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Konno
[Screening for thyroid dysfunction in adults residing in Hokkaido Japan: in relation to urinary iodide concentration and thyroid autoantibodies]Konno N, Iizuka N, Kawasaki K, Taguchi H, Miura K, Taguchi S, Murakami S, Hagiwara K, Noda Y, Ukawa S. Hokkaido Igaku Zasshi. 1994 May;69(3):614-26. Japanese. [abstract only]
"The prevalence of thyroid dysfunction and its relation to thyroid autoantibodies (TAA) and urinary iodide concentration (UI) was studied in apparently healthy adults in Sapporo (n = 4110) (Sapporo group), and in five coastal areas of Hokkaido (n = 1061) (coastal group) which produce iodine-rich seaweed (kelp). The frequency of above normal UI (high UI) in the morning urinary samples of coastal group was 10.8%, significantly higher than that of Sapporo group (6.4%) (p < 0.001). Frequency of positive TAA in both groups were similar. In Sapporo group TAA was positive in 6.4% of males and 13.8% of females with an age-related increase. The overall prevalence of hyperthyroidism (TSH < 0.15 mU/L) in coastal group (0.6%) was similar to that in Sapporo group (1.1%), while that of hypothyroidism (TSH > 5.0 mU/L) in coastal group (3.8%) was significantly higher than that in Sapporo group (1.3%) (P < 0.001). The frequency of high UI correlated significantly with that of hypothyroidism with negative TAA (r = 0.829, P < 0.05), but not with positive TAA, or with that of hyperthyroidism. Hypothyroidism was more prevalent in TAA negative subjects with high UI than with normal UI. Moreover, serum TSH and thyroglobulin levels were higher and free T4 level was lower in former than in latter group.
"These results indicate that 1) the prevalence of TAA negative hypothyroidism in iodine sufficient areas may be associated with the amount of iodine ingested, 2) this hypothyroidism is more prevalent and marked in subjects consuming further excess amounts of iodine, and 3) excessive intake of iodine should be considered an etiology of hypothyroidism in addition to chronic thyroiditis in these areas."
Association between dietary iodine intake and prevalence of subclinical hypothyroidism in the coastal regions of Japan.Konno N, Makita H, Yuri K, Iizuka N, Kawasaki K. J Clin Endocrinol Metab. 1994 Feb;78(2):393-7.
"The prevalence of thyroid dysfunction in relation to iodine intake was studied in adults (n = 1061) in five coastal areas of Japan that produce iodine-rich seaweed (kelp). The prevalence of hyperthyroidism (TSH < 0.15 mU/L) was similar in these areas, whereas that of hypothyroidism (TSH > 5.0 mU/L) varied from 0-9.7%. The relative frequency of above normal iodide concentration in the morning urine (> or = 75 mumol/L) [high urinary iodide (UI)] varied from 3.7%-30.3%. Together with previously reported results of a noncoastal city, the frequency of high UI correlated significantly with that of hypothyroidism with negative thyroid autoantibody (r = 0.829, n = 6, P < 0.05) but not with positive thyroid autoantibody (r = 0.278, NS) or with that of hyperthyroidism (r = 0.038, NS).
"Hypothyroidism was more prevalent in thyroid autoantibody-negative subjects with high UI (group II, 12.1%) than with normal UI (group I, 2.3%) (P < 0.001). The TSH [21.9(6.5-73.7)mU/L] (mean +/- SD) and thyroglobulin [288 (182-456) micrograms/L] levels in group II were significantly higher than the respective levels in group I [9.6(3.7-25.3)mU/L and 123 (38-399) micrograms/L] (P < 0.05). Free T4 of group II (9.9 +/- 3.9 pmol/L) was significantly lower than in group I (14.2 +/- 3.9 pmol/L) (P < 0.05).
"These results indicate that 1) the prevalence of hypothyroidism in iodine sufficient areas may be associated with the amount of iodine ingested; 2) hypothyroidism is more prevalent and marked in subjects consuming further excessive amounts of iodine; and 3) excessive intake of iodine should be considered an etiology of hypothyroidism in addition to chronic thyroiditis in these areas."
Screening for thyroid diseases in an iodine sufficient area with sensitive thyrotrophin assays, and serum thyroid autoantibody and urinary iodide determinations.Konno N, Yuri K, Taguchi H, Miura K, Taguchi S, Hagiwara K, Murakami S. Clin Endocrinol (Oxf). 1993 Mar;38(3):273-81. [abstract only]
"OBJECTIVE: The present study was designed to investigate the prevalence of thyroid dysfunction and its relation to thyroid autoantibodies and urine iodide concentration in apparently healthy people residing in Sapporo, a city of northern Japan, where the iodine intake is high.
DESIGN AND SUBJECTS: Serum TSH and thyroid autoantibodies, and urine iodide were measured in 4110 people (2931 men and 1179 women) (age 45.6 +/- 10.3 years (mean +/- SD)) who were recruited at the hospital for medical examinations. RESULTS: The thyroid autoantibodies were positive in 6.4% of males and 13.8% of females with an age-related increase. Of the people with positive antibodies, 87.2% had normal TSH values (0.15-5.0 mU/l) as measured by a sensitive assay. The prevalence of unsuspected hyperthyroidism as defined by suppressed TSH values was 0.61%, of which 64% was diagnosed as Graves' disease based on positive thyrotrophin receptor antibody results. The prevalence of unsuspected hypothyroidism, as evidenced by supranormal TSH, was 0.68% for males and 3.13% for females with an age-related increase. Of those with hypothyroidism, 45.5% were autoantibody positive. The overall prevalence of Hashimoto's thyroiditis was 13.11% for females and 6.15% for males. The urine iodide levels of hypothyroidism with a positive autoantibody of 38.5 (17.7-83.9) mumol/l and a negative autoantibody of 34.9 (17.9-67.9) mumol/l were both significantly higher than that of normal subjects (26.9 (14.6-49.6) mumol/l) (P < 0.01). When iodine intake was restricted for 6-8 weeks for hypothyroid subjects, the elevated TSH and thyroglobulin and low free T4 levels were reversed in the autoantibody negative but not in the positive group.
CONCLUSIONS: This study provides further information on the prevalence of thyroid dysfunction and autoimmune thyroid diseases in an iodine sufficient area. In addition, it suggests that more than half of the patients with unsuspected hypothyroidism were negative for autoantibodies and that the excessive iodine intake may be involved in causing latent hypothyroidism."
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