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Title: Standardized Map of Iodine Status in Europe
Authors: Ittermann, Till 
Albrecht, Diana 
Arohonka, Petra 
Bilek, Radovan 
De Castro, João Jácome 
Dahl, Lisbeth 
Filipsson Nyström, Helena 
Gaberšček, Simona 
García-Fuentes, Eduardo 
Gheorghiu, Monica Livia 
Hubalewska-Dydejczyk, Alicja B. 
Hunziker, Sandra 
Jukić, Tomislav 
Karanfilski, Borislav T. 
Koskinen, Seppo 
Kusić, Zvonko 
Majstorov, Venjamin 
Makris, Konstantinos C. 
Markou, Kostas Β. 
Meisinger, Christa 
Milevska Kostova, Neda 
Mullen, Karen R. 
Nagy, Endre V. 
Pĩrãgs, Valdis 
Rojo-Martinez, Gemma 
Samardzic, Mira 
Šaranac, Ljiljana 
Strele, Ieva 
Thamm, Michael 
Top, Işlk 
Trofimiuk-Müldner, Małgorzata 
Ünal, Belgin 
Koskinen, Seppo 
Vila, Lluís 
Vitti, Paolo 
Winter, Benjamin 
Woodside, Jayne V. 
Zaletel, Katja 
Zamrazil, Václav 
Zimmermann, Michaël Bruce 
Erlund, Iris 
Völzke, Henry 
Major Field of Science: Medical and Health Sciences
Field Category: Clinical Medicine
Keywords: Epidemiology;Iodine;Iodine supply;Method comparison
Issue Date: Sep-2020
Source: Thyroid, 2020, vol. 30, no. 9, pp. 1346-1354
Volume: 30
Issue: 9
Start page: 1346
End page: 1354
Journal: Thyroid 
Abstract: Knowledge about the population's iodine status is important, because it allows adjustment of iodine supply and prevention of iodine deficiency. The validity and comparability of iodine-related population studies can be improved by standardization, which was one of the goals of the EUthyroid project. The aim of this study was to establish the first standardized map of iodine status in Europe by using standardized urinary iodine concentration (UIC) data. Materials and Methods: We established a gold-standard laboratory in Helsinki measuring UIC by inductively coupled plasma mass spectrometry. A total of 40 studies from 23 European countries provided 75 urine samples covering the whole range of concentrations. Conversion formulas for UIC derived from the gold-standard values were established by linear regression models and were used to postharmonize the studies by standardizing the UIC data of the individual studies. Results: In comparison with the EUthyroid gold-standard, mean UIC measurements were higher in 11 laboratories and lower in 10 laboratories. The mean differences ranged from -36.6% to 49.5%. Of the 40 postharmonized studies providing data for the standardization, 16 were conducted in schoolchildren, 13 in adults, and 11 in pregnant women. Median standardized UIC was <100 μg/L in 1 out of 16 (6.3%) studies in schoolchildren, while in adults 7 out of 13 (53.8%) studies had a median standardized UIC <100 μg/L. Seven out of 11 (63.6%) studies in pregnant women revealed a median UIC <150 μg/L. Conclusions: We demonstrate that iodine deficiency is still present in Europe, using standardized data from a large number of studies. Adults and pregnant women, particularly, are at risk for iodine deficiency, which calls for action. For instance, a more uniform European legislation on iodine fortification is warranted to ensure that noniodized salt is replaced by iodized salt more often. In addition, further efforts should be put on harmonizing iodine-related studies and iodine measurements to improve the validity and comparability of results.
ISSN: 1557-9077
DOI: 10.1089/thy.2019.0353
Rights: © Mary Ann Liebert, Inc.
Type: Article
Affiliation : University Medicine Greifswald 
Leibniz Institute for Plasma Science and Technology 
Finnish Institute for Health and Welfare 
Institute of Endocrinology 
Hospital das Forças Armadas 
Institute of Marine Research 
University of Gothenburg 
Sahlgrenska University Hospital 
Ljubljana University Medical Centre 
Hospital Regional Universitario de Málaga 
Carol Davila University of Medicine and Pharmacy 
C.I. Parhon National Institute of Endocrinology 
Jagiellonian University Medical College 
ETH Zurich 
Sestre Milosrdnice University Hospital Centre 
Centre for Regional Policy Research and Cooperation "studiorum" 
SS Cyril and Methodius University 
Cyprus University of Technology 
University of Patras Medical School 
Ludwig Maximilians University 
German Research Center for Environmental Health 
Belfast Health and Social Care Trust 
University of Debrecen 
University of Niš 
Robert Koch Institute 
Dokuz Eylül University 
Hospital de Sant Joan Despi Moisès Broggi 
University of Pisa 
Queen’s University Belfast 
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