The Effect of Iodine Status on the Risk of Thyroid Nodules: A Cross-Sectional Study in Zhejiang, China

Lou, Xiaoming; Wang, Zhifang; Mao, Guangming; Zhu, Wei; Wang, Yuanyang; Pan, Xuejiao; Chen, Zhijian; Mo, Zhe

doi:10.1155/2020/3760375

Cited by 13 publications

(8 citation statements)

References 26 publications

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“…The incidence of thyroid nodules was 9.45% in the present study, which was slightly lower than that in the coast of China (15.5%) [15] and Germany (23.4%) [16]. Several epidemiological studies have demonstrated that the incidence of thyroid nodules increased with age because of degenerative changes in thyroid [16,17].…”

Section: Discussioncontrasting

confidence: 56%

Iodine status and its association with prevalence of thyroid diseases in adults from Jiangxi Province, China

Yan,

Hu,

Shen

et al. 2023

Endocrine

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Background: Iodine is an essential element for biosynthesis of thyroid-stimulating hormone (TSH). Both excessive and de ciency of iodine are major risk factor for thyroid diseases, including thyroid dysfunction, thyroid nodules, and thyroid autoimmunity (TAI). This study aimed to elucidate the relationship between iodine status and incidence of thyroid diseases through a national cross-sectional epidemiological survey (TIDE) in Jiangxi province (China).Methods: A population-based, cross-sectional study enrolled a total of 2636 Chinese local inhabitants who aged over 18 years from April to August in 2015. Physical examination was performed and biochemical indices, urinary iodine concentration (UIC), and TSH levels were measured and documented for each subject. The Chi-square test, nonparametric test, and 4 multiple logistic regression models adjusted for other risk factors were applied to analysis, and Spearman correlation coe cients were used to investigate the relationship between iodine intake level and the incidence of thyroid diseases.Results: The median UIC was 176.4 μg/L, and a signi cant difference was found in median UIC between males(182.5 μg/L) and females (169.2 μg/L) (P =0.03). Among these participants, 14.4%, 44.5%, 26.1%, and 15.0% had de ciency, adequate, more than adequate, and excessive iodine concentrations, respectively. The incidence rates of hyperthyroidism, subclinical hyperthyroidism, hypothyroidism, subclinical hypothyroidism, thyroid nodules, and TAI were 0.91%, 0.57%, 0.34% and 7.89%, 9.45%, and 12.74%, respectively. Signi cant differences were found in iodine status, waist circumstance, systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), TSH, thyroid nodules, and TAI between males and females (P <0.05). Compared with those with adequate UIC, subjects with excessive UIC had higher incidence rates of thyroid dysfunction (odds ratio (OR)=1.74, 95% con dence interval (CI):1.40-2.54) and thyroid nodules (OR=3.33, 95%CI 1.32-8.42). In addition, subjects with de cient and excessive UIC were at a higher risk of TAI compared with those with adequate UIC (OR=1.68, 95%CI: 1.19-2.60; OR=1.52, 95%CI: 1.04-2.96, respectively). UIC was positively correlated with the incidence rates of thyroid nodules (r=-0.44, P<0.01) and TAI (r=-0.055, P <0.01). On the contrary, UIC was negatively correlated with the risk of thyroid dysfunction (r=-0.24, P >0.05).Conclusion: Adult inhabitants from Jiangxi province in the TIDE study were in the adequate iodine status.The incidence rates of of thyroid dysfunction, thyroid nodules, and TAI were higher in females. Excessive iodine status was noted as a risk factor for thyroid dysfunction and thyroid nodules. In addition, both iodine de ciency and excessive iodine were risk factors for TAI.

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Section: Discussioncontrasting

confidence: 56%

Iodine status and its association with prevalence of thyroid diseases in adults from Jiangxi Province, China

Yan,

Hu,

Shen

et al. 2023

Endocrine

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“…Among 595 controls, 421(70.8%) patients had thyroid nodule. Epidemiologic studies have reported both positive 31 and inverse 15 , 32 associations between iodine excess and the risk of thyroid nodules, and one Korean study reported higher iodine intake in patients with thyroid nodules than in general population 33 . If we assume our control group had a higher intake of iodine than general population, we might have underestimated the true association.…”

Section: Discussionmentioning

confidence: 99%

Association between urinary iodine concentration and the risk of papillary thyroid cancer by sex and age: a case–control study

Hwang

Chung

et al. 2023

Sci Rep

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Previous studies on dietary iodine intake and the risk of papillary thyroid cancer (PTC) have demonstrated inconsistent results. We aimed to evaluate the association between urinary iodine concentration (UIC), a surrogate biomarker for dietary iodine intake, and the risk of thyroid cancer stratified by sex and age in an iodine-sufficient area. A hospital-based case–control study was conducted in Seoul, South Korea. A total of 492 cases of newly diagnosed PTC and 595 controls were included. Compared with the lowest quartile of creatine-adjusted UIC (< 159.3 μg/gCr), the highest quartile (≥ 1037.3 μg/gCr) showed an increased risk of PTC (odds ratio [OR] 1.49, 95% confidence interval [CI] 1.04–2.13), especially in those who were < 45 years old (ptrend = 0.01) compared with those who were ≥ 45 years old (ptrend = 0.48). For those who were < 45 years old, a positive association between creatinine-adjusted UIC and the risk of PTC was observed in both men (q4 vs. q1, OR 4.27, 95% CI 1.14–18.08) and women (OR 1.97, 95% CI 1.04–3.78). For those who were ≥ 45 years old, no association was found in any sex. Creatinine-adjusted UIC was positively associated with the risk of PTC, especially in those who were younger than 45 years for both men and women.

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“…During that same time period, some scholars observed an increasing trend in the incidence of thyroid nodules and thyroid cancer, and they suggested that salt iodization was a risk factor for the occurrence and development of thyroid nodules [12,13]. However, some scholars offered different viewpoints [14]. Chen et al found that even with salt iodization, the intake of iodine in Zhoushan, China, is still insufficient, and salt iodization is necessary for inland areas [9].…”

Section: Introductionmentioning

confidence: 99%

Analysis of the correlation between high iodized salt intake and the risk of thyroid nodules: a large retrospective study

Wang

Zhi-hen

et al. 2021

BMC Cancer

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Background Currently, whether daily excess iodized salt intake increases the risk of thyroid nodules and even thyroid cancer remains controversial. Our research group aimed to provide a theoretical basis for the clinical guidance of daily iodized salt intake and the prevention of thyroid nodules through a retrospective analysis of the correlation between daily iodized salt intake and the risk of thyroid nodules and thyroid cancer in Hunan, China. Methods This study retrospectively analyzed the data of subjects who underwent a physical examination at the Health Management Center, Third Xiangya Hospital of Central South University, between January 1, 2017, and December 31, 2019. Subjects enrolled in this study underwent thyroid ultrasonography and tests to urine routines and liver and kidney function, and all subjects completed a questionnaire survey. The daily iodized salt intake of the study subjects was estimated based on spot urine methods (Tanaka). A multivariate logistic regression model was used to analyze the relationship between daily iodized salt intake and thyroid nodules and thyroid cancer. Results Among the 51,637 subjects included in this study, the prevalence of thyroid nodules was 40.25%, and the prevalence of thyroid cancer was 0.76%; among all enrolled subjects, only 3.59% had a daily iodized salt intake less than 5 g. In addition, we found that a daily intake of more than 5 g of iodized salt was not only an independent risk factor for the occurrence of thyroid nodules (odds ratio (OR): 2.08, 95% confidence interval (CI): 1.86–2.31, p < 0.001) but also an independent risk factor for the occurrence of thyroid cancer (OR: 5.81, 95% CI: 1.44–23.42, p = 0.012). A pooled analysis showed a significantly higher risk of thyroid nodules in subjects aged > 60 years with a daily iodized salt intake of more than 5 g compared to subjects aged < 60 years with a daily iodized salt intake of no more than 5 g (OR: 4.88, 95% CI: 4.29–5.54, p < 0.001); the risk of thyroid cancer was not significantly different between subjects aged > 60 years with a daily iodized salt intake of more than 5 g and those aged < 60 years with a daily iodized salt intake of no more than 5 g (OR: 2.15, 95% CI: 0.52–8.95, p = 0.281). The risk of thyroid nodules was not increased in physically active subjects with a daily iodized salt intake of more than 5 g compared to physically inactive subjects with a daily iodized salt intake of no more than 5 g (OR: 1.12, 95% CI: 0.97–1.28, p = 0.111). The same protective effect of physical activity was observed for thyroid cancer in subjects whose daily iodized salt intake exceeded 5 g. The risk of thyroid nodules was reduced for subjects with an education level of postgraduate and above, even when the daily iodized salt intake exceeded 5 g, compared to those with high school education and below and a daily iodized salt intake of no more than 5 g (OR: 0.79, 95% CI: 0.66–0.93, p = 0.005); however, a protective effect of education level on the occurrence of thyroid cancer was not observed. Independent risk factors affecting daily iodized salt intake greater than 5 g included age, triglycerides, family history of tumors, physical activity, and marital status. Conclusions Daily intake of more than 5 g of iodized salt increased the risk of thyroid nodules and thyroid cancer, while increased physical activity and education level reduced the risk of thyroid nodules and thyroid cancer caused by iodized salt intake.

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The Effect of Iodine Status on the Risk of Thyroid Nodules: A Cross-Sectional Study in Zhejiang, China

Cited by 13 publications

References 26 publications

Iodine status and its association with prevalence of thyroid diseases in adults from Jiangxi Province, China

Iodine status and its association with prevalence of thyroid diseases in adults from Jiangxi Province, China

Association between urinary iodine concentration and the risk of papillary thyroid cancer by sex and age: a case–control study

Analysis of the correlation between high iodized salt intake and the risk of thyroid nodules: a large retrospective study

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