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Thyroglobulin as a functional biomarker of iodine status in a cohort study of pregnant women in the United Kingdom

Bath, SC, Pop, VJM, Furmidge-Owen, VL, Broeren, MAC and Rayman, MP (2016) Thyroglobulin as a functional biomarker of iodine status in a cohort study of pregnant women in the United Kingdom Thyroid.

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Background Though iodine deficiency in pregnancy is a matter of public-health concern, a functional measure of iodine status is lacking. The thyroid-specific protein, thyroglobulin (Tg), which reflects thyroid size, has shown promise as a functional measure in studies of children and adults, but data in pregnancy are sparse. In a cohort of mildly-to-moderately iodine-deficient pregnant women, we aimed to explore whether serum Tg is a sensitive functional biomarker of iodine status and to examine longitudinal change in Tg with gestational age. Method 230 pregnant women were recruited at an ante-natal clinic at 12 weeks of gestation to the Selenium in PRegnancy INTervention (SPRINT) study, in Oxford, UK. Repeated measures of urinary iodine-to-creatinine ratio, serum TSH and Tg at 12, 20, and 35 weeks of gestation were collected. Women were dichotomised by their iodine-to-creatinine ratio, (<150 or ≥150 μg/g) to group them broadly as iodine-deficient or iodine-sufficient. Women with thyroid antibodies were excluded; data and samples were available for 191 women. Results Median Tg concentration was 21, 19, and 23 μg/L in the first, second, and third trimesters, respectively. In a linear mixed model, controlling for confounders, Tg was higher in the <150 μg/g than in the ≥150 μg/g group (p<0.001) but there was no difference in TSH (p=0.27). Gestational week modified the effect of iodine status on TSH (p=0.01) and Tg (p=0.012); Tg did not increase with gestational week in the ≥150 μg/g group but did in the <150 μg/g group, and TSH increased more steeply in the <150 μg/g group. Conclusions Low iodine status (<150 μg/g) in pregnancy is associated with higher serum Tg, suggesting that the thyroid is hyper-stimulated by iodine deficiency, which causes it to enlarge. Tg is a more sensitive biomarker of iodine status in pregnancy than is TSH.

Item Type: Article
Subjects : Medical Science
Authors :
Bath, SC
Pop, VJM
Furmidge-Owen, VL
Broeren, MAC
Rayman, MP
Date : 18 November 2016
DOI : 10.1089/thy.2016.0322
Copyright Disclaimer : Copyright: Sarah C. Bath et al., 2016; Published by Mary Ann Liebert, Inc. This Open Access article is distributed under the terms of the Creative Commons License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.
Uncontrolled Keywords : Iodine, thyroglobulin, pregnancy, thyroid, nutrition
Depositing User : Symplectic Elements
Date Deposited : 25 Oct 2016 11:29
Last Modified : 21 Dec 2016 15:38

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