Neonatal thyrotropin (TSH) screening as a tool for monitoring iodine nutrition in Armenia.
Journal
European journal of clinical nutrition
ISSN: 1476-5640
Titre abrégé: Eur J Clin Nutr
Pays: England
ID NLM: 8804070
Informations de publication
Date de publication:
06 2019
06 2019
Historique:
received:
13
07
2018
accepted:
13
08
2018
revised:
12
08
2018
pubmed:
2
9
2018
medline:
12
8
2020
entrez:
2
9
2018
Statut:
ppublish
Résumé
Neonatal thyrotropin (TSH) is influenced not only by the infant's own thyroid function, but also by maternal thyroid status, and can thus provide a general index of thyroid health in the community. In 2012, the Republic of Armenia implemented a program of universal neonatal hypothyroidism screening by means of measuring the serum TSH level. The Arabkir Medical Center in Yerevan, Armenia, has maintained records of neonatal TSH screening data comprising nearly 100% of all births in Armenia from 2012 through 2016. We analyzed these data to determine the frequency of neonatal TSH levels higher than the cut point of 5 mIU/L, indicative of sufficient iodine nutrition status, and to detect any time dependence over years or regional variation. A total of 127,177 records from 2012 to 2016 were included. The geographic distribution of neonatal TSH records was reflective of the population of Armenia; the national percentage of records over 5 mIU/L ranged from a high of 2.88% in 2012 to a low of 1.71% in 2016. Minimal regional variation was noted, from a 2012-2016 cumulative high of 2.93% of records over 5 mIU/L in Shirak province to a low of 0.95% in the Vayots Dzor province. From all years and from all regions, values were consistently and uniformly below the cut point of 5 mIU/L. These results show no evidence of iodine deficiency in Armenia, and suggest that neonatal TSH may be a useful tool for monitoring iodine nutrition in Armenia.
Sections du résumé
BACKGROUND
Neonatal thyrotropin (TSH) is influenced not only by the infant's own thyroid function, but also by maternal thyroid status, and can thus provide a general index of thyroid health in the community.
METHODS
In 2012, the Republic of Armenia implemented a program of universal neonatal hypothyroidism screening by means of measuring the serum TSH level. The Arabkir Medical Center in Yerevan, Armenia, has maintained records of neonatal TSH screening data comprising nearly 100% of all births in Armenia from 2012 through 2016. We analyzed these data to determine the frequency of neonatal TSH levels higher than the cut point of 5 mIU/L, indicative of sufficient iodine nutrition status, and to detect any time dependence over years or regional variation.
RESULTS
A total of 127,177 records from 2012 to 2016 were included. The geographic distribution of neonatal TSH records was reflective of the population of Armenia; the national percentage of records over 5 mIU/L ranged from a high of 2.88% in 2012 to a low of 1.71% in 2016. Minimal regional variation was noted, from a 2012-2016 cumulative high of 2.93% of records over 5 mIU/L in Shirak province to a low of 0.95% in the Vayots Dzor province.
CONCLUSIONS
From all years and from all regions, values were consistently and uniformly below the cut point of 5 mIU/L. These results show no evidence of iodine deficiency in Armenia, and suggest that neonatal TSH may be a useful tool for monitoring iodine nutrition in Armenia.
Identifiants
pubmed: 30171226
doi: 10.1038/s41430-018-0298-4
pii: 10.1038/s41430-018-0298-4
doi:
Substances chimiques
Thyrotropin
9002-71-5
Iodine
9679TC07X4
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
905-909Références
Jameson J, Mandel SJ, Weetman AP. Disorders of the thyroid gland. In: Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J, editors. Harrison’s principles of internal medicine, 19e. New York, NY: McGraw-Hill; 2014.
Li M, Eastman CJ.Neonatal TSH screening: is it a sensitive and reliable tool for monitoring iodine status in populations?’ Best Pract Res Clin Endocrinol Metab. 2010;24:63–75.
doi: 10.1016/j.beem.2009.08.007
World Health Organization. Assessment of iodine deficiency disorders and monitoring their elimination: a guide for programme managers. 3rd ed. Geneva: World Health Organization; 2007.
Rose SR, Brown RS, Foley T, Kaplowitz PB, Kaye CI, Sundararajan S, et al. Update of newborn screening and therapy for congenital hypothyroidism. Pediatrics. 2006;117:2290–303.
doi: 10.1542/peds.2005-0582
Delange F, Dalhem A, Bourdoux P, Lagasse R, Glinoer D, Fisher DA, et al. Increased risk of primary hypothyroidism in preterm infants. J Pediatr. 1984;105:462–9.
doi: 10.1016/S0022-3476(84)80030-X
Lott JA, Sardovia-Iyer M, Speakman KS, Lee KK. Age-dependent cutoff values in screening newborns for hypothyroidism. Clin Biochem. 2004;37:791–7.
doi: 10.1016/j.clinbiochem.2004.05.019
Working Group on Neonatal Screening of the European Society for Paediatric Endocrinology. Revised guidelines for neonatal screening programmes for primary congenital hypothyroidism. Horm Res. 1999;52:49–52.
Theodoropoulos T, Braverman LE, Vagenakis AG. Iodide-induced hypothyroidism: a potential hazard during perinatal life. Science. 1979;205:502–3.
doi: 10.1126/science.451615
World Health Organization. WHO Indicators for assessing iodine deficiency disorders and their control through salt iodisation. Geneva: WHO; 1994. WHO/NUT/94.6
Burns R, Mayne PD, O’Herlihy C, Smith DF, Higgins M, Staines A, et al. Can neonatal TSH screening reflect trends in population iodine intake? Thyroid. 2008;18:883–8.
doi: 10.1089/thy.2008.0036
Ghazarian HG. On peculiarities of thyroid gland in inhabitants of three different areas of the Armenian SSR. J Exp Clin Med. 1979;2:115–22.
Karamian RK. On the state of the thyroid glands in inhabitants of Zangezour regions of the Armenian SSR. J Exp Clin Med. 1981;1:74–77.
Rossi L, Branca F. Salt iodisation and public health campaigns to eradicate iodine deficiency disorders in Armenia. Public Health Nutr. 2003;6:463–9.
doi: 10.1079/PHN2003461
Government of Armenia Decree # 353-N of 12 February 2004.
Ministry of Health. Report on results of national representative survey of iodine nutrition and implementation of Universal Salt Iodization Program in Armenia. Yerevan: Ministry of Health of the Republic of Armenia & UNICEF Representative Office in Armenia; 2005.
Hutchings N, Aghajanova E, Baghdasaryan S, Qefoyan M, Sullivan C, He X, al. Iodine nutrition in Armenia: a model of representative surveillance. [Abstract] In: 87th Annual Meeting of the American Thyroid Association; 17-22 Oct 2017; Victoria, Canada.
Hovespyan M, Tovmasyan I, Babloyan A. Laboratory organization of the newborn hypothyroid screening program. Yerevan: Arabkir Medical Complex – Child and Adolescent Health Institute; 2006. (Original in Armenian)
Zimmermann M. EUthyroid research protocol.. Zürich: Eidgenössische Technische Hochschule Zürich; 2013.
Vandevijvere S, Coucke W, Vanderpas J, Trumpff C, Fauvart M, Meulemans A. et al. Neonatal thyroid-stimulating hormone concentrations in Belgium: a useful indicator for detecting mild iodine deficiency?. PLoS ONE. 2012;7:e47770
doi: 10.1371/journal.pone.0047770
National Statistical Service, Republic of Armenia. Census 2011 – Initial results. NSS RA: Yerevan; 2012 (Original in Armenian)