Lebanese children are iodine deficient and urinary sodium and fluoride excretion are weak positive predictors of urinary iodine

Ghattas, Hala; Francis, Sirine; Mallah, Carla El; Shatila, Dareen; Merhi, Karina; Hlais, Sani; Zimmermann, Michael; Obeid, Omar

doi:10.1007/s00394-015-1120-x

Cited by 11 publications

(11 citation statements)

References 26 publications

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“…As found in other studies (Ategbo, Sankar, Schultink, van der Haar, & Pandav, ; Ghattas et al, ; Rohner et al, ), the iodine status in Madagascar appears to be partly associated with the salt iodine content at the household level.…”

Section: Discussionsupporting

confidence: 74%

First national iodine survey in Madagascar demonstrates iodine deficiency

Randremanana

Bastaraud

Rabarijaona³

et al. 2018

Maternal & Child Nutrition

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Universal salt iodization (USI) was adopted in Madagascar in 1995 within the framework of a worldwide policy to eliminate iodine deficiency disorders. Despite early USI adoption, there are no representative data on the iodine status of the Malagasy population.The aims of this study were to determine the iodine status of the Malagasy population and to assess the use of adequately iodized salt among households. We randomly sampled women of reproductive age (WRA) using a national, two-stage, stratified crosssectional survey in 2014. Casual urine from WRA and salt samples from the household containing WRA were collected to measure urinary iodine concentration (UIC) and to assess household salt iodine content. Data from 1,721 WRA in 1,128 households were collected and analysed. The national median UIC was 46 μg L −1 (interquartile range [IQR]: 13-98 μg L −1 ), indicating a moderate iodine deficiency. The median UIC was 53 μg L −1 (IQR: 9-89 μg L −1 ) in pregnant women and 46 μg L −1 (IQR: 13-98 μg L −1 ) in non-pregnant women. The national median iodine concentration of household salt was 10 mg kg −1 (IQR: 6.3-15.8 mg kg −1 ) and 26.2% (95% CI [22.1, 31.0]) of households containing WRA used adequately iodized salt (≥15 mg kg −1 ). Women living in households with adequately iodized salt had higher median UIC (72 vs. 50 μg L −1 ). Iodine status was significantly lower among women from low socioeconomic households. Madagascar's USI program needs to be revitalized. Implementing strategies to provide adequately iodized salt and enhancing iodized salt legislation to prevent severe complications resulting from iodine deficiency in the Malagasy population are essential.

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Section: Discussionsupporting

confidence: 74%

First national iodine survey in Madagascar demonstrates iodine deficiency

Randremanana

Bastaraud

Rabarijaona³

et al. 2018

Maternal & Child Nutrition

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“…This prevalence is similar to the one observed in the Spanish population [ 13 ] (which is 3.7%), but lower than the ones reported in the adolescent population of the NHANES III study [ 5 ] (which is, resp., 6.3% and 4.8% for Tg-Ab and TPO-Ab). This lower prevalence in our study compared to that in the US population could be related to an insufficient iodine intake [ 15 ], since iodine excess is a known risk factor for autoimmune thyroid disease [ 26 , 27 ]. In addition, we found that the presence of thyroid antibodies is a determinant of TSH values in girls but not in boys.…”

Section: Discussionmentioning

confidence: 69%

“…The higher cutoff used in this last study may explain part of this difference. Lower iodine status in Lebanese children [ 15 ] or genetic/ethnic factors could also be behind this, since both factors were found to affect the TSH reference interval [ 16 – 20 ].…”

Section: Discussionmentioning

confidence: 99%

Pediatric TSH Reference Intervals and Prevalence of High Thyroid Antibodies in the Lebanese Population

Gannagé‐Yared

Balech

Farah

et al. 2017

International Journal of Endocrinology

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The aims of this study are to establish reference values for TSH in Lebanese schoolchildren; to look at the relationship between TSH and age, gender, BMI, socioeconomic status (SES), and thyroid antibodies (TAb); and to investigate the prevalence of abnormal TAb in this population. 974 Lebanese schoolchildren aged 8–18 years were recruited from 10 schools of different SES. Third-generation TSH, TPO-Ab, and Tg-Ab measurements were performed using the IMMULITE chemiluminescent immunoassay. The mean TSH is 2.06 ± 1.05 μUI/ml. TSH values are inversely correlated with age (p < 0.0001), are higher in boys than in girls (resp., 2.14 ± 1.10 and 1.98 ± 0.99 μUI/ml, p = 0.017), and are positively correlated with BMI (p < 0.0001). They are also significantly higher in subjects from low-SES schools (p = 0.03) and in girls with positive TAb (p = 0.026). In boys, TSH is independently associated with age, BMI, and schools' SES (p = 0.01, p = 0.03, and p = 0.026, resp.) while in girls, the association is only significant for age and TAb (p = 0.0001 and p = 0.015, resp.). The prevalence of TAb is 4.3% (3% for TPO-Ab and 2.1% for Tg-Ab). Our results showed higher TSH values in the pediatric Lebanese population compared to western populations. TSH varies according to age, gender, BMI, and SES and is associated in girls with TAb.

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“…To our knowledge, there are no published data in Lebanon regarding screening protocols or rates of CH among VLBW infants. Based on reports of mild iodine deficiency in Lebanon [26], we hypothesized that the incidence rates of CH among VLBW preterm infants are higher than the ones reported in the literature. The aims of this study were: (1) to survey the compliance rates with screening guidelines for CH and for late TSH rise among VLBW infants at a tertiary care center in Lebanon; (2) to determine the incidence rates of CH and of late-rise TSH in this population over a 6-year period and to explore the associated risk factors.…”

Section: Introductionmentioning

confidence: 74%

“…According to the 2004 WHO global database, Lebanon falls in the mild iodine deficiency category [30]. Recent studies indicate mild iodine deficiency in Lebanese school age children [26]. Although there are no published data on the status of pregnant and lactating women in Lebanon, one could assume by extrapolation that they may fall into this category.…”

Section: Discussionmentioning

confidence: 99%

Higher Incidence Rates of Hypothyroidism and Late TSH Rise in Preterm Very-Low-Birth-Weight Infants at a Tertiary Care Center

Tfayli¹,

Charafeddine²,

Tamim³

et al. 2018

Horm Res Paediatr

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Background/Aims: Preterm newborns with a very low birth weight (VLBW) of < 1,500 g have an atypical form of hypothyroidism with a delayed rise in TSH, necessitating a second newborn screening specimen collection. The aims of this study were to survey the compliance with second newborn screening to detect delayed TSH rise in VLBW preterm infants at a tertiary care center, and to determine the rate of atypical hypothyroidism. Methods: Retrospective review of the records of 104 preterm VLBW infants. Late TSH rise was defined as an increase in TSH concentration after 14 days of age in the presence of a normal initial screen. Results: The compliance rate was 92% for the second screening. High rates of hypothyroidism (16.3%) and of late TSH rise (4.8%) were detected. Patients with hypothyroidism had a significantly lower birth weight (p = 0.01) and longer hospital stay (p = 0.004). Patients with late versus those with early TSH rise had a significantly lower mean birth weight (851 ± 302 vs. 1,191 ± 121 g, p = 0.004). Conclusion: The rates of early and late TSH rise in this VLBW population were higher than those in the literature and could be due to the use of povidone-iodine disinfectants. The yield of a second TSH screening in this study was high indicating the need for vigilance in screening VLBW preterm infants.

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Lebanese children are iodine deficient and urinary sodium and fluoride excretion are weak positive predictors of urinary iodine

Cited by 11 publications

References 26 publications

First national iodine survey in Madagascar demonstrates iodine deficiency

First national iodine survey in Madagascar demonstrates iodine deficiency

Pediatric TSH Reference Intervals and Prevalence of High Thyroid Antibodies in the Lebanese Population

Higher Incidence Rates of Hypothyroidism and Late TSH Rise in Preterm Very-Low-Birth-Weight Infants at a Tertiary Care Center

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