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Determination of Reference Intervals of Ratios of Concentrations of Urinary Iodine to Creatinine and Thyroid Hormone Concentrations in Pregnant Women Consuming Adequate Iodine in Harbin, Heilongjiang Province

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Abstract

The objectives of this study were to explore reference intervals of ratios of concentrations of urinary iodine to creatinine (UIC/UCr) in pregnant women, to determine specific reference intervals for thyroid hormone concentrations (FT3, FT4, TSH) in the first trimester of pregnancy, and provide a comprehensive evaluation of iodine nutritional status and thyroid function. Cross-sectional data analysis, including questionnaires and thyroid ultrasonograms, were used to exclude subjects who had a history of thyroid disease, a family history of thyroid disease, or thyroid morphological abnormalities. Tests of thyroid hormone were evaluated together with urinary iodine concentration (UIC), urinary creatinine concentration (UCr), and salt iodine concentration in pregnant women. For the sample of pregnant women eligible for inclusion, the 95% reference intervals of the bilateral limits of UIC/UCr and thyroid hormone concentrations in pregnant women were determined by the percentile method. Pregnant women were recruited in Harbin, Heilongjiang Province, a particular geographical area of China, where iodine nutrition is adequate. The median UIC was 141.47 μg/L, while the median UIC/UCr was 141.12 μg/g. The reference intervals of thyroid hormone concentrations in the first trimester were FT3 3.63–6.12 pmol/L, FT4 11.89–22.91 pmol/L, and TSH 0.013–3.814 mIU/L. The reference intervals of UIC/UCr were 52.47 to 532.09 μg/g (first trimester 47.25–353.91 μg/g, second trimester 57.95–639.08 μg/g, third trimester 46.98–494.73 μg/g).The established UIC/UCr medical reference intervals and thyroid hormone concentration reference intervals may be used for iodine nutritional assessment and thyroid disease screening in pregnant women.

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Acknowledgements

We are very grateful to Dr. Christopher Dacosta (University of Glasgow UK) for his help in polishing manuscript.

Funding

This study was funded by the National Natural Science Foundation of China (grant no. 81741049).

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Author notes

  1. Chunlei Ji and Ye Bu contributed equally to this work.

Authors and Affiliations

  1. Key Laboratory of Etiology and Epidemiology, National Health and Family Planning Commission, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150086, Heilongjiang, China

    Chunlei Ji, Chunyuan Tian, Lijun Fan, Shoujun Liu, Ying Liu & Dianjun Sun

  2. The Fourth Affiliated Hospital of Harbin Medical University, Harbin, 150001, Heilongjiang, China

    Ye Bu

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  1. Chunlei Ji
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Contributions

Chunlei Ji and Ye Bu conducted the research, completed the laboratory analysis, analyzed the data, and wrote the paper. Chunyuan Tian conducted the sample collection and data collection. Lijun Fan contributed to data collection and analysis. Ying Liu interpreted the results and edited the manuscript. Ying Liu, Shoujun Liu, and Dianjun Sun contributed to the conception and design of the study. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Ying Liu or Dianjun Sun.

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The authors declare that they have no conflicts of interest.

Ethical Approval

The research was conducted according to the Declaration of Helsinki. This survey accords with the requirements of medical ethics, and is approved by the Institutional Research Board of Harbin Medical University.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Ji, C., Bu, Y., Tian, C. et al. Determination of Reference Intervals of Ratios of Concentrations of Urinary Iodine to Creatinine and Thyroid Hormone Concentrations in Pregnant Women Consuming Adequate Iodine in Harbin, Heilongjiang Province. Biol Trace Elem Res 193, 36–43 (2020). https://doi.org/10.1007/s12011-019-01689-4

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