Socioeconomic status of the population – a prime determinant in evaluating iodine nutritional status even in a post salt iodization scenario
-
Udayan Bhattacharya
Abstract
Background
To compare the state of iodine nutrition among school age children (SAC) in high- (HSGs) and low-socioeconomic groups (LSGs) during a post iodation scenario in Kolkata.
Methods
Clinical examinations of the goiter, median urinary iodine (MUI), mean urinary thiocyanate (MUSCN) in SAC (6–12 years) from both sexes in the different socioeconomic groups were carried out and the iodine content of edible salt was measured.
Results
A total of 5315 SAC, of which 2875 SAC were from a HSG and another 2440 SAC from an LSG were clinically examined for goiter. In the HSGs the total goiter prevalence (TGP) was 3.2% and in the LSGs the TGP was 9.1% and the difference was statistically significant (p<0.001). The MUI of the HSGs was 242 μg/L as compared to 155 μg/L in the LSGs (p<0.001). MUSCN of the HSGs was 0.77±0.45 mg/dL while in the LSGs it was 0.94±0.44 mg/dL and the difference was statistically significant (p<0.01). In the HSGs 19.4% salt samples had 15–30 ppm iodine and 80.6% salt samples were above 30 ppm as compared to 26.3% salt samples which were below 15 ppm, 37.1% salt samples which were between 15 and 30 ppm and 36.6% salt samples which were above 30 ppm in the LSGs.
Conclusions
The population of the LSGs was clinically mildly iodine deficient having no biochemical iodine deficiency while in the HSGs it was more than the adequate requirement and the HSG children are possibly at risk of excess iodine induced thyroid diseases. Existing goiter prevalence in the LSGs was from their relatively high consumption of dietary goitrogens. Therefore, socioeconomic status plays a pivotal role in the management of iodine nutrition even in a post salt iodation scenario.
Acknowledgments
The authors duly acknowledge the students who participated in this study.
Author statements: The article is original in nature and based on the studies of school children in the age group 6–12 years from low- and high-socioeconomic groups in the Kolkata metropolitan city of India following the guidelines of WHO/UNICEF/Global Iodine Network.
Authors contribution: Dr. Udayan Bhattacharya wrote the first draft of the manuscript and conducted the whole research work under direct supervision of Prof. Amar K Chandra. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: This work was supported by University of Calcutta research grants BI (92) for Endocrinology and Reproductive Physiology Laboratory, Department of Physiology.
Employment or leadership: None declared.
Honorarium: None declared.
Conflict of interest: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
References
1. WHO/UNICEF/ICCIDD. Assessment of iodine deficiency disorders and monitoring their elimination: A guide for programme managers. Geneva, Switzerland: WHO Publication, 2007:1–97.Suche in Google Scholar
2. Bleichrodt N, Born MP. A metaanalysis of research on iodine and its relationship to cognitive development. In: Stanbury JB, editor. The damaged brain of iodine deficiency. New York, NY: Cognizant Communication Publication, 1994:195–200.Suche in Google Scholar
3. Delange F, Hetzel BS. The scientific basis for the elimination of brain damage due to iodine deficiency. In: Hetzel BS, Delange F, Dunn J, Ling J, Mannar V, Pandav C, editors. Towards the global elimination of brain damage due to iodine deficiency. New York, NY: Oxford University Press, 2004:151–194.Suche in Google Scholar
4. de Benoist B, McLean E, Andersson M, Rogers L. Iodine deficiency in 2007: global progress since 2003. Food Nutr Bull 2008;29:195–202.10.1177/156482650802900305Suche in Google Scholar
5. Pandav CS, Yadav K, Srivastava R, Pandav R, Karmarkar MG. Iodine deficiency disorders (IDD) control in India. Indian J Med Res 2013;138:418–33.Suche in Google Scholar
6. Kapil U, Pandey RM, Prakash S, Kabra M, Sareen N, et al. Assessment of iodine deficiency in school age children in Nainital District, Uttarakhand State. Asia Pac J Clin Nutr 2014;23:278–81.Suche in Google Scholar
7. Clugston GA, Dulberg EM, Pandav CS, Tilden RL. Iodine deficiency in South East Asia. In: Hetzel BS, Dunn JT, Stanbury JB, editors. The prevention and control of iodine deficiency disorder. Amsterdam, The Netherlands: Elsevier, 1987:273–08.Suche in Google Scholar
8. National Census Report. Area, population, decennial growth rate and density for 2001 and 2011 at a glance for West Bengal and the districts: provisional population totals paper 1 of West Bengal: Registrar General and Census Commissioner, 2011.Suche in Google Scholar
9. Aggarwal OP, Bhasin SK, Sharma AK, Chhabra P, Aggarwal K, et al. A new instrument (scale) for measuring the socio-economic status of a family: preliminary study. Ind J Comm Med 2005;30:111–4.Suche in Google Scholar
10. Chandra AK, Bhattacharjee A, Malik T, Ghosh S. Etiological factor for the persistence of endemic goitre in selected areas of Siddharthanagar district in eastern Uttar Pradesh, India. J Pediatr Endocrinol Metab 2009;22:317–5.10.1515/JPEM.2009.22.4.317Suche in Google Scholar
11. Dunn JT, Van dar Haar F. Detection of iodine deficiency. In: A practical guide to the correction of iodine deficiency – Technical Manual no. 3. Netherlands: ICCIDD/UNICEF/WHO Publication, 1990;1320.Suche in Google Scholar
12. Vought RL, London WT. Iodine intake, excretion and accumulation in healthy subjects. J Clin Endocrinol Metab 1967;22:913–9.10.1210/jcem-27-7-913Suche in Google Scholar
13. Karmarkar MG, Pandav CS, Krishnamachari KA. Principle and procedure for iodine estimation; a laboratory manual. New Delhi: Indian Council of Medical Research, 1986;102.Suche in Google Scholar
14. Gaitan E. Environmental goitrogens other than iodine deficiency. IDD Newsletter 1986;2:11–3.Suche in Google Scholar
15. Oginsky EL, Stein AE, Greer MA. Myrosinase activity in bacteria as demonstrated by the conversation of progoitrin to goitrin. Proc Soc Exp Biol Med 1965;119:360–4.10.3181/00379727-119-30181Suche in Google Scholar
16. Aldridge WN. The estimation of micro quantities of cyanide and thiocyanate. Analyst 1945;70:474–5.10.1039/an9457000474Suche in Google Scholar
17. Michajlovskij N, Langer P. Studienuber Benziehungenzwischen Rhodanbildung, kropfbildender Eigenschaftvon Nahrungsmitteln. J Physiol Chem 1958;312:26–30.10.1515/bchm2.1958.312.1.26Suche in Google Scholar
18. De Maeyer EM, Lowenstein PW, Thilly CH. Titration methods for salt iodine analysis. In: Sullivan KM, Houston R, Gorstein J, Cervinskas J, editors. Monitoring universal salt iodization programme. Netherlands: PAMM/MI/ICCIDD, 1995:86–96.Suche in Google Scholar
19. Cochran WC. Nonparametric tests. In: Sampling techniques. New York, NY: Wiley, 2015:274–89.Suche in Google Scholar
20. Dantas LM. Endemic goiter in Brazil. In: Dunn JT, editor. Towards the eradication of endemic goiter, cretinism and iodine deficiency. Washington, DC: Pan American Health Organization, 1986:271–5.Suche in Google Scholar
21. Desai MP. Disorders of thyroid gland in India. Indian J Pediatr 1997;64:11–20.10.1007/BF02795771Suche in Google Scholar
22. Marwaha RK, Tandon N, Gupta N, Karak AK, Verma K, et al. Residual goiter in the postiodization phase: iodine status, thiocyanate exposure and autoimmunity. Clin Endocrinol (Oxf) 2003;59:672–81.10.1046/j.1365-2265.2003.01895.xSuche in Google Scholar
23. Guyton AC, Hall JE. Thyroid metabolic hormones. In: Textbook of medical physiology. Philadelphia, PA: Elsevier, 2006: 931–43.Suche in Google Scholar
24. Zimmermann MB. Iodine deficiency. Endocr Rev 2009;30: 376–408.10.1007/978-3-319-72102-6_8Suche in Google Scholar
25. Gaitan E. Environmental goitrogens. In: Braverman LE, editor. Contemporary Endocrinology: diseases of the thyroid. Totowa, NJ: Humana Press Inc., 1989:331–48.Suche in Google Scholar
26. Erdoğan MF. Thiocyanate overload and thyroid disease. BioFactors 2003;19:107–11.10.1002/biof.5520190302Suche in Google Scholar
27. Erdoğan MF, Erdoğan G, Sav H, Güllü S, Kamel N. Endemic goiter, thiocyanate overload, and selenium status in school-age children. Biol Trace Elem Res 2001;79:121–30.10.1385/BTER:79:2:121Suche in Google Scholar
28. Chandra AK, Singh LH, Ghosh S, Pearce EN. Role of bamboo-shoot in the pathogenesis of endemic goiter in Manipur, North East India. Endocr Pract 2013;19:36–45.10.4158/EP12162.ORSuche in Google Scholar PubMed
29. Chandra AK, Singh LS, Tripathy S, Debnath A, Khanam J. Iodine nutritional status of children in North East India. Indian J Pediatr 2006;73:795–8.10.1007/BF02790388Suche in Google Scholar PubMed
30. Chandra AK, Singh LH, Debnath A, Tripathy S, Khanam J. Dietary supplies of iodine and thiocyanate in the etiology of endemic goitre in Imphal east district of Manipur, North East India. Indian J Med Res 2008;128:601–5.Suche in Google Scholar
31. Das CS, Isichei UP, Otokwula AA, Emokpae MA, Mohammed AZ. Neonatal chemical hypothyroidism in Nigeria. Annal Trop Paediatr 2004;24:237–40.10.1179/027249304225018975Suche in Google Scholar PubMed
32. Chandra AK, Tripathy S, Ghosh D, Debnath A, Mukhopadhyay S. Goitre prevalence and the state of iodine nutrition in Sundarban delta of North 24-Parganas in West Bengal. Asia Pac J Clin Nutr 2006;15:357–61.Suche in Google Scholar
33. Chandra AK, Mukhopadhyay S, Lahiri D, Tripathy S. Goitrogenic content of Indian cyanogenic plant foods & their in vitro anti-thyroidal activity. Indian J Med Res 2004;119:180–5.Suche in Google Scholar
34. Delange F, Thilly C, Bourdoux P, Hennart P, Courtois P, et al. Influence of dietary goitrogens during pregnancy in humans on thyroid function of the newborn. In: Delange F, Iteke FB, Ermans AM, editors. Nutritional factors involved in the goitrogenic action of cassava. Ottawa: International Development Research Centre Publication, 1982:40–50.Suche in Google Scholar
35. NIDDCP. Iodine deficiency disorders. In: Pandav CS, Yadav K, Moorthy D, Sankar R, Anand K, et al., editors. National Iodine Deficiency Disorder Control Programme. New Delhi: National Institute of Health and Family Welfare, 2010:1–100.Suche in Google Scholar
36. Tiwari BK, Kundu AK, Bansal RD. National Iodine Deficiency Disorder Control Programme in India. Indian J Pub Health 1995;39:148–51.Suche in Google Scholar
37. Sankar R, Pandav CS. Ban on sale of non-iodized salt for human consumption: a step in the right direction. Natl Med J India 2005;18:169–71.Suche in Google Scholar
38. National Family Health Survey. Health and living conditions in eight Indian cities. Mumbai, India: International Institute for Population Sciences, 2005:1–50.Suche in Google Scholar
39. Magri F, Zerbini F, Gaiti M, Capelli V, Croce L, et al. Poverty and immigration as a barrier to iodine intake and maternal adherence to iodine supplementation. J Endocrinol Invest 2018;8:938–5.10.1007/s40618-018-0938-5Suche in Google Scholar PubMed
©2019 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
- Frontmatter
- Mini Review
- Clinical, biochemical, and molecular spectrum of short/branched-chain acyl-CoA dehydrogenase deficiency: two new cases and review of literature
- Original Articles
- Assessment of biomarkers of inflammation and premature atherosclerosis in adolescents with type-1 diabetes mellitus
- Frequency, clinical characteristics, biochemical findings and outcomes of DKA at the onset of type-1 DM in young children and adolescents living in a developing country – an experience from a pediatric emergency department
- Hepatopathies in children and adolescents with type 1 diabetes
- Comparative evaluation of neuroendocrine dysfunction in children with craniopharyngiomas before and after mass effects are removed
- Functional and endocrine-metabolic oligomenorrhea: proposal of a new diagnostic assessment tool for differential diagnosis in adolescence
- Socioeconomic status of the population – a prime determinant in evaluating iodine nutritional status even in a post salt iodization scenario
- Long-term outcome of hyperthyroidism diagnosed in childhood and adolescence: a single-centre experience
- Thyroid function in patients with Prader-Willi syndrome: an Italian multicenter study of 339 patients
- Maternal factors associated with neonatal vitamin D deficiency
- IGF-1 assessed by pubertal status has the best positive predictive power for GH deficiency diagnosis in peripubertal children
- One-year treatment with gonadotropin-releasing hormone analogues does not affect body mass index, insulin sensitivity or lipid profile in girls with central precocious puberty
- Letter to the Editor
- Prediabetes in children and adolescents in the United States: prevalence estimates and comorbidities – a population analysis
- Case Reports
- Severe in utero under-virilization in a 46,XY patient with Silver-Russell syndrome with 11p15 loss of methylation
- Carney complex due to a novel pathogenic variant in the PRKAR1A gene – a case report
- Challenging diagnosis of thyroid hormone resistance initially as Hashimoto’s thyroiditis
Artikel in diesem Heft
- Frontmatter
- Mini Review
- Clinical, biochemical, and molecular spectrum of short/branched-chain acyl-CoA dehydrogenase deficiency: two new cases and review of literature
- Original Articles
- Assessment of biomarkers of inflammation and premature atherosclerosis in adolescents with type-1 diabetes mellitus
- Frequency, clinical characteristics, biochemical findings and outcomes of DKA at the onset of type-1 DM in young children and adolescents living in a developing country – an experience from a pediatric emergency department
- Hepatopathies in children and adolescents with type 1 diabetes
- Comparative evaluation of neuroendocrine dysfunction in children with craniopharyngiomas before and after mass effects are removed
- Functional and endocrine-metabolic oligomenorrhea: proposal of a new diagnostic assessment tool for differential diagnosis in adolescence
- Socioeconomic status of the population – a prime determinant in evaluating iodine nutritional status even in a post salt iodization scenario
- Long-term outcome of hyperthyroidism diagnosed in childhood and adolescence: a single-centre experience
- Thyroid function in patients with Prader-Willi syndrome: an Italian multicenter study of 339 patients
- Maternal factors associated with neonatal vitamin D deficiency
- IGF-1 assessed by pubertal status has the best positive predictive power for GH deficiency diagnosis in peripubertal children
- One-year treatment with gonadotropin-releasing hormone analogues does not affect body mass index, insulin sensitivity or lipid profile in girls with central precocious puberty
- Letter to the Editor
- Prediabetes in children and adolescents in the United States: prevalence estimates and comorbidities – a population analysis
- Case Reports
- Severe in utero under-virilization in a 46,XY patient with Silver-Russell syndrome with 11p15 loss of methylation
- Carney complex due to a novel pathogenic variant in the PRKAR1A gene – a case report
- Challenging diagnosis of thyroid hormone resistance initially as Hashimoto’s thyroiditis
