The Iodine Status of Women of Childbearing Age in an Iodine-repleted Area: An Epidemiological Study in Sengi Village on Merapi Mountain Area

Heri Nugroho, Tjokorda Gde Dalem Pemayun, Darmono Darmono, Banundari Rachmawati

Abstract


Background: The low iodine content of daily water sources and repeated volcanic eruptions are expected to affect the iodine status and thyroid hormone profile of women of childbearing age in the Magelang regency. This study aimed to determine the iodine and thyroid profile among women of childbearing age. Methods: We used a cross-sectional descriptive study to learn about 140 women of reproductive age living in Sengi village from October 2017 to January 2018. We assessed the iodine level, dietary intake, and goitrogenic food consumption using food frequency questionnaire (FFQ), urinary iodine concentration (UIC), thyroid stimulating hormone (TSH) and free thyroxine (fT4), and total goiter rate (TGR). Results: The median UIC was 199.5 (126.0 – 264.0)µg/L. The TGR was 10.7% on palpation and 7.8% on ultrasound. The proportion of UIC levels below 100µg/L was 18.5%. The mean water iodine content was 2.03 ± 4.74 μg/L. The mean salt iodine level was 28.6±13.7ppm. There were only 35% who consumed salt with adequate iodine contents, and only 19.29% consumed >150µg iodine from daily dietary intake based on FFQ. The median TSH and FT4 levels were 1.72 and 1.51mIU/L. Conclusion: Women of childbearing age in Sengi Village generally had adequate iodine profiles and normal thyroid hormone levels but a considerable proportion of TGR and low UIC. The iodine contents within the freshwater source, table salt, and daily dietary intake were low. There are no significant association between Iodine status, daily goitrogen intake, daily iodine intake and salt iodine concentration


Keywords


Endocrinology; Thyroid; Goiter; Iodine status; Women of childbearing age

References


World Health Organisation. VMNIS | Vitamin and Mineral Nutrition Information System Goitre as a determinant of the prevalence and severity of iodine deficiency disorders in populations Background. 2014;

Biban BG, Lichiardopol C. Iodine deficiency, still a global problem? Curr Health Sci J [Internet]. 2017 [cited 2023 Jan 20];43(2):103. Available from: /pmc/articles/PMC6284174/

Badan Penelitian dan Pengembangan Kesehatan Kementrian Kesehatan RI. Riset Kesehatan Dasar 2013 [Internet]. 2013 [cited 2023 Jan 20]. Available from: http://labdata.litbang.kemkes.go.id/images/download/laporan/RKD/2013/Laporan_riskesdas_2013_final.pdf

Eastman CJ, Zimmermann MB. The iodine deficiency disorders. 2018 Feb 6 [cited 2023 Jan 20]; Available from: https://www.ncbi.nlm.nih.gov/books/NBK285556/

Niwattisaiwong S, Burman KD, Li-Ng M. Iodine deficiency: Clinical implications. Cleve Clin J Med [Internet]. 2017 Mar 1 [cited 2023 Jan 20];84(3):236–44. Available from: https://www.ccjm.org/content/84/3/236

World Health Organization. Salt reduction and iodine fortification strategies in public health: report of a joint technical meeting convened by the World Health Organization and The George Institute for Global Health in collaboration with the International Council for the Control of Iodine Deficiency Disorders Global Network. 2014 [cited 2023 Jan 20]; Available from: www.who.int

Zimmermann MB, Andersson M. GLOBAL ENDOCRINOLOGY: Global perspectives in endocrinology: coverage of iodized salt programs and iodine status in 2020. Eur J Endocrinol [Internet]. 2021 Jul 1 [cited 2023 Jan 26];185(1):R13–21. Available from: https://academic.oup.com/ejendo/article/185/1/R13/6654349

Knowles JM, Garrett GS, Gorstein J, et al. Household coverage with adequately iodized salt varies greatly between countries and by residence type and socioeconomic status within countries: Results from 10 national coverage surveys. J Nutr [Internet]. 2017 May 1 [cited 2023 Jan 26];147(5):1004S-1014S. Available from: https://academic.oup.com/jn/article/147/5/1004S/4669673

Giulia S, Lea BF, Carol ZC, Lisa M, Harper SL, Elizabeth CJ. The effect of climatic factors on nutrients in foods: evidence from a systematic map. Environmental Research Letters [Internet]. 2020 Nov 26 [cited 2023 Jan 20];15(11):113002. Available from: https://iopscience.iop.org/article/10.1088/1748-9326/abafd4

Haap M, Roth HJ, Huber T, Dittmann H, Wahl R. Urinary iodine: comparison of a simple method for its determination in microplates with measurement by inductively-coupled plasma mass spectrometry. Sci Rep [Internet]. 2017 Jan 3 [cited 2023 Jan 20];7. Available from: /pmc/articles/PMC5206638/

Djokomoeljanto R. Gangguan akibat kekurangan yodium (GAKI) dan kelebihan yodium (EKSES). Semarang: Badan Penerbit Universitas Diponegoro; 2007. p. 377–424.

Azzeh F, Refaat B. Iodine adequacy in reproductive age and pregnant women living in the Western region of Saudi Arabia. BMC Pregnancy Childbirth [Internet]. 2020 Jun 22 [cited 2023 Jan 26];20(1):1–12. Available from: https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-020-03057-w

Burns K, Yap C, Mina A, Gunton JE. Iodine deficiency in women of childbearing age: not bread alone? Asia Pac J Clin Nutr [Internet]. 2018 Jul 1 [cited 2023 Jan 26];27(4):853–9. Available from: https://pubmed.ncbi.nlm.nih.gov/30045431/

Lucchetta RC, Rodriguez Gini AL, de Andrade Cavicchioli S, et al. Iodine deficiency in women of childbearing age in Brazil: systematic review and meta-analysis. Vitae [Internet]. 2021 May 18 [cited 2023 Jan 26];28(2). Available from: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0121-40042021000200006&lng=en&nrm=iso&tlng=en

Panth P, Guerin G, DiMarco NM. A review of iodine status of women of reproductive age in the USA. Biol Trace Elem Res [Internet]. 2019 Mar 15 [cited 2023 Jan 26];188(1):208–20. Available from: https://link.springer.com/article/10.1007/s12011-018-1606-5

Toloza FJK, Motahari H, Maraka S. Consequences of severe iodine deficiency in pregnancy: evidence in humans. Front Endocrinol (Lausanne). 2020;11:409.

Hussain H, Selamat R, Kuay LK, et al. Urinary iodine: biomarker for population iodine nutrition. Biochemical Testing - Clinical Correlation and Diagnosis [Internet]. 2019 Apr 17 [cited 2023 Jan 20]; Available from: https://www.intechopen.com/state.item.id

World Health Organization. Goitre as a determinant of the prevalence and severity of iodine deficiency disorders in populations [Internet]. 2014 [cited 2023 Jan 20]. Available from: https://apps.who.int/iris/handle/10665/133706

World Health Organization. Urinary iodine concentrations for determining iodine status in populations [Internet]. 2013 [cited 2023 Jan 20]. Available from: https://apps.who.int/iris/handle/10665/85972

Gorstein JL, Bagriansky J, Pearce EN, Kupka R, Zimmermann MB. Estimating the health and economic benefits of universal salt iodization programs to correct iodine deficiency disorders. Thyroid [Internet]. 2020 Dec 1 [cited 2023 Jan 26];30(12):1802. Available from: /pmc/articles/PMC7757618/

Næss S, Markhus MW, Strand TA, et al. Iodine nutrition and iodine supplement initiation in association with thyroid function in mildly-to-moderately iodine-deficient pregnant and postpartum women. J Nutr [Internet]. 2021 Oct 1 [cited 2023 Jan 26];151(10):3187–96. Available from: https://academic.oup.com/jn/article/151/10/3187/6320055

Kusrini I, Farebrother J, Mulyantoro DK. Adequately iodized salt is an important strategy to prevent iodine insufficiency in pregnant women living in Central Java, Indonesia. PLoS One [Internet]. 2020 Nov 1 [cited 2023 Jan 20];15(11):e0242575. Available from: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0242575

Nyirenda KK, Nyirenda KK. Toxicity potential of cyanogenic glycosides in edible plants. Med Toxicol [Internet]. 2020 Mar 20 [cited 2023 Jan 20]; Available from: https://www.intechopen.com/state.item.id

Zhong Y, Xu T, Wu X, et al. Dietary exposure and risk assessment of cyanide via cassava consumption in Chinese population. Food Chem. 2021;354:129405.

Hatch-McChesney A, Lieberman HR. Iodine and iodine deficiency: a comprehensive review of a re-emerging issue. Nutrients 2022;14:3474 [Internet]. 2022 Aug 24 [cited 2023 Jan 26];14(17):3474. Available from: https://www.mdpi.com/2072-6643/14/17/3474/htm


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