cause of neurocognitive and motor impairment in children globally. In the United States, universal salt iodization, which began in the 1920s, led to a dramatic decline in iodine deficiency hypothyroidism. However, iodine deficiency may be reemerging due to increased consumption of noniodized salts, decreased dairy iodine concentrations, and decreased intake of iodine containing foods due to food allergies, dietary preferences such as vegan diets, or restrictive food intake disorders. Case Report: We present a case series that challenges the existing clinical paradigm for hypothyroidism and describe 3 patients without underlying thyroid dysfunction who were diagnosed with iodine deficiency hypothyroidism over an 18-month period beginning in February 2021 in Northeastern United States. Prior studies reported 2 additional cases diagnosed in that same time frame at our clinical center. Discussion: We report significant heterogeneity in clinical presentation: 3 patients had large goiters, 1 had a mild goiter, and 1 patient had no goiter. Biochemical tests were also variable and included a wide range of thyroid stimulating hormone elevations. Conclusion: We suggest that a spot urine iodine concentration, combined with an elevated serum thyroglobulin level, can be an alternative to a 24-hour urinary iodine excretion for the diagnosis of iodine deficiency hypothyroidism given the clinical challenges of obtaining the latter. Thyroid function normalized in all patients with iodine supplementation.

BACKGROUND/OBJECTIVE: Iodine deficiency hypothyroidism is an important cause of neurocognitive and motor impairment in children globally. In the United States, universal salt iodization, which began in the 1920s, led to a dramatic decline in iodine deficiency hypothyroidism. However, iodine deficiency may be reemerging due to increased consumption of noniodized salts, decreased dairy iodine concentrations, and decreased intake of iodine containing foods due to food allergies, dietary preferences such as vegan diets, or restrictive food intake disorders. CASE REPORT: We present a case series that challenges the existing clinical paradigm for hypothyroidism and describe 3 patients without underlying thyroid dysfunction who were diagnosed with iodine deficiency hypothyroidism over an 18-month period beginning in February 2021 in Northeastern United States. Prior studies reported 2 additional cases diagnosed in that same time frame at our clinical center. DISCUSSION: We report significant heterogeneity in clinical presentation: 3 patients had large goiters, 1 had a mild goiter, and 1 patient had no goiter. Biochemical tests were also variable and included a wide range of thyroid stimulating hormone elevations. CONCLUSION: We suggest that a spot urine iodine concentration, combined with an elevated serum thyroglobulin level, can be an alternative to a 24-hour urinary iodine excretion for the diagnosis of iodine deficiency hypothyroidism given the clinical challenges of obtaining the latter. Thyroid function normalized in all patients with iodine supplementation.

Context Despite shifting from addressing isolated forms of malnutrition to recognizing its multifaceted nature, evidence on the prevalence and determinants of micronutrient deficiencies, and their coexistence with undernutrition in children under 5, remains insufficient, unsystematic, and incohesive. Objective The aim of this systematic review and meta-analysis was to assess the prevalence and determinants of stunting-anemia and wasting-anemia comorbidities and micronutrient deficiencies in children under 5 in the least-developed countries (LDCs). Data Sources Electronic searches took place from January 15, 2023, to February 14, 2024, across multiple databases, including PubMed, Embase, Web of Science, SCOPUS, African Index Medicus (AIM), World Health Organization's Institutional Repository for Information Sharing (IRIS), and African Journals Online. The search spanned the years 2000 to 2024, yet it yielded eligible full-text English research articles from only 2005 to 2021 conducted in LDCs. Studies lacking quantitative data on malnutrition types and their determinants were excluded. Data Extraction Two independent authors assessed articles for bias and quality using Hoy et al's 10-item scale and Newcastle-Ottawa Scale (NOS) criteria. Prevalence and other details were extracted using a Joanna Briggs Institute Excel template. Authors extracted adjusted odds ratios (aORs) for determinant factors such as sex and vitamin A and iron supplementation. Data Analysis The search yielded 6248 articles from 46 LDCs. Sixty-nine articles, with a total sample size of 181 605, met inclusion criteria for the final meta-analysis. Vitamin A deficiency affected 16.32% of children, and iodine deficiency affected 43.41% of children. The pooled prevalence of wasting-anemia and stunting-anemia comorbidity was 5.44% and 19.47%, respectively. Stunting was associated with vitamin A deficiency (aOR: 1.54; 95% CI: 1.01–2.37), and not taking vitamin A supplementation was associated with iron-deficiency anemia (aOR: 1.37; 95% CI: 1.21–1.55). Conclusion A significant proportion of children under 5 in LDCs experienced stunting-anemia and wasting-anemia comorbidities and micronutrient deficiencies. This study underscores the urgent need to address factors driving these burdens. Systematic Review Registration PROSPERO registration no. CRD42023409483. [ABSTRACT FROM AUTHOR]

Iodine is a trace element necessary for synthesizing thyroid hormones. It is especially crucial for the neurodevelopment and intellectual development of children. Preschool-age children admitted to the hospital tend to have more fragile physical and mental health, but few studies demonstrate their iodine status. Our study aimed to investigate the iodine status of hospitalized and healthy preschool-age children and to explore the factors influencing them. From January to December 2021, 426 children aged 3–6 years were admitted to the respiratory department for pneumonia, bronchopneumonia, or bronchiectasis, but they could eat normally and were recruited as hospitalized children. Six hundred ten healthy children aged 3–6 years were included. We collected anthropometric measurements and urine samples from hospitalized and healthy preschool-age children, and iodine status was assessed through urinary iodine concentration (UIC) and urinary iodine/creatinine ratio (UI/Cr). UIC was 40.1 and 166.1 µg/L for hospitalized and healthy preschool-age children, respectively (P < 0.001). Urinary creatinine concentration (UCr) was 0.2 and 0.8 g/L for hospitalized and healthy preschool-age children, respectively (P < 0.001). UIC decreased with increasing height z-scores in hospitalized children (Spearman's rho = −0.11, P = 0.022). A significantly increased risk of UIC < 100 µg/L was found in hospitalized children (OR = 9.1 (6.8, 12.2), P < 0.001) when compared to healthy children. In conclusion, hospitalized preschool-age children are likelier to have iodine insufficiency than healthy preschool-age children, especially those with good linear growth. Measures should be implemented to ensure adequate iodine intake of preschool-age children during hospitalization to avoid affecting their intellectual and physical development. Due to lower UCr in hospitalized children, creatinine is not appropriate for assessing iodine status in hospitalized children. [ABSTRACT FROM AUTHOR]

Salivary iodine concentrations (SIC) and urinary iodine concentrations are correlated. This study aimed to verify the use of SIC as a biomarker for estimating iodine intake in pregnant and lactating women and to diagnose abnormal thyroid function. A cross-sectional study was conducted in northern Xinjiang, China. Participants provided venous blood, random urine, saliva and milk samples. A total of 607 pregnant and 171 lactating women volunteered to participate in the study. The average daily iodine intake was calculated for each participant. Pregnant women were divided according to trimester. The median daily iodine intake was 436·41 μg/d in the first trimester, 425·83 μg/d in the second trimester and 430·56 μg/d in the third trimester. The average daily iodine intake in lactating women was 416·16 μg/d. Different indicators were used to diagnose excessive iodine intake (> 500 μg/d). Among pregnant women, SIC had an AUC of 0·62 (P < 0·01), sensitivity of 51·75 % and specificity of 65 %. Among lactating women, SIC had an AUC of 0·63 (P = 0·03), sensitivity of 43·52 % and specificity of 85 %. SIC was an effective biomarker for diagnosing abnormal thyroid function (P = 0·03). In conclusion, this study demonstrated that SIC is a reliable biomarker for evaluating both iodine nutrition status and abnormal thyroid function in pregnant and lactating women. [ABSTRACT FROM AUTHOR]

Hypothyroidism, the deficiency of thyroid hormone, is a common condition worldwide. It affects almost all body systems and has a wide variety of clinical presentations from being asymptomatic to, in rare cases, life threatening. The classic symptoms of hypothyroidism include fatigue, lethargy, weight gain, and cold intolerance; however, these symptoms are non-specific and the diagnosis is typically made on biochemical grounds through serum thyroid function tests. The most common cause of hypothyroidism is chronic autoimmune thyroiditis (Hashimoto's thyroiditis), although other causes, including drugs (such as amiodarone, lithium, and immune checkpoint inhibitors), radioactive-iodine treatment, and thyroid surgery, are frequent. Historically, severe iodine deficiency was the most common cause. Reference ranges for thyroid function tests are based on fixed percentiles of the population distribution, but there is increasing awareness of the need for more individualised reference intervals based on key factors such as age, sex, and special circumstances such as pregnancy. Levothyroxine monotherapy is the standard treatment for hypothyroidism; it is safe and inexpensive, restores thyroid function tests to within the reference range, and improves symptoms in the majority of patients. However, 10% of patients have persistent symptoms of ill health despite normalisation of thyroid function tests biochemically and a substantial proportion of patients on levothyroxine have thyroid-stimulating hormone concentrations outside the reference range. Ongoing symptoms despite levothyroxine treatment has led to some patients using liothyronine or desiccated thyroid extract. Taken together, these factors have led to intense debate around the treatment thresholds and treatment strategies for hypothyroidism. In this Seminar, we review the epidemiology, genetic determinants, causes, and presentation of hypothyroidism; highlight key considerations and controversies in its diagnosis and management; and provide future directions for research. [ABSTRACT FROM AUTHOR]

Iodine, an essential trace element for the human body, plays a pivotal role in sustaining health. Malnutrition has emerged as a pressing public health concern, posing a significant threat to human well‐being. Iodine deficiency poses a substantial threat to the development of children, potentially leading to neurological developmental disorders and mental retardation. Conversely, excessive iodine intake can result in structural and functional abnormalities in the thyroid gland. In this study, we selected children aged 3–6 years through a stratified cluster sampling approach in six regions across China to explore the correlation between iodine nutrition and their physical growth. A total of 5920 preschool children participated in this study, with a median urinary iodine concentration (UIC) of 177.33 [107.06, 269.92] μg/L. Among these children, 250 (4.2%) exhibited stunting, 180 (3.0%) were underweight, 198 (3.3%) experienced wasting, 787 (3.3%) were overweight and 414 (7.0%) were classified as obese. The multivariate linear regression revealed that UIC exhibited a positive correlation with body mass index z‐Score (BMIZ) in overweight children (β = 0.038; 95% CI: 0.001, 0.075). In normally growing children, the associations between UIC and height‐for‐age z‐score, weight‐for‐age z‐score and BMIZ displayed nonlinear patterns. Our findings suggest that iodine nutrition is adequate for Chinese children aged 3–6 years. Furthermore, iodine nutrition is intricately linked to the growth and development of these children. Consequently, it is imperative to implement decisive measures to prevent both iodine deficiency and excess. Key messages: This paper is the first large‐scale nationwide epidemiological survey of iodine nutrition in preschool children in China.The median urinary iodine of preschool children in China was 177.33 [107.06, 269.92] μg/L, indicating adequate iodine nutrition.The study suggests that there may be a nonlinear correlation between median urinary iodine and physical growth indicators, such as height‐for‐age z‐score, in preschool children, with gender differences. [ABSTRACT FROM AUTHOR]

Although almost a third of the world's population is exposed to iodine deficiency (ID), and supplementation programs such as enriching table salt have been carried out or are being carried out at the global and national level, in many regions of the world, people are facing an increase in iodine intake, which is mainly due to the presence of large amounts of iodine in water, soil, agricultural products, or high consumption of seafood. Published articles were indexed in the Scopus database (from 2000 to 1 April 2023) were reviewed and analyzed by VOSviewer software. The results showed the growing interest of researchers over the last 20 years in environmental iodine intake. The results of this study can have a significant impact on the planning and policy-making of relevant officials and communities to supply the needed iodine. [ABSTRACT FROM AUTHOR]

Background: With the implementation of the universal salt iodization, the iodine nutrition for children and adults has been appropriate, but pregnant women are still at risk of iodine deficiency. It is of great public health significance to explore the iodine status and knowledge, and influence factors and the appropriate health education methods among pregnant and lactating women. Methods: From January 2022 to December 2023, at least 50 pregnant women and 50 lactating women were randomly selected from the resident population annually in 16 districts of Tianjin, North China. A total of 1671 pregnant women and 1658 lactating women were recruited. All participants' households salt and random urine samples were collected. A questionnaire was conducted to collect data on iodine related knowledge and behaviors as well as needs of health education from all participants. Logistic regression models were constructed to analyze the factors affecting the iodine related knowledge level. We used the Rasch model and the quadrantal graph to analyze the participants' knowledge level on different iodine-related questions and their needs for health education. Results: The median urine iodine concentration (UIC) of pregnant and lactating women in Tianjin were 152.40 μg/L and 124.60 μg/L. In some districts, the median UIC of pregnant and lactating women below the appropriate range. The iodized salt coverage rate of pregnant and lactating women in Tianjin was 76.12% and 77.40%, respectively. In pregnant and lactating women who did not actively supplement with iodine, the median UIC in those who consumed non-iodized salt were significantly lower than that in those who consumed iodized salt (139.26 μg/L and 154.40 μg/L, P = 0.044; 94.60 μg/L and 123.80 μg/L, P < 0.001). Compared with the low knowledge score group, pregnant women in the high knowledge score group had a higher proportion of iodized salt consumption (71.25% and 78.05%, P = 0.003), and pregnant and lactating women in the high knowledge score group had a higher proportion of actively supplement iodine (44.61% and 55.34%, P < 0.001; 39.26% and 49.78%, P < 0.001). Health education may be the main factor affecting the iodine related knowledge scores for pregnant and lactating women, with adjusted odds ratios (OR) and 95% confidence intervals (CI) of 2.89 (2.30, 3.62) and 2.46 (1.97, 3.07), respectively. Pregnant and lactating women are most expected to acquire knowledge through healthcare professionals (72.11%) and wechat/website (74.91%), respectively. Conclusions: Pregnant and lactating women in some areas of Tianjin are at risk of iodine deficiency. Iodized salt consumption is an important way to ensure iodine nutrition of the population, and the lack of iodine related knowledge is an important factor affecting the consumption of iodized salt. Health education in different ways can be carried out for different people to improve the acceptance and efficiency of health education. [ABSTRACT FROM AUTHOR]

Objectives: Hysterosalpingography (HSG) is widely used for evaluating the fallopian tubes; however, controversies regarding the use of water- or oil-based iodine-based contrast media (CM) remain. The aim of this work was (1) to discuss reported pregnancy rates related to the CM type used, (2) to validate the used CM in published literature, (3) to discuss possible complications and side effects of CM in HSG, and (4) to develop guidelines on the use of oil-based CM in HSG. Methods: A systematic literature search was conducted for original RCT studies or review/meta-analyses on using water-based and oil-based CM in HSG with fertility outcomes and complications. Nine randomized controlled trials (RCTs) and 10 reviews/meta-analyses were analyzed. Grading of the literature was performed based on the Oxford Centre for Evidence-Based Medicine (OCEBM) 2011 classification. Results: An approximately 10% higher pregnancy rate is reported for oil-based CM. Side effects are rare, but oil-based CM have potentially more side effects on the maternal thyroid function and the peritoneum. Conclusions: 1. HSG with oil-based CM gives approximately 10% higher pregnancy rates. 2. External validity is limited, as in five of nine RCTs, the CM used is no longer on the market. 3. Oil-based CM have potentially more side effects on the maternal thyroid function and on the peritoneum. 4. Guideline: Maternal thyroid function should be tested before HSG with oil-based CM and monitored for 6 months after. Clinical relevance statement: Oil-based CM is associated with an approximately 10% higher chance of pregnancy compared to water-based CM after HSG. Although side effects are rare, higher iodine concentration and slower clearance of oil-based CM may induce maternal thyroid function disturbance and peritoneal inflammation and granuloma formation. Key Points: • It is unknown which type of contrast medium, oil-based or water-based, is the optimal for HSG. • Oil-based contrast media give a 10% higher chance of pregnancy after HSG, compared to water-based contrast media. • From the safety perspective, oil-based CM can cause thyroid dysfunction and an intra-abdominal inflammatory response in the patient. [ABSTRACT FROM AUTHOR]

Iodine is an essential nutrient for humans, important for thyroid function. Its deficiency can lead to various health disorders. Among so called blue foods, sea weeds are good in iodine content and are becoming a part of the plate. This study aimed to develop hummus using different proportions of wakame (Undaria pinnatifida) and to evaluate the nutritional and sensory properties of the developed hummus. Various formulations of hummus were prepared using rehydrated wakame and were subjected to sensory evaluation using 9-point hedonic scale. The best sample as declared by sensory evaluation was then analysed for its iodine content. Hummus with 20 % rehydrated wakame was found to be the most acceptable. Wakame hummus, per 20 g serving, provided 42 µg of iodine. Since the recommended dietary allowance (RDA) for iodine is 150 µg, one serving of seaweed hummus achieved 28 % of the daily iodine requirement. Seaweed--based products, such as wakame and seaweed hummus, significantly contribute to dietary iodine intake and may play a role in preventing iodine deficiency. [ABSTRACT FROM AUTHOR]

Introduction: Iodine deficiency is a global issue; however, no comparable assessments of the burden of iodine deficiency have been conducted worldwide. Hence, we measured the estimated annual percentage changes (EAPCs) from 1990 to 2019. Our aim was to quantify the geographic differences in the burden of iodine deficiency worldwide. Material and methods: The Global Burden of Diseases, Injuries, and Risk Factors Study 2019 methodology was employed to investigate the worldwide, regional, and national incidence of iodine deficiency and the accompanying disability-adjusted life years (DALYs). Results: The global age-standardized incidence (ASI) and DALY rates of iodine deficiency declined from 1990 to 2019, with an EAPC of –0.44 and –1.35, respectively. Low and low-middle SDI had much higher ASI and DALY rates of iodine deficiency than other SDI regions. At the regional level, the largest growth in the ASI rate of iodine insufficiency from 1990 to 2019 occurred in East Asia, and at the national level, the greatest increases in the ASI rate of iodine deficiency occurred in the Philippines, Pakistan and Nepal. In addition, males had a lower worldwide ASI rate of iodine insufficiency than females did, with the incidence rate peaking in populations aged 20–24. Conclusions: Between 1990 and 2019, there was a decline in the global ASI and DALY rates of iodine deficiency. However, East Asia, the Philippines, Pakistan and Nepal exhibited the largest increases in the ASI rates of iodine deficiency, demonstrating their significant burden of iodine insufficiency. These regions must therefore be targeted for intervention. [ABSTRACT FROM AUTHOR]

The problem of diffuse goiter has attracted the attention of many researchers in recent years. The main reason for the formation of endemic goiter is iodine deficiency in the environment. Epidemiological studies conducted in recent years have shown that almost all regions of Kazakhstan are regions of endemic goiter with natural iodine deficiency. Some of them are characterized by an increase in the severity of endemic goiter. The reasons contributing to the progression of goiter endemicity are the cessation of iodine prophylaxis, the deterioration of the environmental situation and the social situation of a significant part of the population. The purpose of this work was to study the features of thyroid status in children with diffuse goiter. Material and methods There were 38 children under our supervision, 20 (main group) had diffuse (endemic) goiter (5 boys and 15 girls), 18 children (control group) - 5 boys and 13 girls, children in the control group were considered healthy. Results As a result of comparing indicators of the functional state of the pituitary-thyroid system in patients with diffuse goiter, a relatively increased level of thyroid-stimulating hormone is noted, which indicates the negative impact of diffuse goiter on the thyroid status of children. Conclusions As a result of the manifestation of diffuse goiter in children, metabolic disorders of the pituitary-thyroid system occur. Signs of thyroid deficiency are most often observed in children living in iodine-deficient areas. [ABSTRACT FROM AUTHOR]

Iodine deficiency (ID) is a significant global public health issue, particularly affecting low-income countries. The iodization of salt is a widely adopted method to prevent iodine deficiency. This study aimed to assess the iodine content of iodized salt at the market level in various cities within the Hashemite Kingdom of Jordan (HKJ). We collected 152 salt samples from 24 different brands across three cities in Jordan: Amman, Zarqa, and Mafraq. The analysis was conducted using a titration method. The mean iodine content in salt samples varied by city, with values of 5.45 ppm in Mafraq, 10.33 ppm in Amman, and 13.22 ppm in Zarqa, ranging from 0 to 36 ppm. Significant differences in iodine concentration were observed within the same city across different brands (P ≤ 0.05). Additionally, variations were noted in iodine content for samples from the same brand collected in different cities, and even among samples from the same brand at the same location. Of the 152 samples evaluated, an average of 76.5% had iodine levels below the 15 ppm recommended by UNICEF. There was considerable variation in mean iodine content among brands, cities, and even within samples of the same brand. This indicates that the salt iodization process requires ongoing monitoring, and the government should enhance efforts to oversee the iodization process and improve the accessibility and utilization of iodized salt. [ABSTRACT FROM AUTHOR]

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Thyroid nodules are a common, benign condition with a higher prevalence in women, individuals with iodine deficiency, and radiation exposure. Treatment options for benign thyroid nodules include pharmaceutical therapy, thyroidectomy, and thermal ablation (TA). TA, including laser ablation (LA), radiofrequency ablation (RFA), and microwave ablation (MWA), is a procedure that uses heat to cause tissue necrosis. It is commonly used for large, firm, benign, non-functioning thyroid nodules that cause severe symptoms or pain when surgery is not recommended or desired. When thyroid nodules do not respond to TA, they undergo surgery to resolve the symptoms and clarify the diagnosis. This study aims to analyze the histological alterations found in surgically excised TA-treated thyroid nodules and to evaluate the morphological criteria of differential diagnosis between benign and malignant nodules, establishing whether the alterations observed on the histological sample are a consequence of TA or indicative of neoplastic disease. For this purpose, the adoption of ancillary methods, such as immunohistochemistry, is fundamental to distinguish the artifacts induced by TA from the typical morphological characteristics of malignant neoplasms. [ABSTRACT FROM AUTHOR]

Proper supply of bioelements that participate in physiological processes is especially important in childhood, because it significantly affects for the formation of the hormonal profile. The prevalence of dental pathology among schoolchildren reflects the priority of early diagnosis and thorough prevention of pathological processes. In order to find out the risks of dental health disorders, the intensity of nitroso-oxidative processes in the oral fluid of children (boys and girls aged 6-11 and young men and girls aged 12-18) with combined latent iron and mild iodine deficiency was studied and in conditions of sufficient supply of trace elements (control group). As a result of the study, the activation of the peroxidation processes of proteins (the level of products of oxidative modification of proteins increases by 87.3% - 3.3 times) and lipids (the content of diene conjugates increases by 62.7% - 12.4 times) in case of imbalance of antioxidant protection of oral fluid (inhibition of SOD by 20.4-30.7%, activation of glutathione peroxidase by 92.0-93.3%) compared to data in healthy teenagers. The development of iron and iodine deficiency is accompanied by an 8.3-fold increase in NO2- content, a 3.3-fold increase in the amount of NO2- and NO3- in the oral fluid of boys, and a 2.5-11.4-fold increase in the concentration of peroxynitrite in all schoolchildren compared to controls. An increase in H2S content in the oral fluid was also found in girls (by 25.6% compared to the values of the control group). The level of oxidative processes is higher in younger schoolchildren (ages 6-11). With age, the intensity of oxidative stress decreases, but changes in the NO metabolism system increase, especially for girls (cytotoxic peroxynitrite and H2S accumulate in the oral fluid). Therefore, it is possible to assert a high probability of the development of nitroso-oxidative stress in the conditions of a combination of iron and iodine deficiency already at the stage of preclinical changes, which can increase the risks of developing dental pathology. [ABSTRACT FROM AUTHOR]

Background: Humans require iodine as a micronutrient; a deficit in this mineral lowers IQ. Seaweed (E. cottonii) is a non-salt source of iodine. Fortification of E. cottonii flour can be done on food products, such as nuggets. Aside from that, Vanname Shrimp are a high-protein fishery product that can be utilized as a base for nuggets. Therefore, to prevent iodine deficit, Vanname Shrimp nuggets supplemented with E. cottonii flour can be developed as a substitute food. Objectives: Fortification of E. cottonii flour in making Vanname Shrimp nuggets as an effort to increase the iodine content. Methods: Three replications of a non-factorial Completely Randomized Design (CRD) were used in the study. The fisheries products laboratory at Brawijaya University's Faculty of Fisheries and Marine Sciences (FFMS) was the site of the research. There were four additions of E. cottonii flour: 0%, 7.5%, 10%, and 12.5%. Iodine content is the parameter for chemical testing; elasticity is the parameter for physical testing; and color, scent, taste, and texture are the criteria for organoleptic testing (the hedonic approach for determining the optimal treatment utilizing the de Garmo and proximal testing). Results: The study found that adding different quantities of E. cottonii flour fortification significantly altered the iodine content and flexibility of Vanname Shrimp nuggets. E. cottonii flour is optimally fortified at a level of 7.5% treatment, with iodine content of 6.17 mcg/g, elasticity of 6.65 N, carbohydrate content of 77.04%, protein content of 7.78%, fat content of 3.67%, water content of 9.85%, and ash content of 1.66%. Conclusions: In order to prevent and treat iodine deficiency, the Vanname Shrimp nugget product fortified with E. cottonii flour should be further developed as a food option. [ABSTRACT FROM AUTHOR]

Iodine is a micronutrient that is essential for thyroid hormone production. Adequate iodine intake is especially important during pregnancy and early life, when brain development is dependent on thyroid hormones. Iodine intake recommendations vary around the world, but most recommendations generally reflect the increased requirements during pregnancy and lactation, although adequate iodine intake before pregnancy is also important. Tremendous progress has been made in improving iodine intake across the world over the past 30 years, mainly through salt-iodization programmes. However, in countries without strong iodine fortification programmes, and with shifts in dietary patterns, a need has arisen for health organizations, governments and clinicians to ensure that adequate iodine is consumed by everyone in the population. For example, in countries in which adequate iodine intake depends on individual food choice, particularly of iodine-rich milk and dairy products, intake can be highly variable and is also vulnerable to changing dietary patterns. In this Review, iodine is considered in the wider context of the increasing prevalence of overweight and obesity, the dietary trends for salt restriction for cardiovascular health and the increasing uptake of plant-based diets. This Review discusses the importance of adequate iodine intake for thyroid function, outlining the varying global intake recommendations. Iodine is also considered in the context of the increasing prevalence of overweight and obesity, as well as dietary trends such as cardioprotective salt restriction and plant-based diets. Key points: Despite progress since the 1990s, iodine deficiency remains a public health concern across the world, particularly in pregnancy and early life. Severe iodine deficiency is now less common than in the past, but mild-to-moderate deficiency during pregnancy might have consequences for the developing fetus, including on neurodevelopmental outcomes. Iodized salt programmes have been a successful way of improving iodine intake in many countries, but with a focus on salt-reduction campaigns, there is potential for reduced intake of iodized salt, and so reduced iodine intake, although both policies can work together. Animal foods, such as milk and dairy products, provide a considerable proportion of iodine intake in many countries, but with a shift towards a predominantly plant-based diet, iodine intake might be compromised unless consideration is given to ensure adequate iodine intake from suitable sources. [ABSTRACT FROM AUTHOR]

• The Bi 2 O 3 /BiO 1.3 I 0.4 /persulfate system could effectively degrade propranolol. • The system maintained high degradation ability under neutral and alkaline conditions. • NO 3 − had almost no effect on the degradation of propranolol. • 1O 2 and h+ played important role in propranolol degradation. Non-radical activation of persulfate (PS) by photocatalysts is an effective approach for removing organic pollutants from aqueous environments. In this study, a novel Bi 2 O 3 /BiO 1.3 I 0.4 heterojunction was synthesized using a facile solvothermal approach and used for the first time for non-radical activation of PS to degrade propranolol (PRO) in the presence of visible light. The findings found that the degradation rate of PRO in the Bi 2 O 3 /BiO 1.3 I 0.4 /PS system was significantly increased from 19% to more than 90% within 90 min compared to the Bi 2 O 3 /BiO 1.3 I 0.4 system. This indicated that the composite system exerted an excellent synergistic effect between the photocatalyst and the persulfate-based oxygenation. Quenching tests and electron paramagnetic resonance demonstrated that the non-radical pathway with singlet oxygen as the active species played a major role in the photocatalytic process. The existence of photo-generated holes during the reaction could also be directly involved in the oxidation of pollutants. Meanwhile, a possible PRO degradation pathway was also proposed. Furthermore, the impacts of pH, humic acid and common anions on the PRO degradation by the Bi 2 O 3 /BiO 1.3 I 0.4 /PS were explored, and the system's stability and reusability were also studied. This study exhibits a highly productive catalyst for PS activation via a non-radical pathway and provides a new idea for the degradation of PRO. [Display omitted] [ABSTRACT FROM AUTHOR]

This article discusses the importance and complexity of reference intervals for thyroid-stimulating hormone (TSH) levels. Reference intervals are established based on a sample of healthy individuals and are used to determine whether an individual's TSH levels are within the normal range. However, factors such as age, ethnicity, sex, iodine status, and pregnancy can affect the reference intervals for TSH. The article also highlights the impact of genetic factors on TSH reference intervals and suggests that personalized treatment based on more accurate reference intervals may improve patient outcomes. However, further research is needed to explore these possibilities. [Extracted from the article]

AbstractBoth insufficient and excessive iodine intake can lead to thyroid-related disorders. Although China has made progress in eliminating iodine deficiency over the past few decades, the incidence of thyroid cancer is increasing. Currently, there is a lack of relevant research on the tradeoff between the benefits and risks of salt iodization in China. In this study, we developed a method that combines the total probability algorithm and disease burden to evaluate the appropriate amount of salt iodization. Following the principle of minimizing the comprehensive disease burden and using the metabolic model of human iodine nutrition. Based on the average national iodine level in water, the optimal iodine content in Chinese salt is determined to be 17 mg/kg. However, iodine content in water is not evenly distributed in China. Approximately 3.23% of administrative villages have water iodine concentrations exceeding 80 ug/L, eliminating the need for iodine fortification in salt. Approximately 83.51% of administrative villages need to continue implementing the salt iodization policy, with the optimal iodine content in salt ranging from 15 to 18 mg/kg. In 13.16% of administrative villages, the iodine content in salt is determined based on the local water iodine concentration, ranging from 0 to 15 mg/kg. Our study cracks open a window of insight suggesting that the optimal iodine content for salt is lower than the existing benchmark dictated by the prevailing policy in China. Hence, there is an urgent need to refine and advance the iodine supplementation strategy in salt to pave the way for precision medicine and health-centric iodine supplementation strategies. [ABSTRACT FROM AUTHOR]

Background & Objectives: Iodine deficiency is considered as a global challenge, even after decades of efforts to solve the issue. Our objective was to assess the iodine deficiency status and associated prevalence of goiter in population groups (school-age children and women) from rural areas of District Poonch, and to assess the determinants of iodine deficiency in the area. Methods: Cross-sectional study was conducted in District Poonch Azad Jammu and Kashmir from 25 April 2022 to 30 June 2023. A total of 150 goiter patients from different villages of the District Poonch was included. Their urinary iodine concentration and goiter prevalence was assessed. Using palpation techniques, a trained and experienced public health officer assessed the presence of goiters based on WHO/ UNICEF/ICCIDD criteria. Descriptive statistics were computed for continuous variables and presented in frequency and percentage, based on the distributional characteristics of the data. chi-square was used to check association between socio-demographic factors and goiter. It was a HEC Project No.: 20-16988/NRPU/R&D/HEC/2021. Results: Iodine status and associated goiter prevalence was high and 59.3% of them were severely iodine deficient. Within the district, the highest severe iodine deficiency was observed in 81.1% goiter patients of the Rawalakot subdivision, Hajira and Abbaspur subdivisions. Regarding goiter status 40% of the patients were classified with palpablevisible goiter and 56% were characterized with visible but nodular goiter. Conclusion: Study showed that there was a severe iodine deficiency and associated goiter prevalence in the area. Policymakers should take actions for future to overcome iodine deficiency in future. [ABSTRACT FROM AUTHOR]

Abstract Objective: To understand the dietary patterns of adults and explore their association with iodine nutritional levels and thyroid function in adults. Design: We randomly collected 5 ml of adult urine samples and measured urinary iodine concentration (UIC) by cerium arsenate-catalysed spectrophotometry. A serum sample of 5 ml was collected for the determination of free triiodothyronine, free thyroxine and thyrotropin, and diet-related information was collected through a FFQ. Dietary patterns were extracted by principal component analysis, and the relationship between dietary patterns and iodine nutrition levels and thyroid function was explored. Settings: A cross-sectional study involving adults in Xinjiang, China, was conducted. Participants: A total of 435 adults were enrolled in the study. Results: The overall median urinary iodine of the 435 respondents was 219·73 μg/l. The dietary patterns were PCA1 (staple food pattern), PCA2 (fruit, vegetable and meat pattern), PCA3 (fish, shrimp and legume pattern) and PCA4 (dairy-based protein pattern). The correlation analyses showed that PCA1 and PCA3 were positively correlated with the UIC. The results of the multivariable analysis showed that PCA1, Q1, Q2 and Q3 were associated with an increased risk of iodine deficiency compared with Q4 ((OR): 260·41 (95 % CI: 20·16, 663·70)), 59·89 (5·64, 335·81), and 2·01 (0·15, 26·16), respectively). In PCA2, Q3 was associated with an increased risk of iodine deficiency compared with Q4 (OR: 0·16 (0·05, 0·53)). In PCA3, Q3 was associated with an increased risk of iodine deficiency compared with Q4 (OR: 0·23 (0·06, 0·90)). In PCA4, Q1 was associated with an increased risk of iodine deficiency compared with Q4 (OR: 31·30 (4·88, 200·64)). Conclusion: This study demonstrated that of the four dietary patterns, the least dependent staple food pattern (Q1) had a higher risk of iodine deficiency compared with the most dependent staple food pattern (Q4). However, the current evidence on the effect of dietary patterns on thyroid function needs to be validated by further longitudinal studies that include long-term follow-up, larger sample sizes and repeated measures.

The article presents a case study of a 72-year-old woman diagnosed with benign, hormonally active struma ovarii, presenting with abdominal discomfort, ascites, and hyperthyroidism. Topics include the mechanisms of thyrotoxicosis in struma ovarii, potential risks for malignancy, and the aetiology of ascites and pleural effusion. The patient underwent surgery, which resolved her symptoms and normalized her thyroid hormone levels, with no need for further adjuvant therapy.

The distribution of stable iodine and humus in the upper horizon (0–20 cm) of various types of soils of the Bryansk and Oryol regions used as pastures has been studied. Soil sampling was carried out with a hand stick drill in layers in the depth interval: 0–5 cm, 5-10 cm and 10–20 cm. Iodine content was determined by kinetic rhodanide-nitrite method. Corg content was determined by the bichromate method of Tyurin. The work includes data from both long-term studies of the iodine content in the soil cover of the Bryansk region (2008–2020) and new data from expeditionary studies in the Oryol region (2022). It is shown that the soils of the Bryansk pastures are depleted of iodine and organic carbon (OC) in comparison with the Oryol region, which corresponds to the change of soil cover composition from west to east. The humus content in soils was determined and statistically significant correlation between iodine and C org. content in pasture soils were obtained (from r = 0.28 in Chernozems to r = 0.49 in Haplic Albeluvisols; in addition, for the whole sample (n = 48) the correlation coefficient ranged from 0.31 in the 0–5 cm layer to 0.43 in the 10–20 cm layer). The dependence of iodine accumulation on the OC content in different types of soils (Chernozems, Grey-Luvic Phaeozems, Umbric Albeluvisols, Haplic Albeluvisols) and their hydromorphism has been established. The identified differences in soil iodine fixation should be considered as they may influence iodine intake levels in pasture animal milk and local rations.

Abstract Introduction Double malnutrition (co-existing overnutrition and undernutrition) is increasingly prevalent in sub-Saharan Africa due to rapid epidemiological and nutritional transitions. In this region, studies of double malnutrition have largely been conducted at country and household level, with individual-level studies primarily limited to children and women of reproductive age. We investigated the prevalence and determinants of individual-level double malnutrition in middle-aged and older adults who constitute an increasing proportion of the sub-Saharan African population. Methods 250 individuals aged 40–70 years (50% women) and resident in the Agincourt Health and socio-Demographic Surveillance System in rural Mpumalanga province, South Africa, were randomly selected. Double malnutrition was defined as overweight/obesity and anaemia only, overweight/obesity and iodine insufficiency, or overweight/obesity and any micronutrient deficiency (anaemia and/or iodine insufficiency). The Chi-squared goodness of fit test was used to compare the expected and observed numbers of individuals with the type of double malnutrition. Logistic regression was used to investigate determinants of each type of double malnutrition. Results Double malnutrition was present in 22–36% of participants, depending on the definition used. All types of double malnutrition were more common in women than in men (overweight/obesity and anaemia: 34% vs. 10.2%, p

Abstract Background Currently, iodine deficiency has become a significant burden globally; where 2 billion people and 29.8% of school-age children are iodine deficient. It is a leading cause of preventable brain damage among children, resulting in impaired cognitive and motor development. Even though salt iodization was started to be implemented to alleviate this burden in Ethiopia, primary studies assessing iodine deficiency in the country show highly variable findings, and no systematic review was conducted to determine the pooled prevalence of the problem which makes it difficult to assess the effect of the intervention as well as to design appropriate and timely measures. Therefore, this systematic review and meta-analysis aimed to determine the pooled prevalence of iodine deficiency and the common factors affecting its occurrence among school-age children in Ethiopia. Method To obtain the eligible studies, databases (EMBASE, Scopus, Hinari, and PubMed), websites (Google and Google Scholar), and references of the eligible studies were searched systematically. Data were extracted using an Excel spreadsheet and analyzed using the STATA 17 version. The I 2 test was used to assess heterogeneity between the studies. A DerSimonian and Laird random-effects model was used to estimate the pooled prevalence and pooled odds ratio. A funnel plot and Egger’s test were used to detect publication bias. Result A total of 15 eligible studies, representing 15,611 school-age children, were included in the systematic review and meta-analysis. The pooled prevalence of iodine deficiency among school-age children in Ethiopia was found to be 58% (95%CI 44.00–77.00), while the highest prevalence was recorded in the Oromia Region, which was 64% (95% CI 49–79). Goitrogenic food consumption (adjusted odds ratio (AOR) 2.93, 95% CI 1.60–5.35) and being female (adjusted odds ratio (AOR) 1.87, 95% CI 1.43–2.44) showed a significant association with the prevalence of iodine deficiency. Conclusion Iodine deficiency among school-age children in Ethiopia was noticeably high. Goitrogenic food consumption and the sex of the child were determinant factors for the occurrence of iodine deficiency among the children. Therefore, appropriate advice should be given to households to limit goitrogenic foods in the diet of their children by giving due attention to their female children.

Background Insufficient and above WHO-recommended levels of iodine intake during pregnancy can lead to serious health outcomes. This study aimed to assess median urine iodine concentration and its associated risk factors among pregnant women in the Mbeya region, Tanzania. Method A cross sectional survey involving 420 pregnant women (n=420) aged 15-49, registered in Reproductive and Child Health Clinics was conducted. Socio-demographic and dietary factors were assessed by structured questionnaire and the urine samples were analyzed using the ammonium persulfate digestion method. Results Median urinary iodine concentration (mUIC) was 279.4μg/L and it ranged from 26.1 to 1915μg/L. Insufficient mUIC (below 150μg/L) was observed in 17.14% of participants, sufficient mUIC was 24.29% and 58.57% had mUIC above the recommended level (>250μg/L). Sample women who reported consuming fish in the last 24 hours had an increased risk of insufficient mUIC [Adjusted OR= 2.60 (95%CI 1.31-5.15)] while the risk was lower for those who attended at least primary education [AOR= 0.29 (CI 0.08-0.99)]. Further, sample women resident in Mbarali district, in the oldest age group (35-49) and having a higher socio-economic status were associated with an increased risk of having MUIC above recommended level [AOR=4.09 (CI 1.85-9.010], [AOR=2.51 (CI 0.99-6.330] and, [AOR=2.08 (CI 0.91-4.71) respectively. Conclusion This study demonstrated a significant association between geographical, age and socio-economic factors and median urine iodine concentration above the WHO-recommended level. Further, this study found association between inadequate iodine in diet and insufficient median urine iodine concentration. Therefore, educational programs on iodine intake should be strengthened.

Objective The evaluation of lymph node properties before lung cancer surgery has a great impact with the choice of surgical methods. Although there are various examination methods, many methods have invasive or accuracy problems. In order to improve the accuracy of diagnosis, we mainly discuss the value of wide- body spectral CT in the differential diagnosis of mediastinal metastatic lymph nodes, non-metastatic lymph nodes in lung cancer patients and reactive hyperplastic lymph nodes. Methods The clinical and imaging data of 64 patients with lung cancer and 28 patients with pulmonary inflammatory lesions were retrospectively analyzed. All patients underwent plain scan and enhanced dual-phase spectral CT scan. The size, density, three-phase IC, NIC, and λHU of lymph nodes in metastatic, non-metastatic and inflammatory reactive hyperplasia groups were measured on 70 keV single-energy images and iodine-based images, respectively. The single-factor variance and Kruskal-Wallis H rank sum test were used to analyze and compare the differences. Results The short diameter of metastatic lymph nodes was larger than that of non-metastatic lymph nodes and reactive hyperplastic lymph nodes (P < 0.001) . The plain scan density of reactive hyperplastic lymph nodes was higher than that of metastatic lymph nodes (P < 0.001), but there was no significant difference between non-metastatic lymph nodes (P = 0.325) . The CT values of reactive hyperplastic lymph nodes in arterial phase and venous phase were higher than those of metastatic and non-metastatic lymph nodes (P < 0.05) . Except for NIC in arterial phase, IC, NIC and λHU in plain scan, IC and λHU in arterial phase, IC, NIC and λHU in venous phase of reactive hyperplastic lymph nodes and metastatic lymph nodes were statistically significant (all P < 0.05) . There was no significant difference in IC, NIC and λHU between reactive hyperplastic lymph nodes and non-metastatic lymph nodes in plain scan, arterial phase and venous phase (all P > 0.05) . Conclusion The quantitative and spectral curve slope of iodine in mediastinal metastatic lymph nodes of lung cancer were basically lower than those in reactive hyperplastic lymph nodes. The quantitative parameters of spectral CT had certain diagnostic efficacy in differentiating metastatic lymph nodes and reactive hyperplastic lymph nodes, while the spectral parameters of non-metastatic lymph nodes and reactive hyperplastic lymph nodes were not statistically significant. [ABSTRACT FROM AUTHOR]

The objective of this article is to characterize the value of centralized iodization facilities (CIFs) to advance Ethiopia's salt iodization programme and its impact on the population iodine status. The analysis is based on a review of publications relating to salt iodization and iodine deficiency control efforts in Ethiopia. The country has made remarkable progress in improving iodized salt coverage, leading to improved iodine intake across its population that would otherwise be at high risk of iodine deficiency disorders. Establishment of central processing facilities, more frequent monitoring and generation of data and encouraging private sector investment have been instrumental in this achievement. Ethiopia has thus achieved and sustained greater than 89% HH iodized salt coverage from its lowest point of 15% coverage and subsequently improved iodine intake across its population. Iodine intake sufficiency in a population is assessed by median urinary iodine concentration (MUIC). The lessons learned and the experience with CIFs have applicability in several other countries where fragmented salt production continues to create barriers to achieve higher iodized salt coverage. Key messages: Iodized salt access in Ethiopia has improved remarkably and correlates with improved iodine nutrition among the population.The establishment of centralized iodization facilities (CIFs) have been instrumental in improving iodized salt coverage and access.Development partner support and Government commitment and efforts on enforcement have created the right enabling environment to attract investments in salt processing. [ABSTRACT FROM AUTHOR]

Background: Thyroid nodules (TN) are more frequent in the iodine-deficient region and the proportion of benign nodules is higher compared to areas with sufficient iodine intake. Objective: The aim of this study was to assess factors associated with malignant TN specially the EU-TIRADS ultrasound score in a Moroccan population with a high prevalence of iodine deficiency. Methods: In a prospective cross-sectional study, we enrolled outpatients referred for TN with fine needle aspiration biopsy (FNAB) according to EU-TIRADS 2017 classification. Malignancy of TN was defined by histological results indicating a thyroid malignancy on thyroid micro-biopsy or after surgical resection if indicated. Results: 225 participants with TN were enrolled. The median age was 54 (42.5 to 62) years-old. The prevalence of malignant TN was 8.9%. Malignant TN were significantly smaller than non-malignant ones (p = 0.008) and sub-centimetric TN were more frequent in malignant TN (25% vs 1.5%; p < 0.001). On multivariate analysis, male gender (OR : 9.33 ; 95% CI [2.02 ; 43.01]; p = 0,004) and EU-TIRADS score of 5 (OR : 55.6 ; 95% CI [9.34 ; 327.91] ; p < 0.001) were independent factors associated with malignant TN. The EU-TIRADS score of 4 was not associated to malignant TN. Conclusion: Our data suggest a trend of over-diagnosing indolent thyroid cancer. The EU-TIRADS score of 4 was not associated with TN malignancy. Considering clinical, accessory sonographic features, and size threshold for FNAB in EU-TIRADS 4 score TN may refine the diagnosis performance of this score in our population [ABSTRACT FROM AUTHOR]