The Drinking Water Sanitation Standard (GB 5749-2022) has been officially promulgated and implemented, with the iodide listed as a new reference indicator for water quality. This study interprets the distribution of iodine in environmental media, the impact of water iodine on health, the significance of establishing iodide standard limits, and the use of iodide standard limits, in order to provide a scientific basis for the application of iodide standard limits in this revised standard.
Humans ; Water Quality ; Iodides/analysis* ; Drinking Water ; Iodine ; China ; Water Pollutants, Chemical/analysis*

Cross-Sectional Studies ; Dietary Supplements ; Female ; Humans ; Iodides ; Iodine ; Nutritional Status ; Pregnancy ; Pregnancy Complications ; Pregnant Women ; Thyroid Gland ; Thyrotropin

Objective: To investigate the effects of high iodine intake on thyroid function in pregnant and lactating women. Methods: A cross sectional epidemiological study was conducted among 130 pregnant women and 220 lactating women aged 19-40 years in areas with high environment iodine level (>300 μg/L) or proper environment iodine level (50-100 μg/L) in Shanxi in 2014. The general information, urine samples and blood samples of the women surveyed and water samples were collected. The water and urine iodine levels were detected with arsenic and cerium catalysis spectrophotometric method, the blood TSH level was detected with electrochemiluminescence immunoassay, and thyroid stimulating hormone (FT(4)), antithyroid peroxidase autoantibody (TPOAb) and anti-thyroglobulin antibodies (TGAb) were detected with chemiluminescence immunoassay. Results: The median urine iodine levels of the four groups were 221.9, 282.5, 814.1 and 818.6 μg/L, respectively. The median serum FT(4) of lactating women in high iodine area and proper iodine area were 12.96 and 13.22 pmol/L, and the median serum TSH was 2.45 and 2.17 mIU/L, respectively. The median serum FT(4) of pregnant women in high iodine area and proper iodine area were 14.66 and 16.16 pmol/L, and the median serum TSH was 2.13 and 1.82 mIU/L, respectively. The serum FT(4) levels were lower and the abnormal rates of serum TSH were higher in lactating women than in pregnant women in both high iodine area and proper iodine area, the difference was statistically significant (FT(4): Z=-6.677, -4.041, P<0.01; TSH: Z=8.797, 8.910, P<0.01). In high iodine area, the abnormal rate of serum FT(4) in lactating women was higher than that in pregnant women, the difference was statistically significant (Z=7.338, P=0.007). The serum FT(4) level of lactating women in high iodine area was lower than that in proper iodine area, the difference was statistically significant (Z=-4.687, P=0.000). In high iodine area, the median serum FT(4) in early pregnancy, mid-pregnancy and late pregnancy was 16.26, 14.22 and 14.80 pmol/L, respectively, and the median serum TSH was 1.74, 1.91 and 2.38 mIU/L, respectively. In high iodine area, the serum FT(4) level in early pregnancy was higher than that in mid-pregnancy and late pregnancy, and the serum TSH level was lower than that in mid-pregnancy and late pregnancy, the difference was statistically significant (FT(4): Z=-2.174, -2.238, P<0.05; TSH: Z=-2.985, -1.978, P<0.05). There were no significant differences in the positive rates of serum thyroid autoantibodies among the four groups of women and women in different periods of pregnancy (P>0.05). The morbidity rates of subclinical hyperthyroidism in pregnant women and lactating women in high iodine area were obviously higher than those in proper iodine areas, the difference was statistically significant (χ(2)=5.363, 5.007, P<0.05). Conclusions: Excessive iodine intake might increase the risk of subclinical hypothyroidism in pregnant women and lactating women. It is suggested to strengthen the iodine nutrition and thyroid function monitoring in women, pregnant women and lactating women in areas with high environmental iodine.
Adult ; China/epidemiology* ; Cross-Sectional Studies ; Female ; Humans ; Hypothyroidism/epidemiology* ; Iodides/administration & dosage* ; Iodine/urine* ; Lactation ; Nutritional Status ; Pregnancy ; Prevalence ; Thyroid Diseases/epidemiology* ; Thyroid Function Tests ; Thyroid Gland/physiology* ; Young Adult

BACKGROUND: Increased oxidative stress has been suggested as one of the underlying mechanisms in iodide excess-induced thyroid disease. Metallothioneins (MTs) are regarded as scavengers of reactive oxygen species (ROS) in oxidative stress. Our aim is to investigate the effects of propylthiouracil (PTU), a thyroid peroxidase inhibitor, perchlorate (KClO4), a competitive inhibitor of iodide transport, and thyroid stimulating hormone (TSH) on mitochondrial superoxide production instigated by high concentrations of iodide in the thyroids of MT-I/II knockout (MT-I/II KO) mice. METHODS: Eight-week-old 129S7/SvEvBrd-Mt1(tm1Bri) Mt2(tm1Bri)/J (MT-I/II KO) mice and background-matched wild type (WT) mice were used. RESULTS: By using a mitochondrial superoxide indicator (MitoSOX Red), lactate dehydrogenase (LDH) release, and methyl thiazolyl tetrazolium (MTT) assay, we demonstrated that the decreased relative viability and increased LDH release and mitochondrial superoxide production induced by potassium iodide (100 µM) can be relieved by 300 µM PTU, 30 µM KClO4, or 10 U/L TSH in the thyroid cell suspensions of both MT-I/II KO and WT mice (P<0.05). Compared to the WT mice, a significant decrease in the relative viability along with a significant increase in LDH release and mitochondrial superoxide production were detected in MT-I/II KO mice(P<0.05). CONCLUSION: We concluded that PTU, KClO4, or TSH relieved the mitochondrial oxidative stress induced by high concentrations of iodide in the thyroids of both MT-I/II KO and WT mice. MT-I/II showed antioxidant effects against high concentrations of iodide-induced mitochondrial superoxide production in the thyroid.
Animals ; Antioxidants ; Iodide Peroxidase ; Iodides ; L-Lactate Dehydrogenase ; Metallothionein* ; Mice ; Mice, Knockout* ; Oxidative Stress ; Potassium Iodide ; Propylthiouracil* ; Reactive Oxygen Species ; Superoxides* ; Suspensions ; Thyroid Diseases ; Thyroid Gland* ; Thyrotropin*

This is a case of a 54-year-old male, diagnosed to have insular thyroid carcinoma. The histopathologic characteristic of this rare neoplasm arising from follicular epithelial cells has the potential to take up 1-131 As shown in his postoperative 1-131 imaging, there are iodine-avid lesions in the parietal bone, thyroidal beds, ribs and vertebrae. The presence of these lesions in a &agnostic radioactive iodine scan makes it possible to do radioactive iodine therapy. A follow-up diagnostic study with 1-131 shows interval resolution and regression of the metastatic lesions. Thus, radioactive iodine therapy has a role in the treatment of this rare and aggressive neoplasm.

Human ; Male ; Middle Aged ; Iodine ; Parietal Bone ; Thyroid Neoplasms ; Iodides ; Radionuclide Imaging ; Ribs ; Epithelial Cells

This is a case of a 54-year-old male, diagnosed to have insular thyroid carcinoma. The histopathologic characteristic of this rare neoplasm arising from follicular epithelial cells has the potential to take up 1-131 As shown in his postoperative 1-131 imaging, there are iodine-avid lesions in the parietal bone, thyroidal beds, ribs and vertebrae. The presence of these lesions in a &agnostic radioactive iodine scan makes it possible to do radioactive iodine therapy. A follow-up diagnostic study with 1-131 shows interval resolution and regression of the metastatic lesions. Thus, radioactive iodine therapy has a role in the treatment of this rare and aggressive neoplasm.

Human ; Male ; Middle Aged ; Iodine ; Parietal Bone ; Thyroid Neoplasms ; Iodides ; Radionuclide Imaging ; Ribs ; Epithelial Cells

OBJECTIVETo understand the distribution of esophageal squamous cell cancer and precursor lesions in high-risk areas of China, and to provide evidence for determining the reference ranges of detection rates in high-risk areas.

METHODSEndoscopy with Lugol's iodine staining was performed on 15 709 local residents aged 40 to 69 years old in Linzhou of Henan province and Feicheng of Shandong province from 2005-2009. 35 cases without accurate pathology diagnosis and 11 cases with vital disease before screening were excluded. 15 663 subjects were enrolled in this study. Compliance was calculated by the percentage of the people who had endoscopic screening among the target population. Chi-square test and trend chi-square test were used to compare the distribution differences in age, gender and areas of esophageal squamous cell cancer and precancer. 95% CI of the detection rates was then employed to represent the reference ranges of esophageal squamous cell cancer and precursor lesions.

RESULTSThe compliance rate of screening endoscopy of this study was 49.36% (15 709/31 826) of all, and female's compliance (54.05%, 8 447/15 628) was much higher than that of male (44.83%, 7 262/16 198) (χ(2) = 88.14, P < 0.001). The detection rates of basal cell hyperplasia, low grade intraepithelial neoplasia, high grade intraepithelial neoplasia and esophageal squamous cell cancer of males were 4.17% (302/7 246), 17.22% (1 248/7 246), 1.67% (121/7 246), 0.83% (60/7 246), and were higher than that of females (3.45% (290/8 417), 14.82% (1 247/8 417), 1.41% (119/8 417), 0.48% (40/8 417), respectively). Except for high-grade intraepithelial neoplasia, the detection rates of male were higher than that of female (P values were 0.018, < 0.001, 0.960, 0.006). The detection rates of all grades of precursor lesions increased with age rising (all P values < 0.001), among which the detection rates of the mentioned four lesions for 40-44 years old were 2.69% (94/3 500), 8.11% (284/3 500), 0.40% (14/3 500), 0.14% (5/3 500), and that of 65-69 years old were 5.46% (46/843), 23.25% (196/843), 3.68% (31/843), 2.14% (18/843). The proportion of esophageal precursor lesion of Linzhou were higher than that of Feicheng observably except for esophageal squamous cell cancer (P values were < 0.001, < 0.001, < 0.001, 0.437). The detection rates of the four lesions of Linzhou and Feicheng were 4.90% (504/10 287), 17.37% (1 787/10 287), 1.79% (184/1 0287), 0.60% (62/10 287) and 1.64% (88/5 376), 13.17% (708/5 376), 1.04% (56/5 376), 0.71% (38/5 376). The 95% CI of detection rates of various lesions were, 3.78% (3.48%-4.08%) for basal cell hyperplasia, 15.93% (15.37%-16.50%) for low-grade intraepithelial neoplasia, 12.31% (11.79%-12.82%) for mild dysplasia and 3.62% (3.33%-3.91%) for moderate hyperplasia, 1.53% (1.34%-1.72%) for high-grade intraepithelial neoplasia and 0.64% (0.51%-0.76%) for esophageal squamous cell cancer, respectively.

CONCLUSIONUp to 21.88% residents that were asymptomatic were suffered from esophageal squamous cancer or precursor lesions in high-risk areas in China. The distribution of esophageal squamous cell cancer and precursor lesions was closely related to the gender and the age, which suggested that males were supposed to be paid more attention to.

Adult ; Age Distribution ; Aged ; Carcinoma, Squamous Cell ; epidemiology ; China ; epidemiology ; Endoscopy ; Esophageal Neoplasms ; epidemiology ; Female ; Humans ; Iodides ; Male ; Middle Aged ; Precancerous Conditions ; epidemiology ; Sex Distribution

OBJECTIVETo assess the clinical application value of iodine metabolism biomarkers in assessing iodine nutrition status in surgically treated patients with thyroid disease.

METHODSBlood,morning urine and 24-hour urine samples were collected in 31 healthy volunteers and in 30 surgically treated patients with thyroid disease before and after surgery. Iodine concentration was analyzed by inductively coupled plasma mass spectrometry. The iodine metabolism biomarkers including serum iodine (SI), morning urine iodine(UI), morning urine iodine/urine creatinine ratio (UI/UCr), 24-hour urine iodine (24 h UI), and 24-hour urine iodine excretion (24 h UIE) were evaluated in these two groups. In addition, the validation coincidence rate of iodine metabolism biomarkers in healthy volunteers to different reference ranges including World Health Organization, Mayo Clinic, and Quest Diagnostics were calculated.

RESULTSThe UI/UCr ratio of pre-operative thyroid disease patients was significantly lower than that of healthy volunteers (P<0.05), while the other biomarkers showed no significant differences (all P>0.05) between these two groups. The SI, UI ,and 24 h UI in postoperative thyroid disease patients were significantly higher than those of the pre-operative patients (all P<0.05). Though the medians of all biomarkers in healthy volunteers were within the reference ranges,only the validation coincidence rates of SI, UI, and UI/UCr in the 41-70-year populations were over than 90% according to Mayo Clinic; furthermore, the area under the receiver operating characteristic curve about UI/UCr ratio (0.737) was the biggest within the iodine metabolism biomarkers.

CONCLUSIONThe UI/UCr ratio may be used for iodine nutrition evaluation in surgically treated patients with thyroid disease.

Biomarkers ; Creatinine ; Humans ; Iodides ; Iodine ; Nutrition Assessment ; Nutritional Status ; Reference Values ; Thyroid Diseases

OBJECTIVETo investigate the value of quantitative iodine-based material decomposition images with gemstone spectral CT imaging in the follow-up of patients with hepatocellular carcinoma (HCC) after transcatheter arterial chemoebolization (TACE).

METHODSConsecutive 32 HCC patients with previous TACE treatment were included in this study. For the follow-up, arterial phase (AP) and venous phase (VP) dual-phase CT scans were performed with a single-source dual-energy CT scanner (Discovery CT 750HD, GE Healthcare). Iodine concentrations were derived from iodine-based material-decomposition images in the liver parenchyma, tumors and coagulation necrosis (CN) areas. The iodine concentration difference (ICD) between the arterial-phase (AP) and venal-phase (VP) were quantitatively evaluated in different tissues.The lesion-to-normal parenchyma iodine concentration ratio (LNR) was calculated. ROC analysis was performed for the qualitative evaluation, and the area under ROC (Az) was calculated to represent the diagnostic ability of ICD and LNR.

RESULTSIn all the 32 HCC patients, the region of interesting (ROI) for iodine concentrations included liver parenchyma (n=42), tumors (n=28) and coagulation necrosis (n=24). During the AP the iodine concentration of CNs (median value 0.088 µg/mm(3)) appeared significantly higher than that of the tumors (0.064 µg/mm(3), P=0.022) and liver parenchyma (0.048 µg/mm(3), P=0.005). But it showed no significant difference between liver parenchyma and tumors (P=0.454). During the VP the iodine concentration in hepatic parenchyma (median value 0.181 µg/mm(3)) was significantly higher than that in CNs (0.140 µg/mm(3), P=0.042). There was no significant difference between liver parenchyma and tumors, CNs and tumors (both P>0.05). The median value of ICD in CNs was 0.006 µg/mm(3), significantly lower than that of the HCC (0.201 µg/mm(3), P<0.001) and hepatic parenchyma (0.117 µg/mm(3), P<0.001). The ICDs in tumors and hepatic parenchyma showed no significant difference (P=0.829). During the AP, the LNR had no significant difference between CNs and tumors (a median value 1.805 vs. 1.310, P=0.389), and during the VP, the difference was also non-significant (the median value 0.647 vs. 0.713, P=0.660). The mean Az value of ICDs for evaluation of surviving tumor tissues was 0.804, whiles LNR measured a disappointing result in both AV images and VP images.

CONCLUSIONQuantitative iodine-based material decomposition images with gemstone spectral CT imaging can improve the diagnostic efficacy of CT imaging for HCC patients after TACE treatment.

Arteries ; Carcinoma, Hepatocellular ; diagnostic imaging ; therapy ; Embolization, Therapeutic ; Follow-Up Studies ; Humans ; Iodides ; Iodine ; Liver Neoplasms ; diagnostic imaging ; therapy ; ROC Curve ; Tomography, X-Ray Computed

Therapeutic plasma exchange (TPE) is one possible treatment for patients resistant to conventional antithyroid drugs or requiring urgent attention for thyrotoxicosis. We report a 35-yr-old man with thyrotoxicosis, ultimately attributed to Graves' disease in whom antithyroid drug used initially was soon discontinued, due to abnormal liver function, and replaced by Lugol's solution. Three weeks later, an escape phenomenon (to Lugol's solution) was apparent, so we performed TPE to control the thyrotoxicosis. Two courses of TPE by a centrifugal type machine resulted in diminished levels of thyroid hormone levels, which then rebounded after another two courses of membrane filtration type TPE. However, the patient could be treated with radioactive iodine therapy without any complications at present.
Adult ; Antithyroid Agents/adverse effects/therapeutic use ; Cetirizine/adverse effects/therapeutic use ; Graves Disease/*radiotherapy ; Hepatitis B, Chronic/complications ; Humans ; Iodides/therapeutic use ; Iodine Radioisotopes/*therapeutic use ; Male ; Methimazole/adverse effects/therapeutic use ; Plasmapheresis/*methods ; Thyroid Gland/*pathology ; Thyrotoxicosis/*therapy