Residual goitre in the postiodization phase: iodine status, thiocyanate exposure and autoimmunity

Marwaha, Raman K.; Tandon, Nikhil; Gupta, Nidhi; Karak, Asis Kumar; Verma, Kusum; Kochupillai, N.

doi:10.1046/j.1365-2265.2003.01895.x

Cited by 89 publications

(88 citation statements)

References 30 publications

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“…In contrast, subjects from an equal number of villages had a much lower goitre prevalence of 29 %, albeit higher than the internationally acceptable norm, despite UIC levels showing unsatisfactory iodine nutrition. This heterogeneous picture could in part be explained by: (i) a possible contribution of thiocyanate and other goitrogens as reported previously from the same area (22) ; and (ii) single point analysis may not reflect the USI failure at earlier times (13) .…”

Section: Discussionmentioning

confidence: 81%

Persistence of severe iodine-deficiency disorders despite universal salt iodization in an iodine-deficient area in northern India

Yadav

Gupta

Godbole

et al. 2009

Public Health Nutr.

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Objective: The aim of the present study was to determine the impact of universal salt iodization (USI) on the prevalence of iodine deficiency in the population of an area previously known to have severe iodine deficiency in India. Design: In a cross-sectional survey, a total of 2860 subjects residing in fifty-three villages of four sub-districts of Gonda District were examined for goitre and urinary iodine concentration. Free thyroxine and thyroid-stimulating hormone levels were also measured. Salt samples from households were collected for estimation of iodine content. Results: A reduction in goitre prevalence was observed from 69 % reported in 1982 to 27?7 % assessed in 2007. However, 34 % of villages still had very high endemicity of goitre (goitre prevalence .30 %). Twenty-three per cent of households consumed a negligible amount (,5 ppm) and 56 % of households consumed an insufficient amount (5-15 ppm) of iodine from salt. Conclusions: Although there was an overall improvement in iodine nutrition as revealed by decreased goitre prevalence and increased median urinary iodine levels, there were several pockets of severe deficiency that require a more targeted approach. Poor coverage, the use of unpackaged crystal salt with inadequate iodine and the washing of salt before use by 90 % of rural households are the major causes of persisting iodine-deficiency disorders. This demonstrates lapses in USI implementation, lack of monitoring and the need to identify hot spots. We advocate strengthening the USI programme with a mass education component, the supply of adequately iodized salt and the implementation of complementary strategies for vulnerable groups, particularly neonates and lactating mothers.

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Section: Discussionmentioning

confidence: 81%

Persistence of severe iodine-deficiency disorders despite universal salt iodization in an iodine-deficient area in northern India

Yadav

Gupta

Godbole

et al. 2009

Public Health Nutr.

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“…Increased iodine intake in diet, presence of goitrogens in diet as reported from studies in India, deficiency of micronutrients like selenium and iron, are some of the reasons for high Hypothyroidism prevalence in India. [16][17][18] …”

Section: Discussionmentioning

confidence: 99%

Prevalence of thyroid disorders among patients attending the antenatal clinic at tertiary care centre, Parel, Mumbai, India

Gedam

Rajput

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Pregnancy is associated with major changes in the physiology of the thyroid gland. Undiagnosed thyroid disorders can adversely affect fetal and maternal outcome. This study was done to study the prevalence of thyroid disorder among antenatal women. Methods: This was a prospective study done in the antenatal clinic in the Department of Obstetrics and Gynaecology, ESI PGIMSRMGM Hospital, Parel, Mumbai, India. Results: In present study, fifty out of three hundred and fifty pregnant women screened had thyroid disorder. The prevalence of thyroid disorder in this study was 14.2%. The prevalence of subclinical hypothyroidism was 7.7% (n= 27), overt hypothyroidism was 4% (n=14), subclinical hyperthyroidism was 1.7% (n=6) and overt hyperthyroidism was 0.8% (n=3). Conclusions: Thyroid disorders in pregnancy are associated with adverse fetomaternal outcome. Its prevalence is high in Indian women. Thus thyroid screening should be included in the routine antenatal investigations.

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“…Increased iodine intake in diet, presence of goitrogens in diet as reported from studies in India, deficiency of micronutrients like selenium and iron are some of the reasons ascribed to high hypothyroidism prevalence in India. [19][20][21] An inter-relation of this high prevalence of thyroid disorders with a high prevalence of the other major endocrinopathy diabetes mellitus has to be explored further. Prevalence of hyperthyroidism, both overt and subclinical in various studies has been reported to be around 1%.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of thyroid dysfunction and impact on maternal and fetal outcome in Central Indian pregnant women

Pokhanna

Gupta

Alwani

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Introduction: Thyroid dysfunctions have become common endocrine problems in pregnant women. It is now well established that not only overt, but subclinical thyroid dysfunction also has adverse effects on maternal and fetal outcome. There are very few data from India about the prevalence of thyroid dysfunction in pregnancy. In this study, we determined the prevalence of thyroid dysfunction in pregnancy and its impact on obstetrical outcome in Central Indian Indore Pregnant Women.Methods: Total 300 pregnant women between the 13 and 26 weeks of gestation were recruited for this study who is residing in Indore. In all patients routine obstetrical investigations, TSH tests were done. Anti-TPO antibody tests and Free T4 were done in patients with deranged TSH. The obstetrical and perinatal outcomes were recorded. Almost all the patients were followed up to delivery.Results: The prevalence of hypothyroidism and hyperthyroidism was 13 and 4%, respectively. Adverse maternal effects in overt hypothyroidism included preeclampsia (22.2 versus 11.6%) and placental abruption (22.2 versus 2.0%). Subclinical hypothyroidism was associated with preeclampsia (30.0 versus 11.6%) as compared to the euthyroid patients. Adverse fetal outcomes in overt hypothyroidism included spontaneous abortion (22.2 versus 6.6%), preterm birth (44.4 versus 30.0%), low birth weight (66.6 versus 30.0%), intrauterine growth retardation (33.3 versus 10.0%), and fetal death (22.2 versus 0%) as compared to the euthyroid women. Adverse fetal outcomes in subclinical hypothyroidism included spontaneous abortion (2.0 versus 6.6%), preterm delivery (5.2 versus 30.0%), low birth weight (11.2 versus 30.0%), and intrauterine growth retardation (4.4 versus 10 %) as compared to the euthyroid women.Conclusions: The prevalence of thyroid disorders was high in our study with associated adverse maternal and fetal outcomes. Routine screening of thyroid dysfunction is recommended to prevent adverse fetal and maternal outcome.

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Residual goitre in the postiodization phase: iodine status, thiocyanate exposure and autoimmunity

Cited by 89 publications

References 30 publications

Persistence of severe iodine-deficiency disorders despite universal salt iodization in an iodine-deficient area in northern India

Persistence of severe iodine-deficiency disorders despite universal salt iodization in an iodine-deficient area in northern India

Prevalence of thyroid disorders among patients attending the antenatal clinic at tertiary care centre, Parel, Mumbai, India

Prevalence of thyroid dysfunction and impact on maternal and fetal outcome in Central Indian pregnant women

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