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What Iodine Intervention Measures Should Be Taken in Different Water Iodine Areas? Evidence from a Cross-sectional Chinese Survey

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Abstract

The aim of this study was to assess the population’s iodine nutrition and thyroid diseases in different water iodine areas and to offer suggestions to the governments of different countries to adjust the present policy in different water iodine areas. A cross-sectional survey was conducted in different water iodine areas in China. Urinary iodine, water iodine, salt iodine and thyroid function were determined. The thyroid volumes and nodules were measured by ultrasound. Upon categorization by water iodine level for the 10.0 ~ 39.9 μg/L, 40.0 ~ 100.0 μg/L and 100.1 ~ 150.0 μg/L areas, in adults, the prevalence of subclinical hypothyroidism was 9.28%, 5.35% and 11.07%, and the median urinary iodine (MUI) was 153.7 μg/L, 189.8 μg/L and 317.0 μg/L; in children of the three areas, the prevalence of goitre was 3.83%, 4.47% and 16.02%, and the MUI was 164.1 μg/L, 221.0 μg/L and 323.3 μg/L; in pregnant women of those areas, the MUI was 148.6 μg/L, 176.9 μg/L and 324.9 μg/L. Logistic regression results indicated that low iodine intake was a risk factor for developing hypothyroxinaemia in pregnant women. The iodine status of pregnant women is insufficient in areas with a median water iodine level of 10.0 ~ 39.9 μg/L. Low iodine intake increases the risk of developing hypothyroxinaemia in pregnant women. The iodine status of adults and children is excessive, and the iodine status of pregnant women is above the requirements in areas with a median water iodine concentration of 100.1 ~ 150.0 μg/L. Iodized salt, especially for pregnant women, should be supplied in areas with a median water iodine concentration of 10.0 ~ 39.9 μg/L to improve the iodine status of pregnant women. Supplying non-iodized salt is not enough to protect local residents from the harm from excess iodine in areas with a median water iodine concentration above 100.0 μg/L.

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Data Availability

The datasets generated during the current study are not publicly available due to privacy considerations but are available from the corresponding author on reasonable request.

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Acknowledgements

We thank all the organizations that participated in this survey: the provincial Centers for Disease Control (CDC) and the Centers for Endemic Disease Control in Shanxi, Anhui, Shandong, Hebei, Henan and Jiangsu and the residents who participated in this survey.

Funding

This study was supported by grants from the National Natural Science Foundation of China (81830098).

Author information

Author notes

  1. Yang Du and Peng Liu contributed equally to this work

Authors and Affiliations

  1. Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & National Health Commission (23618504), Key Lab of Microelement and Human Health, Harbin Medical University, Baojian Road 157, Harbin, 150081, China

    Yang Du, Peng Liu, Fangang Meng, Lijun Fan, Dianjun Sun & Hongmei Shen

  2. Institute for Endemic Disease Prevention and Treatment of Shanxi Province, Linfen, China

    Qingzhen Jia

  3. Center for Disease Control and Prevention of Anhui Province, Hefei, China

    Weidong Li

  4. Institute for Endemic Disease Prevention and Treatment of Shandong Province, Jinan, China

    Wen Jiang

  5. Center for Disease Control and Prevention of Hebei Province, Shijiazhuang, China

    Jing Ma

  6. Center for Disease Control and Prevention of Henan Province, Zhengzhou, China

    Heming Zheng

  7. Center for Disease Control and Prevention of Jiangsu Province, Nanjing, China

    Peihua Wang

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Contributions

Shen H. and Liu P. contributed to the study’s conception and design. Material preparation and data collection were performed by Meng F., Fan L., Jia Q., Li W., Jiang W., Ma J., Zheng H., Wang P. and Sun D. Data analysis and the first draft of the manuscript was written by Du Y. Previous versions of the manuscript were commented by Liu P. and Shen H.

Corresponding author

Correspondence to Hongmei Shen.

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Ethics Approval and Consent to Participate

Research approval was obtained from the Ethics Committee of Harbin Medical University. The study was performed in accordance with the Declaration of Helsinki. All participants consent to participate in this study.

Research Involving Human Participants and/or Animals

This study involved human participants.

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Written informed consent was obtained from the adult participants or the guardians on behalf of the participating children prior to the survey.

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The authors declare no competing interests.

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Du, Y., Liu, P., Meng, F. et al. What Iodine Intervention Measures Should Be Taken in Different Water Iodine Areas? Evidence from a Cross-sectional Chinese Survey. Biol Trace Elem Res 200, 4654–4663 (2022). https://doi.org/10.1007/s12011-021-03050-0

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