Systematic review using meta-analyses to estimate dose-response relationships between iodine intake and biomarkers of iodine status in different population groups

Ristić‐Medić, Danijela; Dullemeijer, Carla; Tepšić, Jasna; Petrović-Oggiano, Gordana; Popović, Tamara; Arsić, Aleksandra; Glibetić, Marija; Souverein, Olga W.; Collings, Rachel; Cavelaars, Adriënne E J M; Groot, Lisette C. P. G. M. de; Gurinović, Mirjana

doi:10.1111/nure.12092

Cited by 16 publications

(7 citation statements)

References 89 publications

(433 reference statements)

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“…Level of iodine intake and iodine sources differ between countries and regions. While low iodine intake has been reported in most European countries and the United States, high iodine intake has been reported in Korea and Japan [17]. In countries where an iodized salt program has been implemented, iodized salt is the most important source of iodine [18].…”

Section: Discussionmentioning

confidence: 99%

Iodine status and characteristics of Korean adolescents and their parents based on urinary iodine concentration: a nationwide cross-sectional study

Choi

Cheong

Chueh

et al. 2019

Ann Pediatr Endocrinol Metab

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Purpose Iodine is a major component of thyroid hormones. Both deficiency and excess of iodine are major risk factors for thyroid disease, making it important to accurately assess iodine level in the human body. Urinary iodine concentration (UIC) is a commonly used measure of iodine status. However, there is little research on iodine status and related characteristics in Korean adolescents. Methods Using data from the sixth Korea National Health and Nutrition Examination Survey (KNHANES VI) for the years 2013–2015, we analyzed UIC and thyroid function test results in adolescents aged 10–18 years and their parents. We also investigated the influence of socioeconomic factors and family history of thyroid disease on iodine status. Results Mean UIC in Korean adolescents was 963.5±55.7 μg/L. Among evaluated subjects, 6.6%±1.0%, 29.8%±1.7%, and 63.9%±1.9% had low (UIC<100 μg/L), adequate (UIC: 100–299.9 μg/L), and excess (UIC≥300 μg/L) iodine concentrations, respectively. Based on regional trends, the incidence of iodine deficiency exceeded 10% in several regions, even though there was a dominance of regions with excess iodine. Parental UIC, female sex, average monthly income, and expenditure were all found to affect the iodine status of Korean adolescents. Conclusions Although regional differences exist, the iodine status in Korean adolescents is mainly affected by the eating habits of their families and socioeconomic factors. Therefore, monitoring of iodine status is necessary in this population.

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Section: Discussionmentioning

confidence: 99%

Iodine status and characteristics of Korean adolescents and their parents based on urinary iodine concentration: a nationwide cross-sectional study

Choi

Cheong

Chueh

et al. 2019

Ann Pediatr Endocrinol Metab

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“…Support for this distributional assumption comes from a meta‐analysis 18 demonstrating a monotonic concave relationship between DUP and negative symptoms, and a primary study 49 documenting a similar relationship between DUP and Positive and Negative Syndrome Scale (PANSS) total and subscale scores. Due to the double log transformation, the effect size measure (beta) represents the difference in the log e‐transformed predicted value of the outcome for each one‐unit difference in the log e‐transformed value in DUP 50 . Therefore, an overall beta of 0.1 means that, for every doubling in DUP, the predicted difference in the outcome is 2 beta (2 0.1 =1.07 or 7%) 51 .…”

Section: Methodsmentioning

confidence: 99%

The clinical significance of duration of untreated psychosis: an umbrella review and random‐effects meta‐analysis

et al. 2021

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The idea that a longer duration of untreated psychosis (DUP) leads to poorer outcomes has contributed to extensive changes in mental health services worldwide and has attracted considerable research interest over the past 30 years. However, the strength of the evidence underlying this notion is unclear. To address this issue, we conducted an umbrella review of available meta‐analyses and performed a random‐effects meta‐analysis of primary studies. MEDLINE, Web of Science, PsycINFO and EMBASE were searched from inception to September 3, 2020 to identify relevant meta‐analyses of studies including patients with schizophrenia spectrum disorders, first‐episode psychosis, or affective and non‐affective psychosis. Thirteen meta‐analyses were included, corresponding to 129 individual studies with a total sample size of 25,657 patients. We detected potential violations of statistical assumptions in some of these meta‐analyses. We therefore conducted a new random‐effects meta‐analysis of primary studies. The association between DUP and each outcome was graded according to a standardized classification into convincing, highly suggestive, suggestive, weak, or non‐significant. At first presentation, there was suggestive evidence for a relationship between longer DUP and more severe negative symptoms (beta=–0.07, p=3.6×10–5) and higher chance of previous self‐harm (odds ratio, OR=1.89, p=1.1×10–5). At follow‐up, there was highly suggestive evidence for a relationship between longer DUP and more severe positive symptoms (beta=–0.16, p=4.5×10–8), more severe negative symptoms (beta=–0.11, p=3.5×10–10) and lower chance of remission (OR=2.16, p=3.0×10–10), and suggestive evidence for a relationship between longer DUP and poorer overall functioning (beta=–0.11, p=2.2×10–6) and more severe global psychopathology (beta=–0.16, p=4.7×10–6). Results were unchanged when analysis was restricted to prospective studies. These effect sizes are clinically meaningful, with a DUP of four weeks predicting >20% more severe symptoms at follow‐up relative to a DUP of one week. We conclude that DUP is an important prognostic factor at first presentation and predicts clinically relevant outcomes over the course of illness. We discuss conceptual issues in DUP research and methodological limitations of current evidence, and provide recommendations for future research.

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“…Thyrotropin (TSH) secretion is extremely sensitive to circulating levels of thyroid hormone, and is commonly used clinically as an index of thyroid hormone homeostasis (1). In defining a ''normal'' TSH, it is noteworthy that TSH levels can vary within an individual (2) due to the influence of factors such as circadian rhythms (3), genetic background (4), or iodine intake (5). Furthermore, the reference range within which a TSH level should be considered normal at the population level remains controversial (6,7).…”

Section: Introductionmentioning

confidence: 99%

Thyrotropin Levels Are Associated with Cardiometabolic Risk Factors in Euthyroid Adolescents

2016

Thyroid

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Background: Increased thyrotropin (TSH) levels and free triiodothyronine to free thyroxine (fT3:fT4) ratios, even within the euthyroid range, have been associated with cardiometabolic risk factors in adults but are less characterized in youth. This study sought to determine relations between TSH, thyroid hormones, and cardiometabolic risk factors in euthyroid adolescents. Methods: Data were extracted from the United States National Health and Nutrition Examination Survey, 2007-2010, for univariate and multivariate analyses of TSH, thyroid hormones, body mass index (BMI), blood pressure, lipids, and glucose metabolism. Subjects aged 12-18 years, with normal TSH and antithyroid peroxidase antibody levels, and without a history of thyroid disease, diabetes, or treatment of hypertension/dyslipidemia (n = 1167) were included. TSH and thyroid hormones were assessed for impact on BMI Z-score, systolic blood pressure (SBP) diastolic blood pressure, total cholesterol (TC), high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, apolipoprotein B, triglycerides, and glucose metabolism. Results: Univariate analyses revealed positive linear relations between TSH and SBP, TC, fasting and two-hour glucose, and homeostasis model assessment of insulin resistance (HOMA-IR). The fT3:fT4 ratio negatively correlated with high-density lipoprotein cholesterol but positively with BMI Z-score, SBP, triglycerides, fasting and two-hour glucose, fasting insulin, and HOMA-IR. In multivariate analyses controlling for age, sex, race/ ethnicity, and BMI Z-score, relations between TSH and both TC and fasting glucose remained significant, and the fT3:fT4 ratio was positively associated with fasting glucose and HOMA-IR. Conclusions:In an unselected population of euthyroid U.S. adolescents, TSH and thyroid hormones correlate with multiple cardiometabolic risk factors, with age-and sex-independent effects on cholesterol and glucose metabolism.

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Systematic review using meta-analyses to estimate dose-response relationships between iodine intake and biomarkers of iodine status in different population groups

Cited by 16 publications

References 89 publications

Iodine status and characteristics of Korean adolescents and their parents based on urinary iodine concentration: a nationwide cross-sectional study

Iodine status and characteristics of Korean adolescents and their parents based on urinary iodine concentration: a nationwide cross-sectional study

The clinical significance of duration of untreated psychosis: an umbrella review and random‐effects meta‐analysis

Thyrotropin Levels Are Associated with Cardiometabolic Risk Factors in Euthyroid Adolescents

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