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J Clin Endocrinol Metab. 2017 Jan 1;102(1):23-32. doi: 10.1210/jc.2016-2829.

Dried Blood Spot Thyroglobulin as a Biomarker of Iodine Status in Pregnant Women.

Author information

1
Human Nutrition Laboratory, Institute of Food Nutrition and Health, ETH Zurich, Zurich 8092, Switzerland.
2
Swiss Newborn Screening Laboratory, Children's Research Center (CRC), University Children's Hospital of Zurich, Zurich 8032, Switzerland.
3
Institute of Nutrition, Mahidol University, Nakhon Pathom 73170, Thailand.
4
Department of Nutrition, University of California, Davis, Davis, California 95616.
5
St. John's Research Institute, St. John's National Academy of Health Sciences, Bangalore 560034, India.
6
Department of Oncology and Nuclear Medicine, University of Zagreb School of Medicine, Sisters of Charity University Hospital Centre, Zagreb 10,000, Croatia.
7
Department of Nutrition, University of Venda, Thohoyandou 0950, South Africa.
8
Department of Biochemistry, B.P. Koirala Institute of Health Sciences, Ghopa, Dharan 56700, Nepal.
9
Iodine Global Network (IGN), Manila 1102, Philippines; and.
10
Shanxi Institute for Endemic Disease Prevention and Treatment, LinFen 041000, China.

Abstract

Context:

Thyroglobulin (Tg) could be a sensitive biomarker of iodine nutrition in pregnant women (PW). A dried blood spot (DBS) assay would simplify collection and transport in field studies.

Objectives:

Our aims were to (1) establish and test a reference range for DBS-Tg in PW; (2) determine whether co-measurement of Tg antibodies (Abs) is necessary to define population iodine status.

Design, Setting, and Participants:

Standardized cross-sectional studies of 3870 PW from 11 countries. For the DBS-Tg reference range, we included TgAb-negative PW (n = 599) from 3 countries with sufficient iodine intake.

Main Outcome Measures:

We measured the urinary iodine concentration and DBS thyroid-stimulating hormone, total thyroxin, Tg, and TgAb.

Results:

In the reference population, the median DBS-Tg was 9.2 μg/L (95% confidence interval, 8.7 to 9.8 μg/L) and was not significantly different among trimesters. The reference range was 0.3 to 43.5 μg/L. Over a range of iodine intake, the Tg concentrations were U-shaped. Within countries, the median DBS-Tg and the presence of elevated DBS-Tg did not differ significantly between all PW and PW who were TgAb-negative.

Conclusions:

A median DBS-Tg of ∼10 μg/L with <3% of values ≥44 μg/L indicated population iodine sufficiency. Concurrent measurement of TgAb did not appear necessary to assess the population iodine status.

PMID:
27732337
DOI:
10.1210/jc.2016-2829
[Indexed for MEDLINE]
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