Human Nutrition Laboratory, Institute of Food, Nutrition, and Health, ETH Zurich, Zurich, Switzerland.
Department of Women and Children's Health, King's College London, London, UK.
Ann N Y Acad Sci. 2019 Jun;1446(1):44-65. doi: 10.1111/nyas.14041. Epub 2019 Mar 20.
Iodine is essential for thyroid hormone synthesis. High iodine intakes are well tolerated by most healthy individuals, but in some people, excess iodine intakes may precipitate hyperthyroidism, hypothyroidism, goiter, and/or thyroid autoimmunity. Individuals with preexisting thyroid disease or those previously exposed to iodine deficiency may be more susceptible to thyroid disorders due to an increase in iodine intake, in some cases at intakes only slightly above physiological needs. Thyroid dysfunction due to excess iodine intake is usually mild and transient, but iodine-induced hyperthyroidism can be life-threatening in some individuals. At the population level, excess iodine intakes may arise from consumption of overiodized salt, drinking water, animal milk rich in iodine, certain seaweeds, iodine-containing dietary supplements, and from a combination of these sources. The median urinary iodine concentration (UIC) of a population reflects the total iodine intake from all sources and can accurately identify populations with excessive iodine intakes. Our review describes the association between excess iodine intake and thyroid function. We outline potential sources of excess iodine intake and the physiological responses and consequences of excess iodine intakes. We provide guidance on choice of biomarkers to assess iodine intake, with an emphasis on the UIC and thyroglobulin.
碘是甲状腺激素合成所必需的。大多数健康个体都能很好地耐受高碘摄入，但在某些人中，过量的碘摄入可能会引发甲状腺功能亢进、甲状腺功能减退、甲状腺肿和/或自身免疫性甲状腺疾病。有甲状腺疾病病史或以前曾接触过碘缺乏的个体，由于碘摄入量增加，可能更容易发生甲状腺疾病，在某些情况下，摄入量仅略高于生理需求。由于碘摄入过多导致的甲状腺功能障碍通常是轻微和短暂的，但碘诱导的甲状腺功能亢进在某些个体中可能有生命危险。在人群层面上，过量的碘摄入可能来自食用加碘盐、饮用水、富含碘的动物奶、某些海藻、含碘膳食补充剂，以及这些来源的组合。人群的中位数尿碘浓度（UIC）反映了来自所有来源的总碘摄入量，可以准确识别碘摄入过量的人群。我们的综述描述了过量碘摄入与甲状腺功能之间的关系。我们概述了过量碘摄入的潜在来源以及过量碘摄入的生理反应和后果。我们提供了评估碘摄入量的生物标志物选择指南，重点是 UIC 和甲状腺球蛋白。
