Risks of Iodine Excess.

IF 22 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Seo Young Sohn, Kosuke Inoue, Connie M Rhee, Angela M Leung
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引用次数: 0

Abstract

Iodine is a micronutrient that is required for thyroid hormone synthesis. The iodide cycle in thyroid hormone synthesis consists of a series of transport, oxidation, organification, and binding/coupling steps in thyroid follicular cells. Common sources of iodine include the consumption of an iodine-rich diet or iodine-fortified foods, the administration of amiodarone, iodine-containing supplements, or iodinated contrast media, and other miscellaneous sources. Methods to assess population iodine status include the measurement of urinary iodine concentrations, blood thyroglobulin levels, prevalence of elevated neonatal thyrotropin levels, and thyroid volume. Although excessive iodine intake or exposure is generally well tolerated, an acute iodine load may result in thyroid dysfunction (hypothyroidism or hyperthyroidism) in certain susceptible individuals due to the failure to escape from the Wolff-Chaikoff effect and to the Jod-Basedow phenomenon, respectively. In this review, we discuss the associations between excessive iodine intake or exposure, with particular focus on iodinated contrast media as a common source of excess iodine in health care settings, and risks of incident thyroid dysfunction. We also summarize the risks of iodine excess in vulnerable populations and review current guidelines regarding the screening and monitoring of iodinated contrast-induced thyroid dysfunction. Finally, we discuss the long-term potential nonthyroidal health risks associated with iodine excess and suggest the need for more data to define safe upper limits for iodine intake, particularly in high-risk populations.

碘过量的风险。
碘是甲状腺激素合成所需的微量营养素。甲状腺激素合成过程中的碘循环包括甲状腺滤泡细胞中的一系列运输、氧化、组织化和结合/偶联步骤。碘的常见来源包括食用富碘饮食或碘强化食品、服用胺碘酮、含碘补充剂或含碘造影剂以及其他杂项来源。评估人群碘状况的方法包括测量尿碘浓度、血液甲状腺球蛋白水平、新生儿 TSH 水平升高的发生率以及甲状腺体积。虽然摄入或接触过量的碘一般都能很好地耐受,但在某些易感人群中,急性碘负荷可能会导致甲状腺功能障碍(甲状腺功能减退症或甲状腺功能亢进症),这分别是由于未能摆脱沃尔夫-柴可夫效应和乔德-伯斯托现象所致。在这篇综述中,我们讨论了碘摄入过量或碘暴露过量与甲状腺功能障碍发病风险之间的关联,尤其关注医疗机构中碘造影剂这一常见的碘过量来源。我们还总结了碘过量在易感人群中的风险,并回顾了有关筛查和监测碘造影剂引起的甲状腺功能障碍的现行指南。最后,我们讨论了与碘过量相关的非甲状腺健康的长期潜在风险,并建议需要更多的数据来确定碘摄入量的安全上限,尤其是在高危人群中。
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来源期刊
Endocrine reviews
Endocrine reviews 医学-内分泌学与代谢
CiteScore
42.00
自引率
1.00%
发文量
29
期刊介绍: Endocrine Reviews, published bimonthly, features concise timely reviews updating key mechanistic and clinical concepts, alongside comprehensive, authoritative articles covering both experimental and clinical endocrinology themes. The journal considers topics informing clinical practice based on emerging and established evidence from clinical research. It also reviews advances in endocrine science stemming from studies in cell biology, immunology, pharmacology, genetics, molecular biology, neuroscience, reproductive medicine, and pediatric endocrinology.
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