Associations of Urinary Cotinine-Verified Active and Passive Smoking with Thyroid Function: Analysis of Population-Based Nationally Representative Data

Kang, Jihun; Kong, Eunhee; Choi, Jong-Soon

doi:10.1089/thy.2017.0567

Cited by 11 publications

(6 citation statements)

References 32 publications

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“…This study demonstrated that the median UIC in smokers was higher than in nonsmokers, but not with statistical significance. Kang et al reported that active smokers had significantly lower iodine levels than passive smokers and nonsmokers . Regardless of smoking status, both groups were associated with decreasing serum TSH levels, which might be related to lower urinary iodine levels .…”

Section: Discussionmentioning

confidence: 97%

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Iodine status of euthyroid adults: A cross‐sectional, multicenter study

Wang

Yin

et al. 2019

Clinical Laboratory Analysis

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BackgroundIodine, an essential nutrient, is the most important trace element in thyroid hormone synthesis and maintenance of thyroid function. This study investigated the iodine nutrition status in healthy Chinese adults and assessed the relationship between urinary iodine concentration (UIC) and thyroid hormone levels.MethodsA cross‐sectional, multicenter study was conducted between October 2017 and January 2018, with 1017 adults recruited from five cities in China. All subjects underwent thyroid ultrasonography, and only those with normal results were included in the study. UICs were measured by inductively coupled plasma mass spectroscopy and adjusted using urine creatinine levels. Thyroid hormone levels were measured using an automated immunoassay analyzer.ResultsThe median UIC and adjusted UIC were 134.0 µg/L and 114.2 µg/g, respectively. UIC was not significantly different between males and females (P = 0.737). However, the adjusted UIC was significantly different between sexes (P < 0.001). The median UIC was higher than 100 µg/L. According to the World Health Organization criterion (100 µg/L), the total prevalence of iodine deficiency is 33.1% (n = 271). The prevalence rates of iodine deficiency in our study were 33.2% and 32.9% in males and females, respectively, and had no difference between sexes and among cities (P > 0.05). Serum thyroid‐stimulating hormone (TSH) levels increased when UIC increased. The Kruskal‐Wallis test showed no significant differences in free triiodothyronine, free thyroxine, and TSH, with different levels of UIC (all P > 0.05).ConclusionsChinese adults with normal thyroid structure have relatively sufficient iodine levels.

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Section: Discussionmentioning

confidence: 97%

“…Kang et al reported that active smokers had significantly lower iodine levels than passive smokers and nonsmokers . Regardless of smoking status, both groups were associated with decreasing serum TSH levels, which might be related to lower urinary iodine levels . It was unclear whether smoking decreased the urinary iodine levels until now.…”

Section: Discussionmentioning

confidence: 99%

Iodine status of euthyroid adults: A cross‐sectional, multicenter study

Wang

Yin

et al. 2019

Clinical Laboratory Analysis

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“…The effects of smoking on hypothyroidism were inconsistent in different studies which may be affected by iodine nutrition. A study in an iodine-deficient area in India and an iodine-sufficient area in Korea also found that smoking reduced serum TSH levels 28 29. Research by Park et al also showed that smoking reduced TSH levels at different iodine levels and smoking status was not associated with iodine intake 30.…”

Section: Discussionmentioning

confidence: 93%

Prevalence and risk factors of hypothyroidism after universal salt iodisation: a large cross-sectional study from 31 provinces of China

Shi

et al. 2023

BMJ Open

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ObjectivesTo investigate the prevalence and risk factors of hypothyroidism after universal salt iodisation for 20 years in mainland China.DesignNationwide, cross-sectional survey.Setting and participantsThe Thyroid Disorders, Iodine Status and Diabetes epidemiological study included adults from 31 provinces of China. Data included demographic, physical characteristics, urine, serum thyroid-stimulating hormone (TSH), thyroid-peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb) and thyroid ultrasonography. Subclinical hypothyroidism (SCH) was classified into severe SCH (TSH >10 mU/L) and mild SCH (TSH 4.2–9.9 mU/L). A total of 78 470 (38 182 men and 40 288 women) participants were included in the final analysis.ResultsThe prevalence of hypothyroidism was 13.95%. The prevalence rates of overt hypothyroidism (OH) and SCH were 1.02% and 13.93%, which mild SCH was significantly higher than severe SCH (12.18% vs 0.75%). Prevalence was higher in women than in men, and this gender difference was noted among all age groups. The prevalence of mild SCH, severe SCH and OH increases by 1.16%, 1.40% and 1.29% for every 10 years older. TPOAb or/and TgAb positive were significantly associated with OH and severe SCH (OR 15.9, p<0.001). However, SCH was positively correlated with increased urine iodine concentration, but this correlation was only in antibody-negative female patients. In non-autoimmune and male populations, there was a U-shaped relationship between severe SCH and OH and urine iodine concentration.ConclusionsMild SCH is the most common form of hypothyroidism, which is related to iodine intake. Severe SCH is more similar to OH which autoimmune is the main cause. The various effects of iodine on hypothyroidism depend on thyroid autoimmune and gender.

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“…In 1991, Feldman J et al reported that passive smoking can affect lipid metabolism in adolescents [20]. Subsequently, several studies related to endocrine and metabolic diseases were reported [8,21]. However, the results from studies on the effects of passive smoking on the prevalence of prediabetes and T2DM have been inconsistent.…”

Section: Discussionmentioning

confidence: 99%

Effects of passive smoking and its duration on the prevalence of prediabetes and type 2 diabetes mellitus in Chinese women

Pan

Huang

et al. 2020

Aging

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Several studies have shown that active smoking is a risk factor for type 2 diabetes mellitus (T2DM). However, the effects of passive smoking on T2DM remains unknown. In this study, we investigated the effects of passive smoking and its duration on the prevalence of prediabetes and T2DM. According to passive smoking status, participants were divided into Group A (passive smokers) and Group B (controls). Furthermore, Group A was divided into three subgroups according to the duration of passive smoking: Group A1 (≤10 years), Group A2 (10-20 years), and Group A3 (>20 years). We found that the prevalence of impaired glucose tolerance (IGT) in Group A (26.6%), Group A2 (28%), and Group A3 (37.8%) was significantly higher than that in Group B (19.6%), and the prevalence gradually increased with an increase in the duration of passive smoking. Multiple logistic regression analysis showed that passive smoking for >10 years was a risk factor for impaired fasting glucose (IFG), IGT, and T2DM. Therefore, passive smoking not only increases the prevalence of IGT in a time-dependent manner, but also a risk factor for IFG, IGT, and T2DM when its duration is over 10 years.

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Associations of Urinary Cotinine-Verified Active and Passive Smoking with Thyroid Function: Analysis of Population-Based Nationally Representative Data

Abstract: Active and passive smoking were associated with decreasing serum TSH levels and a lower risk of SCH in a Korean population. These associations might be related to lower urinary iodine levels in active smokers.

Cited by 11 publications

References 32 publications

Iodine status of euthyroid adults: A cross‐sectional, multicenter study

Iodine status of euthyroid adults: A cross‐sectional, multicenter study

Prevalence and risk factors of hypothyroidism after universal salt iodisation: a large cross-sectional study from 31 provinces of China

Effects of passive smoking and its duration on the prevalence of prediabetes and type 2 diabetes mellitus in Chinese women

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