Background: Knowledge about the population's iodine status is important, because it allows adjustment of iodine supply and prevention of iodine deficiency. The validity and comparability of iodine-related population studies can be improved by standardization, which was one of the goals of the EUthyroid project. The aim of this study was to establish the first standardized map of iodine status in Europe by using standardized urinary iodine concentration (UIC) data. Materials and Methods: We established a gold-standard laboratory in Helsinki measuring UIC by inductively coupled plasma mass spectrometry. A total of 40 studies from 23 European countries provided 75 urine samples covering the whole range of concentrations. Conversion formulas for UIC derived from the gold-standard values were established by linear regression models and were used to postharmonize the studies by standardizing the UIC data of the individual studies. Results: In comparison with the EUthyroid gold-standard, mean UIC measurements were higher in 11 laboratories and lower in 10 laboratories. The mean differences ranged from -36.6% to 49.5%. Of the 40 postharmonized studies providing data for the standardization, 16 were conducted in schoolchildren, 13 in adults, and 11 in pregnant women. Median standardized UIC was <100 μg/L in 1 out of 16 (6.3%) studies in schoolchildren, while in adults 7 out of 13 (53.8%) studies had a median standardized UIC <100 μg/L. Seven out of 11 (63.6%) studies in pregnant women revealed a median UIC <150 μg/L. Conclusions: We demonstrate that iodine deficiency is still present in Europe, using standardized data from a large number of studies. Adults and pregnant women, particularly, are at risk for iodine deficiency, which calls for action. For instance, a more uniform European legislation on iodine fortification is warranted to ensure that noniodized salt is replaced by iodized salt more often. In addition, further efforts should be put on harmonizing iodine-related studies and iodine measurements to improve the validity and comparability of results.

Belfast Health and Social Care Trust Belfast United Kingdom

C 1 Parhon National Institute of Endocrinology Bucharest Romania

Carol Davila University of Medicine and Pharmacy Bucharest Romania

Centre for Public Health Queen's University Belfast Belfast United Kingdom

Centre for Regional Policy Research and Cooperation Studiorum Skopje North Macedonia

Chair of Epidemiology Ludwig Maximilians Universität Munich UNIKA T Augsburg Augsburg Germany

Cyprus International Institute for Environmental and Public Health Cyprus University of Technology Limassol Cyprus

Department of Clinical and Experimental Medicine University of Pisa Pisa Italy

Department of Endocrinology and Diabetes Institute for Sick Children Podgorica Montenegro

Department of Endocrinology and Nutrition Hospital de Sant Joan Despi Moisès Broggi Barcelona Spain

Department of Endocrinology and Nutrition Hospital Regional Universitario de Málaga IBIMA Málaga Spain

Department of Endocrinology Hospital das Forças Armadas Lisbon Portugal

Department of Endocrinology Institute University of Patras Medical School Patras Greece

Department of Endocrinology Jagiellonian University Medical College Krakow Poland

Department of Endocrinology Sahlgrenska University Hospital Göteborg Sweden

Department of Epidemiology and Health Monitoring Robert Koch Institute Berlin Germany

Department of Government Services Finnish Institute for Health and Welfare Helsinki Finland

Department of Health Sciences and Technology ETH Zürich Switzerland

Department of Internal Medicine University of Latvia Riga Latvia

Department of Nuclear Medicine University Medical Centre Ljubljana Slovenia

Department of Oncology and Nuclear Medicine Sestre Milosrdnice University Hospital Centre Zagreb Croatia

Department of Pediatrics Faculty of Medicine University of Niš Niš Serbia

Department of Public Health Dokuz Eylul University Medical Faculty İzmir Turkey

Department of Public Health Solutions Finnish Institute for Health and Welfare Helsinki Finland

Division of Endocrinology Faculty of Medicine University of Debrecen Debrecen Hungary

Food Security and Nutrition Institute of Marine Research Bergen Norway

Independent Research Group Clinical Epidemiology Helmholtz Zentrum München German Research Center for Environmental Health Neuherberg Germany

Institute for Community Medicine University Medicine Greifswald Greifswald Germany

Institute of Endocrinology Prague Czech Republic

Institute of Medicine Sahlgrenska Academy University of Gothenburg Gothenburg Sweden

Institute of Pathophysiology and Nuclear Medicine Ss Cyril and Methodius University Skopje Former Yougoslavian Rebublic of Macedonia

Leibniz Institute for Plasma Science and Technology Greifswald Germany

Thyroid. 2022 May;32(5):603. doi: 10.1089/thy.2019.0353.correx. PubMed

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