Document Detail


Low urinary iodine postpartum is associated with hypothyroid postpartum thyroid dysfunction and predicts long-term hypothyroidism.
MedLine Citation:
PMID:  21470286     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Background  Postpartum thyroid dysfunction (PPTD) is characterized by an early hyperthyroid phase followed, with peak prevalence at 6 months, by a hypothyroid phase which carries a risk of long-term hypothyroidism. Iodine has a major effect on thyroid function. Western Australia has previously been shown to be iodine replete. Objective  To examine the iodine status of women with and without PPTD and the relationship of iodine status postpartum with long-term hypothyroidism. Design  Case-control with follow-up. Patients  A total of 149 women at 6 months postpartum (74 PPTD, 75 controls) with 98 (46 PPTD, 52 controls) followed up at 12 years. Measurements  Urinary iodine concentration (UIC) and thyroid function at 6 months postpartum; thyroid function at 12-year follow-up. Results  At 6 months postpartum, median UIC (quartiles) for observed TSH ranges were: for TSH < 0·4 mU/l 130·0 μg/l (82·0, 170·0); for TSH 0·4-4·0 mU/l 123·0 μg/l (80·5, 168·0); for TSH > 4·0 mU/l 85·0 μg/l (40·0, 141·5), P = 0·018. The odds ratio (OR) of hypothyroid PPTD with each unit of decreasing log iodine was 2·54, (95%CI: 1·47, 4·35), and with UIC < 50 μg/l, OR 4·22, (95%CI: 1·54, 11·55). In the long term, decreased log UIC significantly predicted hypothyroidism at 12-year follow-up (P = 0·002); as did UIC < 100 μg/l (P = 0·03) and UIC < 50 μg/l (P = 0·02). The association was independent of antibody status. Conclusion  Low UIC measured at 6 months postpartum is associated with hypothyroid PPTD and independently predicts long-term hypothyroidism. We believe that it results from more severe preceding destructive thyroiditis, with discharge of thyroidal iodine, and thereby predicts a greater risk of long-term hypothyroidism.
Authors:
B G A Stuckey; G N Kent; J R Allen; L C Ward; S J Brown; J P Walsh
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical endocrinology     Volume:  74     ISSN:  1365-2265     ISO Abbreviation:  Clin. Endocrinol. (Oxf)     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-04-07     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0346653     Medline TA:  Clin Endocrinol (Oxf)     Country:  England    
Other Details:
Languages:  eng     Pagination:  631-5     Citation Subset:  IM    
Copyright Information:
© 2011 Blackwell Publishing Ltd.
Affiliation:
Keogh Institute for Medical Research Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital School of Medicine and Pharmacology, University of Western Australia Department of Clinical Biochemistry and Clinical Pharmacology and Toxicology, PathWest Laboratory Medicine, Nedlands, Western Australia, Australia.
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