ESPE2022 Poster Category 2 Thyroid (22 abstracts)
Iodine: Double Edged Sword in Hypothyroidism
Humeyra Acikan 1 , Sebahattin Muhtaroglu 1 & Nihal Hatipoglu 2
1Erciyes University, Faculty of Medicine, Department of Biochemistry, Kayseri, Turkey; 2Erciyes University, Faculty of Medicine, Department of Pediatric Endocrinology, Kayseri, Turkey
Iodine is the most important element in thyroid function. Its deficiency and excess can cause hypothyroidism. Our location has been known as the iodine deficiency area for the last 20 years. In this study, we aimed to investigate thyroid dysfunction and assess its relationship with iodine levels in the neonatal period.
Method: One hundred and seventy newborns were included in the study. Infants were selected from patients referred to for neonatal heel blood screening in the last 2 years. At the beginning of the study, their weight, height, head circumference, thyroid function (TF), thyroglobulin (Tg) and urinary iodine excretion (UIL) were evaluated. According to their TF, the three groups were separated as congenital hypothyroid (CH), subclinical hypothyroid (SH) and euthyroid (E), and compared.
Results: Eighty-four patients (49.4 %) were male. The ratios of CH, SH and E were 34.7%, 16.7% and 47.1%, respectively. In terms of anthropometric parameters, there was no difference. As expected, TSH, free T3 and T4, Tg levels were significantly different in the CH groups than in the others. Surprisingly, UIE values were the highest in the CH group. Iodine levels according to diagnoses were given in Table 1. In the CH, SH and E groups, while the ratio of the iodine excess was 37.3%, 20% and 21%, iodine deficiency rate was 23.7%, 40% and 46.9%, respectively.
| Congenital hypothyroidism (n=59) | Subclinical hypothyroidism (n=31) | Euthyroidism (n=80) | ||
| Laboratory data | Median±SD (min-max) | Median±SD (min-max) | Median±SD (min-max) | p value |
| UIE (μg/l) | 160.0 ± 240.3 a (10-1160) |
110.0 ± 90.8 b (10-390) |
100.0 ± 140.5 b (10-760) |
0.004* |
| TSH (µIU/mL) | 55.8 ± 33.9 a (9.55-100) |
12.9 ± 2.9 b (10.0-20.6) |
5.2.0 ± 2.2 b (1.2-9.4) |
0.001* |
| fT3 (Pg/ml | 4.0 ± 1.1 a (1.0-6.7) |
4.7 ± 1.3 b (3.4- 8.5) |
4.6 ± 0.6 b (3.2-6.4) |
0.001** |
| fT4 (ng/dL) | 0.8 ± 0.4 a (0.1- 1.7) |
1.3 ± 0.2 b (2.0-1.0) |
1.4 ± 0.2 b (0.9-2.1) |
0.001** |
| Tg (ng/mL) | 300.0 ± 302.8 a (0.3-2118.0) |
145.0 ± 107.4 b (39.4- 500.0) |
85.5 ± 103.0 b (2.2-539.0) |
0.001* |
| *Kruskall–Wallis test. ** One-way ANOVA test. | ||||
Conclusion: Although iodine deficiency is still seen as a problem in our region, iodine excess also causes congenital hypothyroidism at an increasing rate. Post hoc test results are indicated by character (ab). The same character indicates that there is no difference and different character indicate that there is a significant difference.
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