TY - JOUR
T1 - Standardized Map of Iodine Status in Europe
AU - Ittermann, Till
AU - Albrecht, Diana
AU - Arohonka, Petra
AU - Bilek, Radovan
AU - De Castro, Joao J.
AU - Dahl, Lisbeth
AU - Filipsson Nystrom, Helena
AU - Gaberscek, Simona
AU - Garcia-Fuentes, Eduardo
AU - Gheorghiu, Monica L.
AU - Hubalewska-Dydejczyk, Alicja
AU - Hunziker, Sandra
AU - Jukic, Tomislav
AU - Karanfilski, Borislav
AU - Koskinen, Seppo
AU - Kusic, Zvonko
AU - Majstorov, Venjamin
AU - Makris, Konstantinos C.
AU - Markou, Kostas B.
AU - Meisinger, Christa
AU - Milevska Kostova, Neda
AU - Mullen, Karen R.
AU - Nagy, Endre V.
AU - Pirags, Valdis
AU - Rojo-Martinez, Gemma
AU - Samardzic, Mira
AU - Saranac, Ljiljana
AU - Strele, Ieva
AU - Thamm, Michael
AU - Top, Işlk
AU - Trofimiuk-Müldner, Malgorzata
AU - Ünal, Belgin
AU - Koskinen, Seppo
AU - Vila, Lluis
AU - Vitti, Paolo
AU - Winter, Benjamin
AU - Woodside, Jayne V.
AU - Zaletel, Katja
AU - Zamrazil, Vaclav
AU - Zimmermann, Michael
AU - Erlund, Iris
AU - Völzke, Henry
N1 - Funding Information:
The EUthyroid project has received funding from the European Union’s Horizon 2020 research and innovation program under grant agreement no. 634453.
Publisher Copyright:
© Copyright 2020, Mary Ann Liebert, Inc., publishers 2020.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/9
Y1 - 2020/9
N2 - Knowledge about the population's iodine status is important, because it allows adjustment of iodine supply and prevention of iodine deficiency. The validity and comparability of iodine-related population studies can be improved by standardization, which was one of the goals of the EUthyroid project. The aim of this study was to establish the first standardized map of iodine status in Europe by using standardized urinary iodine concentration (UIC) data. Materials and Methods: We established a gold-standard laboratory in Helsinki measuring UIC by inductively coupled plasma mass spectrometry. A total of 40 studies from 23 European countries provided 75 urine samples covering the whole range of concentrations. Conversion formulas for UIC derived from the gold-standard values were established by linear regression models and were used to postharmonize the studies by standardizing the UIC data of the individual studies. Results: In comparison with the EUthyroid gold-standard, mean UIC measurements were higher in 11 laboratories and lower in 10 laboratories. The mean differences ranged from -36.6% to 49.5%. Of the 40 postharmonized studies providing data for the standardization, 16 were conducted in schoolchildren, 13 in adults, and 11 in pregnant women. Median standardized UIC was <100 μg/L in 1 out of 16 (6.3%) studies in schoolchildren, while in adults 7 out of 13 (53.8%) studies had a median standardized UIC <100 μg/L. Seven out of 11 (63.6%) studies in pregnant women revealed a median UIC <150 μg/L. Conclusions: We demonstrate that iodine deficiency is still present in Europe, using standardized data from a large number of studies. Adults and pregnant women, particularly, are at risk for iodine deficiency, which calls for action. For instance, a more uniform European legislation on iodine fortification is warranted to ensure that noniodized salt is replaced by iodized salt more often. In addition, further efforts should be put on harmonizing iodine-related studies and iodine measurements to improve the validity and comparability of results.
AB - Knowledge about the population's iodine status is important, because it allows adjustment of iodine supply and prevention of iodine deficiency. The validity and comparability of iodine-related population studies can be improved by standardization, which was one of the goals of the EUthyroid project. The aim of this study was to establish the first standardized map of iodine status in Europe by using standardized urinary iodine concentration (UIC) data. Materials and Methods: We established a gold-standard laboratory in Helsinki measuring UIC by inductively coupled plasma mass spectrometry. A total of 40 studies from 23 European countries provided 75 urine samples covering the whole range of concentrations. Conversion formulas for UIC derived from the gold-standard values were established by linear regression models and were used to postharmonize the studies by standardizing the UIC data of the individual studies. Results: In comparison with the EUthyroid gold-standard, mean UIC measurements were higher in 11 laboratories and lower in 10 laboratories. The mean differences ranged from -36.6% to 49.5%. Of the 40 postharmonized studies providing data for the standardization, 16 were conducted in schoolchildren, 13 in adults, and 11 in pregnant women. Median standardized UIC was <100 μg/L in 1 out of 16 (6.3%) studies in schoolchildren, while in adults 7 out of 13 (53.8%) studies had a median standardized UIC <100 μg/L. Seven out of 11 (63.6%) studies in pregnant women revealed a median UIC <150 μg/L. Conclusions: We demonstrate that iodine deficiency is still present in Europe, using standardized data from a large number of studies. Adults and pregnant women, particularly, are at risk for iodine deficiency, which calls for action. For instance, a more uniform European legislation on iodine fortification is warranted to ensure that noniodized salt is replaced by iodized salt more often. In addition, further efforts should be put on harmonizing iodine-related studies and iodine measurements to improve the validity and comparability of results.
KW - epidemiology
KW - iodine
KW - iodine supply
KW - method comparison
UR - http://www.scopus.com/inward/record.url?scp=85090899904&partnerID=8YFLogxK
U2 - 10.1089/thy.2019.0353
DO - 10.1089/thy.2019.0353
M3 - Article
C2 - 32460688
AN - SCOPUS:85090899904
SN - 1050-7256
VL - 30
SP - 1346
EP - 1354
JO - Thyroid
JF - Thyroid
IS - 9
ER -
