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Correlation Between Drinking Water and Iodine Status: a Systematic Review and Meta-analysis

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Abstract

Iodine is a micronutrient essential for maintaining normal body functioning, and the consumption depends on the distribution in the environment, and insufficient or excessive intake results in thyroid dysfunction. The purpose of this review was to evaluate the correlation between iodine concentration in drinking water and the iodine status of the population. The systematic review was conducted following the PRISMA guidelines and was registered at the International Prospective Register of Ongoing Systematic Reviews (CRD42019128308). A literature search was conducted using MEDLINE/PUBMED (National Library of Medicine), LILACS (Latin-American and Caribbean Literature on Health Sciences), and Cochrane Library, June 2021. The quality of the studies was assessed by a checklist for cross-sectional studies developed by Joanna Briggs Institute. The initial search identified 121 articles, out of which ten were included in this systematic review, and five were included in the meta-analysis. Among the articles listed, six adopted cutoff points to classify the iodine content in the drinking water. The study identified median iodine concentration in drinking water from 2.2 to 617.8 μg/L and the correlation between iodine concentration in drinking water and urinary iodine concentration was 0.92, according to meta-analysis. Furthermore, the iodine status was correlated to the iodine content in water. The determination of a cutoff point can contribute to the implementation of iodine consumption control measures.

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References

  1. WHO. Assessment of the iodine deficiency disorders and monitoring their elimination. Geneva; 2007.

  2. Alexander EK, Pearce EN, Brent GA, Brown RS, Chen H, Dosiou C, et al. 2017 Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and the postpartum. THYROID. 2017 [cited 2018 Nov 30];27(3). Available from: https://www.liebertpub.com/doi/pdf/https://doi.org/10.1089/thy.2016.0457

  3. Dold S, Zimmermann MB, Jukic T, Kusic Z, Jia Q, Sang Z, et al. Universal salt iodization provides sufficient dietary iodine to achieve adequate iodine nutrition during the first 1000 days: a cross-sectional multicenter study. J Nutr. 2018;148(4):587–98. Available from: https://academic.oup.com/jn/article/148/4/587/4965927

  4. Global Fortification Data Exchange. Chart: Year when food fortification mandated.

  5. Teng X, Shan Z, Chen Y, Lai Y, Yu J, Shan L et al (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(6):943–950

    Article  CAS  Google Scholar 

  6. Leung AM, Braverman LE (2014) Consequences of excess iodine. Nat Rev Endocrinol 10(3):136–142

    Article  CAS  Google Scholar 

  7. Katagiri R, Yuan X, Kobayashi S, Sasaki S (2017) Effect of excess iodine intake on thyroid diseases in different populations: a systematic review and meta-analyses including observational studies. PLoS One 12(3):1–24

    Article  Google Scholar 

  8. Kim HJ, Kim NK, Park HK, Byun DW, Suh K, Yoo MH et al (2017) Strong association of relatively low and extremely excessive iodine intakes with thyroid cancer in an iodine-replete area. Eur J Nutr 56(3):965–971

    Article  CAS  Google Scholar 

  9. Duan L, Wang W, Sun Y, Zhang C. Iodine in groundwater of the Guanzhong Basin, China: sources and hydrogeochemical controls on its distribution. Environ Earth Sci. 2016;75(11).

  10. Shamseer L, Moher D, Clarke M, Ghersi D, Liberati A, Petticrew M et al (2012) Preferred reporting items for systematic review and meta-analysis protocols (prisma-p) 2015: Elaboration and explanation. BMJ 349(February 2012):1–25

    Google Scholar 

  11. Morgan RL, Whaley P, Thayer KA, Schünemann HJ. Identifying the PECO: a framework for formulating good questions to explore the association of environmental and other exposures with health outcomes. Environ Int. 2018 Dec;121:1027–31. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0160412018302046

  12. Moola S, Munn Z, Tufanaru C, Aromataris E, Sears K, Sfetcu R, Currie M, Qureshi R, Mattis P, Lisy K MP-F. Systematic reviews of etiology and risk. In: JBI Manual for Evidence Synthesis. JBI; 2020.

  13. Costa AB, Zoltowski APC, Koller SH, Teixeira MAP. Construção de uma escala para avaliar a qualidade metodológica de revisões sistemáticas. Cien Saude Colet. 2015 Aug;20(8):2441–52. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-81232015000802441&lng=pt&tlng=pt

  14. Mathias Harrer, Pim Cuijpers, Toshi A. Furukawa, David D. Ebert. Chapter 4 Pooling effect sizes | doing meta-analysis in R. Taylor & Francis eBooks; 2021 [cited 2021 Dec 7]. 1–500 p. Available from: https://bookdown.org/MathiasHarrer/Doing_Meta_Analysis_in_R/pooling-es.html#pooling-cor

  15. Balduzzi S, Rücker G, Schwarzer G (2019) How to perform a meta-analysis with R: a practical tutorial. Evid Based Ment Health 22(4):153–160

    Article  Google Scholar 

  16. Baujat B, Mahé C, Pignon J-P, Hill C. A graphical method for exploring heterogeneity in meta-analyses: application to a meta-analysis of 65 trials. Stat Med. 2002 Sep 30;21(18):2641–52. Available from: https://onlinelibrary.wiley.com/doi/https://doi.org/10.1002/sim.1221

  17. Chandra AK, Tripathy S, Ghosh D, Debnath A, Mukhopadhyay S (2005) Iodine nutritional status & prevalence of goitre in Sundarban delta of South 24-Parganas, West Bengal. Indian J Med Res 122(November):419–424

    CAS  Google Scholar 

  18. Wang Y, Cui Y, Chen C, Duan Y, Wu Y, Li W et al (2020) Stopping the supply of iodized salt alone is not enough to make iodine nutrition suitable for children in higher water iodine areas: a cross-sectional study in northern China. Ecotoxicol Environ Saf. 188(September):109930

    Article  CAS  Google Scholar 

  19. Lv S, Zhao Y, Li Y, Wang Y, Liu H, Li Y et al (2015) Impact of removing iodized salt on the iodine nutrition of children living in areas with variable iodine content in drinking water. Eur J Nutr 54(6):905–912

    Article  CAS  Google Scholar 

  20. Lv S, Chong Z, Du Y, Ma J, Rutherford S, Jia L et al (2012) An epidemiological survey of children’s iodine nutrition and goitre status in regions with mildly excessive iodine in drinking water in Hebei Province, China. Public Health Nutr 15(07):1168–1173

    Article  Google Scholar 

  21. Chandra AK, Tripathy S, Ghosh D, Debnath A, Mukhopadhyay S (2006) Goitre prevalence and the state of iodine nutrition in sundarban delta of north 24-parganas in West Benegal. Asia Pac J Clin Nutr 15(3):357–361

    CAS  Google Scholar 

  22. Lv S, Zhao J, Rutherford S, Du Y, Xu D, Wang Y et al (2013) Drinking water contributes to excessive iodine intake among children in Hebei, China. Eur J Clin Nutr 67(9):961–965

    Article  CAS  Google Scholar 

  23. Henjum S, Barikmo I, Strand TA, Oshaug A, Torheim LE (2012) Iodine-induced goitre and high prevalence of anaemia among Saharawi refugee women. Public Health Nutr 15(8):1512–1518

    Article  Google Scholar 

  24. Sang ZN, Wei W, Zhao N, Zhang GQ, Chen W, Liu H et al (2012) Thyroid dysfunction during late gestation is associated with excessive iodine intake in pregnant women. J Clin Endocrinol Metab 97(8):1363–1369

    Article  Google Scholar 

  25. Liu L, Wang D, Liu P, Meng F, Wen D, Jia Q et al (2015) The relationship between iodine nutrition and thyroid disease in lactating women with different iodine intakes. Br J Nutr 114(9):1487–1495

    Article  CAS  Google Scholar 

  26. Li WH, Dong B Sen, Li P, Li YF. Benefits and risks from the national strategy for improvement of iodine nutrition: a community-based epidemiologic survey in Chinese schoolchildren. Nutrition. 2012;28(11–12):1142–5. Available from: https://doi.org/10.1016/j.nut.2012.04.014

  27. WHO. Nutrients in Drinking Water. Geneva; 2005.

  28. China Ministry of Health. Classification of areas with high iodine in water and endemic areas of goiterNo Title. Beijing;

  29. Brucker-Davis F, Hiéronimus S, Fénichel P (2016) Thyroïde et environnement. Press Medicale 45(1):78–87

    Article  Google Scholar 

  30. WHO. Iodine in Drinking Waters. Geneva; 2003.

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Funding

We would like to thank the Coordination of Improvement of Higher Education Personnel—Brazil (CAPES)—Financing Code 001. National Council for Scientific and Technological Development (CNPq), case 408295/2017–1. Foundation of Support and Research of the State of Minas Gerais (FAPEMIG) case APQ-03336–18.

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Correspondence to Francilene Maria Azevedo.

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Azevedo, F.M., Machamba, A.A.L., Candido, A.C. et al. Correlation Between Drinking Water and Iodine Status: a Systematic Review and Meta-analysis. Biol Trace Elem Res 201, 129–138 (2023). https://doi.org/10.1007/s12011-022-03127-4

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  • DOI: https://doi.org/10.1007/s12011-022-03127-4

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