Urinary iodine concentration and its associations with iodized table salt and thyroid parameters during pregnancy in Algeria

Samira Oudahmane-Akdader, Lakabi Lynda, Assia Kamel, Michael B Zimmermann, Hanane Kherrab, Zohra Hamouli-Said, Djamila Meskine

Abstract

Iodine is a trace element whose adequate intakes are essential during pregnancy to promote the correct development of the fetus. Iodine excess or deficiency is the cause of several disorders associated with a rise risk of miscarriage or premature birth. The aim of our study was to assess the urinary iodine concentration (UIC) and thyroid function of pregnant women (PW) in northern Algeria. Healthy PW (n=174) were recruited from Gynecology-obstetrics service divided into three group. Spot urine and venous blood samples were collected to assess iodine status through the measurement of urinary iodine concentration, serum thyroid hormones and thyroid peroxidase antibodies concentrations. The relation between thyroid parameters and UIC was studied using correlation analysis. The median UIC values were 246.74 μg/L, 244.68 μg/L and 220,63 μg/L, in the first, second and third trimester respectively. Median TSH and FT4 concentrations were within reference ranges. Among PW, More than 70% of PW, were TPO Ab+. In northern Algeria, median UICs indicate iodine sufficiency. Monitoring of iodine fortification programs is vital to avoid both iodine deficiency and excess in Algeria.

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Muramatsu Y, Yoshida S, Fehn U, Amachi S and Ohmomo

Y. Studies with natural and anthropogenic iodine

isotopes: iodine distribution and cycling in the global

environment. J. Environ. Radioact 2004; (74):221

Zimmermann MB. The role of iodine in human growth and

development, Semin. Cell Dev. Biol 2011 ; (22) 645

Harding KB, Peña-Rosas JP, Webster AC, Yap CM, Payne

BA, Ota E and De-Regil LM. Iodine supplementation

for women during the preconception, pregnancy and

postpartum period. Cochrane Database SystRev 2017;

:CD011761.

Kouame P, Bellis G, Roux F, Delafosse JR and Chaventre A

. Choix des indicateurs et de la prophylaxie selon la

gravité des troubles dus à la carence iodée (TDCI) :

état de la question. Médecine d'Afrique Noire 1999 ;

(46)40-7.

Zimmermann MB.. Deficiency disorders and prevention

programs. In: Caballero B, Allen L, Prentice A,

editors. Encyclopedia of human nutrition, vol. 3.

Oxford, UK: Elsevier 2013; p 28–32

Zimmermann MB, Boelaer K . Iodine deficiency and thyroid

disorders. Lancet Diabetes Endocrinol 2015; (3)286

Chaouki ML, Maoui R and Benmiloud M. Comparative study

of neurological and mxyoedematouis cretinism

associated with severe iodine deficiency. Clin.

Endocrinol 1988 ; (28) 399–408.

Décret Exécutif N° 90-40 Du 30 Janvier 1990. Rendant

obligatoire la vente de sel iodé pour la prévention de

la carence en iode, JO N°05 du 31 janvier 1990 ; p.

WHO/UNICEF/ICCIDD. Assessment of Iodine Deficiency

Disorders and Monitoring Their Elimination. A Guide

for Programme Managers 2007 ; 3rd ed. pp. 1–97

Geneva, Switzerland.

Brakni L, Kemali Z and Ouldkablia S. Statut iodé au cours

du 1er trimestre de la grossesse. Ann Endocrinol

; (77) 397.

Amani MEA, Amani S and Chentli F. Statut iodé et

paramètres thyroïdiens chez des femmes en âge de

procréer. Ann Endocrinol 2016; (77)378.

Pino S, Fang SL and Braverman LE. Ammonium persulfate:

a safe alternative oxidizing reagent for measuring

urinary iodine. Clin. Chem 1998 ; (42) 239–243.

Arrêté du 21 novembre. Rendant obligatoire la méthode de

détermination de la teneur en iode dans le sel

alimentaire. JORADP n° 07 du 30-01-2013 2011; p.2.

Anaforoğlu İ, Algün E, İnceçayır Ö, Topbaş M and Erdoğan

MF. Iodine status among pregnant women after

mandatory salt iodisation. Br J Nutr 2016 ;

(3):405-10.

Rajput R, Yadav L, Nanda S and Yadav R. Trimester

specific nutritional status of iodine among euthyroid

pregnant women. J. Thyroid Disord. Ther 2017 ; (6)

–4.

Glinoer D. Pregnancy and Iodine. Thyroid 2001 ; 11(5),

–481.

Yarrington C, Pearce EN. Iodine and pregnancy. J Thyroid

Res 2011 ; 934104.

Glinoer D. The Regulation of Thyroid Function in

Pregnancy: Pathways of Endocrine Adaptation from

Physiology to Pathology. Endocr Rev 1997 ; 18

(3):404-433.

Zimmermann MB. Iodine deficiency in pregnancy and the

effects of maternal iodine supplementation on the

offspring: a review. Am J Clin Nutr 2009 ;

(2):668S–672S.

Brucker-Davis F, Panaïa-Ferrari P, Gal J, Fénichel P and

Hiéronimus S. Iodine supplementation throughout

pregnancy does not prevent the drop in FT4 in the

second and third trimesters in women with normal

initial thyroid function. Eur Thyroid J 2013 ;

(3):187-194.

Ren F, Zhou H, Chen M, Xiao X and Rui X. Comparative

analysis of thyroid function parameters in pregnant

women. Biomed Rep 2017 ; 7 (5) : 455-459.

Lazarus JH. Thyroid function in pregnancy. Br Med Bull.

97 (1):137-148.

Arturi F, Lacroix L, Presta I, Scarpelli D, Caillou B,

Schlumberger M, Russo D, Bidart JM and Filetti S.

Regulation by human chorionic gonadotropin of

sodium/iodide symporter gene expression in the JAr

human choriocarcinoma cell line. Endocrinology

; 143(6):2216–2220.

Moleti M, Trimarchi F and Vermiglio F. Thyroid Physiology

in Pregnancy. Endocr Pract 2014 ; 20(6): 589-596.

Delange F. Iodine deficiency as a cause of brain damage.

Postgrad Med J 2001 ; 77(906): 217-220.

Zimmermann MB, Andersson M. Assessment of iodine

nutrition in populations: Past, present, and future. Nutr

Rev 2012 ; 70(10):553-570.

Bath SC, Pop VJM, Furmidge-Owen VL, Broeren MAC and

Rayman MP. Thyroglobulin as a Functional

Biomarker of Iodine Status in a Cohort Study of

Pregnant Women in the United Kingdom. Thyroid

; 27(3):426-433.

Glinoer D, Riahi M, Grun JP and Kinthaert J. Risk of

subclinical hypothyroidism in pregnant women with

asymptomatic autoimmune thyroid disorders. J Clin

Endocrinol Metab 1994; 79(1):197-204.

Smyth PPA, Wijeyaratne CN, Kaluarachi WN, Smith DF,

Premawardhana LDKE, Parkes AB, Jayasinghe A, de

Silva DGH and Lazarus JHN. Sequential Studies on

Thyroid Antibodies during Pregnancy. Thyroid 2005;

(5): 474-477.

Bagchi N, Sundick RS, Hu LH, Cummings GD and Brown

TR. Distinct regions of thyroglobulin control the

proliferation and suppression of thyroid specific

lymphocytes in obese strain chickens. Endocrinology

; 37(8):3286-3290.

Li HS, Jiang HY and Carayanniotis G. Modifying effects of

iodine on the immunogenicity of thyroglobulin

peptides. J Autoimmun 2007 ; 28(4):171-176.

Fiore E, Latrofa F and Vitti P. Iodine, Thyroid

Autoimmunity and Cancer. Eur Thyroid J 2015 ;

(1):26-35.

Fernández MP, García RA, Galindo DEB, Moreno AH,

Ramos MA, Arias SG, Pomar MDB and Rodríguez

IMC. Influence of thyroid peroxidase antibodies on

TSH levels of pregnant women and maternal-fetal

complications. Endocrinol Diabetes Nutr 2018;

(8):444-450.

Stilwell G, Reynolds PJ, Parameswaran V, Blizzard L,

Greenaway TM and Burgess JR. The Influence of

Gestational Stage on Urinary Iodine Excretion in

Pregnancy. J Clin Endocrinol Metab 2008 ;

(5):1737-1742.

Leung AM, Pearce EN and Braverman LE. Iodine Nutrition

in Pregnancy and Lactation. Endocrinol Metab Clin

North Am 2011 ; 40(4): 765-777.

Leung AM. Thyroid function in pregnancy. J Trace Elem

Med Biol 2012 ; 26(0):137-140.

Glinoer D, Nayer PD, Bourdoux P, Lemone M, Robyn C,

Steirteghem AV and Lejeune B. Regulation of

Maternal Thyroid during Pregnancy. J Clin

Endocrinol Metab 1990 ; 71(2), 276-287.

Soldin OP, Tractenberg RE, Hollowell JG, Jonklaas J,

Janicic N and Soldin SJ. Trimester-Specific Changes

in Maternal Thyroid Hormone, Thyrotropin, and

Thyroglobulin Concentrations during Gestation:

Trends and Associations Across Trimesters in Iodine

Sufficiency. Thyroid 2004 ; 14(12):1084-1090.

Zhang X, Li C, Mao J, Wang W, Xie X, Peng S, Wang Z,

Han C, Zhang X, Wang D, Fan C, Shan Z and Teng

W. Gestation-specific changes in maternal

thyroglobulin during pregnancy and lactation in an

iodine-sufficient region in China: a longitudinal study.

Clin Endocrinol 2016 ; 86(2): 229-235.

Zimmermann MB, Aeberli I, Andersson M, Assey V, Yorg

JA, Jooste P, Jukić T, Kartono D, Kusić Z, Pretell E,

San Luis TO, Untoro J and Timmer A. Thyroglobulin

is a sensitive measure of both deficient and excess

iodine intakes in children and indicates no adverse

effects on thyroid function in the UIC range of 100

μg/L: a UNICEF/ICCIDD study group report. J

Clin Endocrinol Metab 2013; 98(3):1271-1280.

Laurberg P, Andersen S, Bjarnadóttir RI, Carlé A,

Hreidarsson AB, Knudsen N, Ovesen L, Pedersen IB

and Rasmussen LB. Evaluating iodine deficiency in

pregnant women and young infants-complex

physiology with a risk of misinterpretation. Public

Health Nutr 2007 ; 10(12A): 1547-1552.

Rochester DB, Davies TF. Increased Risk of Graves'Disease

After Pregnancy. Thyroid 2000; 15(11):1287-1290.

Borba VV, Zandman-Goddard G and Shoenfeld Y.

Exacerbations of autoimmune diseases during

pregnancy and postpartum. Best Pract Res Clin

Endocrinol Metab 2019 ; 33(6):101321.

Executive Decree N° 90-40 of 3 Rajab 1430 corresponding

to January 30 making the sale of iodized salt

mandatory for the prevention of iodine deficiency.

JORADP No 05 of 31 January 1990 ; p. 180.

Guerras I. Contrôle de la teneur en iode du sel alimentaire

commercialisé sur le marché Algérien. Master’s thesis

in Nutrition and Food Sciences, University of M.

Boudiaf, M’Sila 2019 ; 52p.

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