Skip to main content

Advertisement

Springer Nature Link
Log in

Impact of urinary iodine concentration on blood glucose levels and blood pressure: a nationwide population-based study

  • Original Contribution
  • Published:
European Journal of Nutrition Aims and scope Submit manuscript

Abstract

Purpose

Iodine is a vital trace element for systemic metabolic control as well as thyroid hormone synthesis. Though iodine has significant antioxidant and anti-inflammatory effects, reports on its effects on metabolic disorders are limited and inconsistent.

Methods

Impact of urinary iodine concentrations (UICs) on fasting blood glucose (FBG) levels and blood pressure (BP) in the general Korean population was evaluated adjusting for covariates including thyrotropin level and presence of thyroid diseases.

Results

The median UIC was 302.3 μg/L in all participants and was significantly lower in those with dysglycemia (303.6 μg/L in normal participants, 285.1 μg/L in participants with FBG levels of 100–125 mg/dL, and 261.8 μg/L in participants with FBG levels ≥ 126 mg/dL; p = 0.002). Similarly, the UIC was lower in participants with higher BP (311.6 μg/L in normal participants, 288.7 μg/L in prehypertensive participants, and 265.8 μg/L in hypertensive participants; p < 0.001). The multiple linear regression model showed a negative correlation between the UIC and FBG levels (p = 0.002), and the UIC and systolic BP (p < 0.001). One standard deviation increase in the UIC showed odds ratios of 0.84 (95% confidence interval [CI] = 0.73–0.98) for elevated FBG levels (≥ 100 mg/dL) and 0.94 (95% CI = 0.88–0.99) for elevated SBP (≥ 120 mm Hg) after full adjustment.

Conclusion

Higher UICs were associated with lower FBG and BP levels, independent of thyroid function and other confounding factors in Korea, an iodine-replete country.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+
from $39.99 /Month
  • Starting from 10 chapters or articles per month
  • Access and download chapters and articles from more than 300k books and 2,500 journals
  • Cancel anytime
View plans

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Explore related subjects

Discover the latest articles, books and news in related subjects, suggested using machine learning.

Availability of data and materials

The KNHANES database used for this study is publicly available at http://knhanes.cdc.go.kr/knhanes/eng.

Code availability

Not applicable.

References

  1. Braverman LE (1994) Iodine and the thyroid: 33 years of study. Thyroid 4:351–356. https://doi.org/10.1089/thy.1994.4.351

    Article  CAS  PubMed  Google Scholar 

  2. Clark OH (1990) Excess iodine intake and thyroid function and growth. Thyroid 1:69–72. https://doi.org/10.1089/thy.1990.1.69

    Article  CAS  PubMed  Google Scholar 

  3. World Health Organization. Nutrition U, Micronutrient Deficiency Information System P (1993) Global prevalence of iodine deficiency disorders. In: World Health Organization, Geneva

  4. World Health O (2004) Iodine status worldwide: WHO Global Database on Iodine Deficiency/editors: Bruno de Benoist ... [et al.]. In. World Health Organization, Geneva

  5. Zimmermann MB, Andersson M (2012) Update on iodine status worldwide. Curr Opin Endocrinol Diabetes Obes 19:382–387. https://doi.org/10.1097/MED.0b013e328357271a

    Article  CAS  PubMed  Google Scholar 

  6. Jeon MJ, Kim WG, Kwon H, Kim M, Park S, Oh HS, Han M, Kim TY, Shong YK, Kim WB (2017) Excessive iodine intake and thyrotropin reference interval: data from the Korean National Health and Nutrition Examination Survey. Thyroid 27:967–972. https://doi.org/10.1089/thy.2017.0078

    Article  CAS  PubMed  Google Scholar 

  7. Kwon H, Kim WG, Jeon MJ, Han M, Kim M, Park S, Kim TY, Shong YK, Kim WB (2017) Age-specific reference interval of serum TSH levels is high in adolescence in an iodine excess area: Korea national health and nutrition examination survey data. Endocrine 57:445–454. https://doi.org/10.1007/s12020-017-1375-5

    Article  CAS  PubMed  Google Scholar 

  8. Aakre I, Strand TA, Moubarek K, Barikmo I, Henjum S (2017) Associations between thyroid dysfunction and developmental status in children with excessive iodine status. PLoS ONE 12:e0187241. https://doi.org/10.1371/journal.pone.0187241

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Kang MJ, Hwang IT, Chung HR (2018) Excessive iodine intake and subclinical hypothyroidism in children and adolescents aged 6–19 years: results of the Sixth Korean National Health and Nutrition Examination Survey, 2013–2015. Thyroid 28:773–779. https://doi.org/10.1089/thy.2017.0507

    Article  CAS  PubMed  Google Scholar 

  10. Teng X, Shan Z, Chen Y, Lai Y, Yu J, Shan L, Bai X, Li Y, Li N, Li Z, Wang S, Xing Q, Xue H, Zhu L, Hou X, Fan C, Teng W (2011) More than adequate iodine intake may increase subclinical hypothyroidism and autoimmune thyroiditis: a cross-sectional study based on two Chinese communities with different iodine intake levels. Eur J Endocrinol 164:943–950. https://doi.org/10.1530/eje-10-1041

    Article  CAS  PubMed  Google Scholar 

  11. Chen W, Zhang Y, Hao Y, Wang W, Tan L, Bian J, Pearce EN, Zimmermann MB, Shen J, Zhang W (2018) Adverse effects on thyroid of Chinese children exposed to long-term iodine excess: optimal and safe Tolerable Upper Intake Levels of iodine for 7- to 14-y-old children. Am J Clin Nutr 107:780–788. https://doi.org/10.1093/ajcn/nqy011

    Article  PubMed  Google Scholar 

  12. Aceves C, Anguiano B, Delgado G (2013) The extrathyronine actions of iodine as antioxidant, apoptotic, and differentiation factor in various tissues. Thyroid 23:938–946. https://doi.org/10.1089/thy.2012.0579

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Sebastiano V (2011) Evolutionary significance of iodine. Curr Chem Biol 5:155–162. https://doi.org/10.2174/2212796811105030155

    Article  Google Scholar 

  14. Beukelman CJ, van den Berg AJ, Hoekstra MJ, Uhl R, Reimer K, Mueller S (2008) Anti-inflammatory properties of a liposomal hydrogel with povidone-iodine (Repithel) for wound healing in vitro. Burns 34:845–855. https://doi.org/10.1016/j.burns.2007.11.014

    Article  CAS  PubMed  Google Scholar 

  15. Liu J, Liu L, Jia Q, Zhang X, Jin X, Shen H (2019) Effects of excessive iodine intake on blood glucose, blood pressure, and blood lipids in adults. Biol Trace Elem Res 192:136–144. https://doi.org/10.1007/s12011-019-01668-9

    Article  CAS  PubMed  Google Scholar 

  16. Mancini FR, Rajaobelina K, Dow C, Habbal T, Affret A, Balkau B, Bonnet F, Boutron-Ruault MC, Fagherazzi G (2019) High iodine dietary intake is associated with type 2 diabetes among women of the E3N-EPIC cohort study. Clin Nutr 38:1651–1656. https://doi.org/10.1016/j.clnu.2018.08.015

    Article  CAS  PubMed  Google Scholar 

  17. Lee KW, Shin D, Song WO (2016) Low urinary iodine concentrations associated with dyslipidemia in US adults. Nutrients 8:171. https://doi.org/10.3390/nu8030171

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Wang D, Wan S, Liu P, Meng F, Zhang X, Ren B, Qu M, Wu H, Shen H, Liu L (2021) Relationship between excess iodine, thyroid function, blood pressure, and blood glucose level in adults, pregnant women, and lactating women: a cross-sectional study. Ecotoxicol Environ Saf 208:111706. https://doi.org/10.1016/j.ecoenv.2020.111706

    Article  CAS  PubMed  Google Scholar 

  19. Kim HK, Lee SY, Lee JI, Jang HW, Kim SK, Chung HS, Tan AH, Hur KY, Kim JH, Chung JH, Kim SW (2010) Usefulness of iodine/creatinine ratio from spot-urine samples to evaluate the effectiveness of low-iodine diet preparation for radioiodine therapy. Clin Endocrinol (Oxf) 73:114–118. https://doi.org/10.1111/j.1365-2265.2009.03774.x

    Article  CAS  Google Scholar 

  20. Ahn J, Lee JH, Lee J, Baek JY, Song E, Oh HS, Kim M, Park S, Jeon MJ, Kim TY, Kim WB, Shong YK, Kim WG (2020) Association between urinary sodium levels and iodine status in Korea. Korean J Intern Med 35:392–399. https://doi.org/10.3904/kjim.2017.375

    Article  CAS  PubMed  Google Scholar 

  21. Kim HI, Oh HK, Park SY, Jang HW, Shin MH, Kim SW, Kim TH, Chung JH (2019) Urinary iodine concentration and thyroid hormones: Korea National Health and Nutrition Examination Survey 2013–2015. Eur J Nutr 58:233–240. https://doi.org/10.1007/s00394-017-1587-8

    Article  CAS  PubMed  Google Scholar 

  22. Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF 3rd, Feldman HI, Kusek JW, Eggers P, Van Lente F, Greene T, Coresh J (2009) A new equation to estimate glomerular filtration rate. Ann Intern Med 150:604–612. https://doi.org/10.7326/0003-4819-150-9-200905050-00006

    Article  PubMed  PubMed Central  Google Scholar 

  23. Kweon S, Kim Y, Jang MJ, Kim Y, Kim K, Choi S, Chun C, Khang YH, Oh K (2014) Data resource profile: the Korea National Health and Nutrition Examination Survey (KNHANES). Int J Epidemiol 43:69–77. https://doi.org/10.1093/ije/dyt228

    Article  PubMed  PubMed Central  Google Scholar 

  24. Ahad F, Ganie SA (2010) Iodine, Iodine metabolism and Iodine deficiency disorders revisited. Indian J Endocrinol Metab 14:13–17

    PubMed  PubMed Central  Google Scholar 

  25. Zimmermann MB (2009) Iodine deficiency. Endocr Rev 30:376–408. https://doi.org/10.1210/er.2009-0011

    Article  CAS  PubMed  Google Scholar 

  26. World Health O (2007) Assessment of iodine deficiency disorders and monitoring their elimination: a guide for programme managers. In: 3rd ed edn. World Health Organization, Geneva

  27. Al-Attas OS, Al-Daghri NM, Alkharfy KM, Alokail MS, Al-Johani NJ, Abd-Alrahman SH, Yakout SM, Draz HM, Sabico S (2012) Urinary iodine is associated with insulin resistance in subjects with diabetes mellitus type 2. Exp Clin Endocrinol Diabetes 120:618–622. https://doi.org/10.1055/s-0032-1323816

    Article  CAS  PubMed  Google Scholar 

  28. Cuellar-Rufino S, Navarro-Meza M, García-Solís P, Xochihua-Rosas I, Arroyo-Helguera O (2017) Iodine levels are associated with oxidative stress and antioxidant status in pregnant women with hypertensive disease. Nutr Hosp 34:661–666. https://doi.org/10.20960/nh.460

    Article  CAS  PubMed  Google Scholar 

  29. Wang C (2013) The relationship between Type 2 diabetes mellitus and related thyroid diseases. J Diabetes Res 2013:390534. https://doi.org/10.1155/2013/390534

    Article  PubMed  PubMed Central  Google Scholar 

  30. Hage M, Zantout MS, Azar ST (2011) Thyroid disorders and diabetes mellitus. J Thyroid Res 2011:439463. https://doi.org/10.4061/2011/439463

    Article  PubMed  PubMed Central  Google Scholar 

  31. Smyth PP (2003) Role of iodine in antioxidant defence in thyroid and breast disease. BioFactors 19:121–130. https://doi.org/10.1002/biof.5520190304

    Article  CAS  PubMed  Google Scholar 

  32. Pangestuti R, Kim SK (2011) Neuroprotective effects of marine algae. Mar Drugs 9:803–818. https://doi.org/10.3390/md9050803

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Solovyev N, Vanhaecke F, Michalke B (2019) Selenium and iodine in diabetes mellitus with a focus on the interplay and speciation of the elements. J Trace Elem Med Biol 56:69–80. https://doi.org/10.1016/j.jtemb.2019.07.005

    Article  CAS  PubMed  Google Scholar 

  34. Jin C, Henao-Mejia J, Flavell RA (2013) Innate immune receptors: key regulators of metabolic disease progression. Cell Metab 17:873–882. https://doi.org/10.1016/j.cmet.2013.05.011

    Article  CAS  PubMed  Google Scholar 

  35. Furman D, Campisi J, Verdin E, Carrera-Bastos P, Targ S, Franceschi C, Ferrucci L, Gilroy DW, Fasano A, Miller GW, Miller AH, Mantovani A, Weyand CM, Barzilai N, Goronzy JJ, Rando TA, Effros RB, Lucia A, Kleinstreuer N, Slavich GM (2019) Chronic inflammation in the etiology of disease across the life span. Nat Med 25:1822–1832. https://doi.org/10.1038/s41591-019-0675-0

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Rodrigo R, González J, Paoletto F (2011) The role of oxidative stress in the pathophysiology of hypertension. Hypertens Res 34:431–440. https://doi.org/10.1038/hr.2010.264

    Article  CAS  PubMed  Google Scholar 

  37. Yang H, Jin X, Kei Lam CW, Yan SK (2011) Oxidative stress and diabetes mellitus. Clin Chem Lab Med 49:1773–1782. https://doi.org/10.1515/cclm.2011.250

    Article  CAS  PubMed  Google Scholar 

  38. Larsson-Nyren G, Sehlin J (2002) Anion-selective amplification of glucose-induced insulin secretion. Acta Diabetol 39:41–47. https://doi.org/10.1007/s005920200011

    Article  CAS  PubMed  Google Scholar 

  39. Nudda A, Battacone G, Bomboi G, Floris B, Decandia M, Pulina G (2013) Effect of dietary iodine on thyroid hormones and energy blood metabolites in lactating goats. Animal 7:60–65. https://doi.org/10.1017/S1751731112001073

    Article  CAS  PubMed  Google Scholar 

Download references

Funding

This work was supported by Korea University Guro Hospital (Korea Research-Driven Hospital) and grant funded by Korea University Medicine (K2115701).

Author information

Authors and Affiliations

  1. Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine and School of Medicine, Seoul, 08308, Korea

    Eyun Song, Min Jeong Park, Jung A Kim, Eun Roh, Ji Hee Yu, Nam Hoon Kim, Hye Jin Yoo, Ji A Seo, Sin Gon Kim, Nan Hee Kim, Sei Hyun Baik & Kyung Mook Choi

Authors
  1. Eyun Song
    View author publications

    Search author on:PubMed Google Scholar

  2. Min Jeong Park
    View author publications

    Search author on:PubMed Google Scholar

  3. Jung A Kim
    View author publications

    Search author on:PubMed Google Scholar

  4. Eun Roh
    View author publications

    Search author on:PubMed Google Scholar

  5. Ji Hee Yu
    View author publications

    Search author on:PubMed Google Scholar

  6. Nam Hoon Kim
    View author publications

    Search author on:PubMed Google Scholar

  7. Hye Jin Yoo
    View author publications

    Search author on:PubMed Google Scholar

  8. Ji A Seo
    View author publications

    Search author on:PubMed Google Scholar

  9. Sin Gon Kim
    View author publications

    Search author on:PubMed Google Scholar

  10. Nan Hee Kim
    View author publications

    Search author on:PubMed Google Scholar

  11. Sei Hyun Baik
    View author publications

    Search author on:PubMed Google Scholar

  12. Kyung Mook Choi
    View author publications

    Search author on:PubMed Google Scholar

Contributions

Conceptualization: ES, KMC. Data curation: ES, JAK, ER, HJY, SHB, KMC. Formal analysis: ES, MJP, JHY, NHK, KMC. Investigation: ES, JAK, ER, JHY, NHK, HJY, JAS, SGK, NHK, SHB, and KMC. Methodology: ES, KMC. Project administration: KMC. Resources: ES, MJP, JAK, ER, JHY, NHK, HJY, JAS, SGK, NHK, SHB, and KMC. Supervision: HJY, JAS, SGK, NHK, SHB, and KMC. Visualization: ES, JAK, ER, JHY, NHK. Writing—original draft: ES, KMC. Writing—review and editing: ES, MJP, JAK, ER, JHY, NHK, HJY, JAS, SGK, NHK, SHB, and KMC.

Corresponding author

Correspondence to Kyung Mook Choi.

Ethics declarations

Conflict of interest

The authors have nothing to disclose.

Ethics approval

The institutional review board of the Korea Centers for Disease Control and Prevention approved the protocol of the KNHANES (IRB approval number: 2013-07CON-03-4C, 2013-12EXP-03-5C, and 2015–01-02-6C).

Consent to participate

Informed consent was obtained from each participant.

Consent for publication

We, the undersigned, give our consent for the publication of identifiable details to be published in the European Journal of Nutrition.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 31 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Song, E., Park, M.J., Kim, J.A. et al. Impact of urinary iodine concentration on blood glucose levels and blood pressure: a nationwide population-based study. Eur J Nutr 61, 3227–3234 (2022). https://doi.org/10.1007/s00394-022-02888-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00394-022-02888-x

Keywords

Profiles

  1. Nam Hoon Kim View author profile