期刊
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
卷 100, 期 4, 页码 1630-1638出版社
ENDOCRINE SOC
DOI: 10.1210/jc.2014-3704
关键词
-
资金
- 973 Science and Technology Research Foundation, Ministry of Science and Technology in China [2011CB512112]
- Chinese National Natural Science Foundation [81 170 730]
- Health and Medicine Research Foundation, Ministry of Health in China [201 002 002]
- Research Foundation, Department of Science and Technology, Liaoning Province government, China [2012225020, 2011225023]
- Guanghua Science and Technology Foundation of China [2007-02]
- Research Foundation of Key Laboratory of Endocrine Diseases, Department of Science and Technology, Shenyang Government, Liaoning Province, China [F11-244-1-00]
- Research Foundation innovative team from the Advanced Educational Institute [LT 2 012 015]
- Twelve-Five Science and Technology Support Program [No2014BAI06B02]
Context: The WHO Technical Consultation recommends urinary iodine concentrations (UIC) from 250 to 499 mu g/L as more-than-adequate iodine intake and UIC >= 500 mu g/L as excessive iodine for pregnant and lactating women, but scientific evidence for this is weak. Objective: We investigated optimal and safe ranges of iodine intake during early pregnancy in an iodine-sufficient region of China. Method: Seven thousand one hundred ninety pregnant women at 4-8 weeks gestation were investigated and their UIC, serum thyroid stimulating hormone (TSH), free thyroxine (FT4), thyroidperoxidase antibody (TPOAb), thyroglobulin antibody (TgAb), and thyroglobulin (Tg) were measured. Results: The prevalence of overt hypothyroidism was lowest in the group with UIC 150-249 mu g/L, which corresponded to the lowest serum Tg concentration (10.18 mu g/L). Prevalences of subclinical hypothyroidism (2.4%) and isolated hypothyroxinemia (1.7%) were lower in the group with UIC 150-249 mu g/L. Multivariate logistic regression indicated that more-than-adequate iodine intake (UIC 250-499 mu g/L) and excessive iodine intake (UIC > 500 mu g/L) were associated with a 1.72-fold and a 2.17-fold increased risk of subclinical hypothyroidism, respectively. Meanwhile, excessive iodine intake was associated with a 2.85-fold increased risk of isolated hypothyroxinemia. Moreover, the prevalence of TPOAb positivity and TgAb positivity presented a U-shaped curve, ranging from mild iodine deficiency to iodine excess. Conclusion: The upper limit of iodine intake during early pregnancy in an iodine-sufficient region should not exceed UIC 250 mu g/L, because this is associated with a significantly high risk of subclinical hypothyroidism, and a UIC of 500 mu g/L should not be exceeded, as it is associated with a significantly high risk of isolated hypothyroxinemia.
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