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Haddow
Urine Iodine Measurements, Creatinine Adjustment and Thyroid Deficiency in an Adult United States Population.Haddow JE, McClain MR, Palomaki GE, Hollowell JG. J Clin Endocrinol Metab. 2007 Jan 2; [Epub ahead of print]
"Purpose: To explore the relationships between urine iodine, creatinine, serum TSH and total T4 in a diverse population of United States adults with the aim of determining whether low urine iodine is associated with thyroid deficiency.
Methods: Using the NHANES III data set, we examined median TSH and total T4 values according to deciles of urine iodine (with and without creatinine correction). Stepwise regression analysis was used to further explore these relationships in the context of possible confounding variables. Exclusion criteria included age less than 21 years, pregnancy and the presence of thyroid antibodies.
Results: Among the 5,963 men and 5,722 women, median urine iodine concentrations do not vary with increasing age, while median creatinine levels decrease (p<0.001). Urine iodine and creatinine concentrations are lower among women (p<0.001). TSH increases with age (p<0.001), while total T4 decreases (p<0.001). Neither TSH nor total T4 median values are associated with urine iodine. If the urine iodine to creatinine ratio is used instead, an extensive re-distribution of study subjects occurs that results in an apparent positive relationship between this ratio and TSH measurements. A multivariate regression analysis that accounts for age, BMI, race, creatinine, iodine, estrogen use, smoking, and gender reveals only a weak association between levels of urine iodine and markers of thyroid function.
Conclusions: Our analyses indicate that the United States non-pregnant, adult population is iodine sufficient."
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