van Veggel Kristin Mariëlla, Ivarson Dina Mehus, Rondeel Jan Maria Martinus, Mijnhout Gerritje Sophie
Department of Internal Medicine, Amsterdam UMC-VUmc, De Boelelaan 1117, 1081 HV Amsterdam, Netherlands.
Department of Obstetrics and Gynaecology, Stavanger University Hospital, Gerd-Ragna Bloch Thorsens gate 8, 4011 Stavanger, Norway.
J Thyroid Res. 2022 Jun 2;2022:4328548. doi: 10.1155/2022/4328548. eCollection 2022.
Worldwide, 21 countries have insufficient iodine in their diets. Persistent iodine deficiency may result in hypothyroidism. The aim of this study is to determine whether iodine measurements can be used to determine the prevalence of iodine deficiency in patients with (subclinical) hypothyroidism compared to a control group.
A prospective cohort pilot study was performed at the Internal Medicine Outpatient Clinic of Isala, a large teaching hospital in Zwolle, the Netherlands. . This study consisted of two groups of 24 adult patients each: a group of consecutive patients presenting with overt or subclinical hypothyroidism and a control group of euthyroid patients with type 1 diabetes mellitus. . All patients collected 24-hour urine. Iodine status was determined using urinary iodine concentration (UIC), urinary iodine excretion (UIE), and iodine creatinine ratio (I : Cr). Iodine deficiency was defined as an iodine concentration <100 g/L for UIC, iodine level <125 g for UIE, and <0.13 mol/mmol for I : Cr.
According to UIE and UIC measurements, 54.2% of hypothyroid patients were iodine-deficient compared to 41.7-45.8% in the control group. According to the I : Cr measurement 91.7% of hypothyroid patients were iodine-deficient compared to 87.5% in the control group. No significant difference was seen between the two groups. No correlation was found between thyroid-stimulating hormone (TSH) level and iodine deficiency.
Iodine deficiency is prevalent in both hypothyroid patients and euthyroid patients. Because there is no significant difference between the groups, a single 24-hour urine or spot urine sample to determine UIC, UIE, and I : Cr, seems not suitable to determine iodine status in an individual participant.
在全球范围内，有21个国家的饮食中碘含量不足。持续的碘缺乏可能导致甲状腺功能减退。本研究的目的是确定与对照组相比，碘测量是否可用于确定（亚临床）甲状腺功能减退患者碘缺乏的患病率。
在荷兰兹沃勒一家大型教学医院伊萨拉内科门诊进行了一项前瞻性队列试点研究。本研究包括两组，每组24名成年患者：一组为连续出现显性或亚临床甲状腺功能减退的患者，另一组为患有1型糖尿病的甲状腺功能正常的患者。所有患者收集24小时尿液。使用尿碘浓度（UIC）、尿碘排泄量（UIE）和碘肌酐比值（I∶Cr）来确定碘状态。碘缺乏的定义为UIC<100μg/L、UIE<125μg、I∶Cr<0.13μmol/mmol。
根据UIE和UIC测量，54.2%的甲状腺功能减退患者碘缺乏，而对照组为41.7%-45.8%。根据I∶Cr测量，91.7%的甲状腺功能减退患者碘缺乏，而对照组为87.5%。两组之间未见显著差异。未发现促甲状腺激素（TSH）水平与碘缺乏之间存在相关性。
碘缺乏在甲状腺功能减退患者和甲状腺功能正常的患者中都很普遍。由于两组之间没有显著差异，因此单一的24小时尿液或随机尿液样本用于确定UIC、UIE和I∶Cr，似乎不适用于确定个体参与者的碘状态。
