Strong association of relatively low and extremely excessive iodine intakes with thyroid cancer in an iodine-replete area
- 551 Downloads
The relationship between iodine intake and development of thyroid diseases shows a U-shaped curve with an increase of risk in both deficient and excessive iodine intakes. Our aim was to investigate the relationship between iodine intake and thyroid cancer in patients with thyroid nodules in an iodine-replete area.
Retrospective analysis of 1170 patients with thyroid nodules was performed. Urinary iodine concentration (UIC) was measured by inductively-coupled plasma mass spectrometry. Predictive factors for thyroid cancer were evaluated using multivariate logistic regression models.
The median UIC in all patients with thyroid nodules was 360 μg/L (range from 4 to 9631 μg/L). More than half of the patients (650/1170, 56 %) belonged to the category of excessive iodine intake (UIC ≥ 300 μg/L) according to WHO iodine recommendations. Patients with thyroid cancer were more likely to be distributed in UIC < 300 μg/L and in UIC ≥ 2500 μg/L than those with benign thyroid nodules. Male gender (OR 1.528, p = 0.028) and UIC were independent predictors for thyroid cancer. The multivariate-adjusted OR (95 % CI) in the relatively low (UIC < 300 μg/L) and extremely excessive (UIC ≥ 2500 μg/L) iodine intake groups for thyroid cancer were 1.519 (1.099–2.098) and 1.874 (1.094–3.208), respectively, compared to the other iodine intake group (300–2499 μg/L).
Male gender and UIC were independent predictors of thyroid cancer in patients with thyroid nodules. This study suggests that relatively low and extremely excessive iodine intakes are associated with thyroid cancer in an iodine-replete area.
KeywordsIodine Thyroid nodules Thyroid cancer
This study was supported by the Research Grant Number CB-2011-03-02 of the Korean Foundation for Cancer Research and Soonchunhyang University Research Fund.
Compliance with ethical standards
Conflict of interest
The authors have nothing to disclose.
- 2.Oh EY, Jang HW, Lee JI, Kim HK, Kim SW, Chung JH (2010) Prevalence of thyroid nodules and cancer detected by ultrasonography in healthy Korean adults: clinical features and the risk for malignancy. J Korean Thyroid Assoc 3:142–148Google Scholar
- 12.Burgess JR, Dwyer T, McArdle K, Tucker P, Shugg D (2000) The changing incidence and spectrum of thyroid carcinoma in Tasmania (1978–1998) during a transition from iodine sufficiency to iodine deficiency. J Clin Endocrinol Metab 85:1513–1517Google Scholar
- 20.Cho YW, Kim YS, Baick SH, Oh DY, Kim WJ, Chang NS, Kang MW, Kim KS (1994) Analysis of daily intake and urinary excretion of iodine in normal control and patient with thyroid disease. J Korean Soc Endocrinol 9:307–317Google Scholar
- 21.Curado MP, Edwards B, Shin HR, Storm H, Ferlay J, Heanue M, Boyle P (2007) Cancer incidence in five continents. IARC Scientific Publications, LyonGoogle Scholar
- 22.WHO/UNICEF/ICCIDD (2007) Assessment of iodine deficiency disorders and monitoring their elimination, a guide for programme managers. World Health Organization Press, GenevaGoogle Scholar
- 25.Harach HR, Escalante DA, Onativia A, Lederer Outes J, Saravia Day E, Williams ED (1985) Thyroid carcinoma and thyroiditis in an endemic goitre region before and after iodine prophylaxis. Acta Endocrinol (Cph) 108:55–60Google Scholar