The physical and chemical properties of iodine, the importance of iodine for human health, iodine deficiency in the world and in Europe, the cycle of iodine in nature, values of iodine concentration in urine describing iodine deficiency, and the adequate or excessive supply of iodine to the body are presented in the work. The iodine intake of pregnant and lactating women and the state of iodine intake of these women in the Czech Republic are discussed. The history of iodine deficiency as well as the first mentions of the role of iodine in the thyroid gland and the first mentions of iodine prophylaxis in the world are explained. The present section describes the activities in the Czech Republic since the end of the Second World War, which contributed to the elimination of the iodine deficiency, including the establishment of the Interdepartmental Commission for Solving Iodine Deficiency. Population and other studies carried out in this period, which were related to the issue of iodine supply, are described. It was recorded that officially since 2004, the Czech Republic is among the countries where iodine deficiency is not currently a general problem. The future part is based on the Krakow appeal to leaders, politicians, scientists and officials, but also to the general population, to support actions leading to the elimination of iodine deficiency in Europe.

• MeSH
• Iodine * deficiency   administration & dosage   urine   MeSH
• Humans MeSH
• Nutritional Status * physiology   MeSH
• Pregnancy MeSH
• Check Tag
• Humans MeSH
• Pregnancy MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Czech Republic epidemiology   MeSH
• Names of Substances
• Iodine * MeSH

OBJECTIVES: Hearing impairment can have major impacts on behavior, educational attainment, social status, and quality of life. In congenital hypothyroidism, the incidence of hearing impairment reaches 35-50%, while in acquired hypothyroidism there is a reported incidence of 25%. Despite this, knowledge of the pathogenesis, incidence and severity of hearing impairment remains greatly lacking. The aim of our study was to evaluate hearing in patients with acquired hypothyroidism. METHODS: 30 patients with untreated and newly diagnosed peripheral hypothyroidism (H) and a control group of 30 healthy probands (C) were enrolled in the study. Biochemical markers were measured, including median iodine urine concentrations (IUC) µg/L. The hearing examination included a subjective complaint assessment, otomicroscopy, tympanometry, transitory otoacoustic emission (TOAE), tone audiometry, and brainstem auditory evoked potential (BERA) examinations. The Mann-Whitney U test, Fisher's Exact test and multivariate regression were used for statistical analysis. RESULTS: The H and C groups had significantly different thyroid hormone levels (medians with 95% CI) TSH mU/L 13.3 (8.1, 19.3) vs. 1.97 (1.21, 2.25) p = 0 and fT4 pmol/L 10.4 (9.51, 11.1) vs. 15 (13.8, 16.7) p = 0. The groups did not significantly differ in age 39 (34, 43) vs. 41 (36,44) p = 0.767 and IUC 142 (113, 159) vs. 123 (101, 157) p = 0.814. None of the hearing examinations showed differences between the H and C groups: otomicroscopy (p = 1), tympanometry (p = 1), TOAE (p = 1), audiometry (p = 0.179), and BERA (p = 0.505). CONCLUSIONS: We did not observe any hearing impairment in adults with acquired hypothyroidism, and there were no associations found between hearing impairment and the severity of hypothyroidism or iodine status. However, some forms of hearing impairment, mostly mild, were very common in both studied groups.

• MeSH
• Adult MeSH
• Hypothyroidism * complications   urine   blood   physiopathology   MeSH
• Iodine * urine   MeSH
• Middle Aged MeSH
• Humans MeSH
• Hearing Loss * etiology   urine   complications   MeSH
• Otoacoustic Emissions, Spontaneous MeSH
• Pilot Projects MeSH
• Evoked Potentials, Auditory, Brain Stem MeSH
• Case-Control Studies MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Names of Substances
• Iodine * MeSH

The aim of our study was to address the potential for improvements in thyroid cancer detection in routine clinical settings using a clinical examination, the American College of Radiology Thyroid Imaging Reporting and Database System (ACR TI-RADS), and fine-needle aspiration cytology (FNAC) concurrently with molecular diagnostics. A prospective cohort study was performed on 178 patients. DNA from FNA samples was used for next-generation sequencing to identify mutations in the genes BRAF, HRAS, KRAS, NRAS, and TERT. RNA was used for real-time PCR to detect fusion genes. The strongest relevant positive predictors for malignancy were the presence of genetic mutations (p < 0.01), followed by FNAC (p < 0.01) and ACR TI-RADS (p < 0.01). Overall, FNAC, ACR TI-RADS, and genetic testing reached a sensitivity of up to 96.1% and a specificity of 88.3%, with a diagnostic odds ratio (DOR) of 183.6. Sensitivity, specificity, and DOR decreased to 75.0%, 88.9%, and 24.0, respectively, for indeterminate (Bethesda III, IV) FNAC results. FNA molecular testing has substantial potential for thyroid malignancy detection and could lead to improvements in our approaches to patients. However, clinical examination, ACR TI-RADS, and FNAC remained relevant factors.

• Keywords
• ACR-TIRADS, BRAF, FNAC, RAS, TERT, fusions, molecular testing, thyroid cancer, thyroid nodule,
• Publication type
• Journal Article MeSH

Iodine is essential in the biosynthesis of thyroid hormones that affect metabolic processes in the organism from the prenatal state to the elderly. The immediate indicator of iodine intake is the concentration of iodine in urine, but the indicator of iodine intake in the longer term of several months is thyroglobulin (Tg). Tg negatively correlated with increasing intake of iodine in population that do not suffer from thyroid disease, while a more than adequate to excessive iodine intake leads to an increase in Tg. The dependence of Tg on iodine can be described by a U-shaped curve. Thyroglobulin in serum is elevated in thyroid disease mainly in hyperthyroidism (diagnosis E05 of WHO ICD-10 codes) and in goiter (diagnosis E04 of WHO ICD-10 codes). Tg values decrease below 20 microg/l after effective treatment of patients with thyroid disease. Thyroglobulin may thus be an indicator of thyroid stabilization and the success of the thyroid gland treatment.

• MeSH
• Iodine administration & dosage   adverse effects   MeSH
• Humans MeSH
• Thyroid Diseases chemically induced   metabolism   pathology   MeSH
• Thyroid Gland drug effects   metabolism   pathology   MeSH
• Thyroglobulin metabolism   MeSH
• Animals MeSH
• Check Tag
• Humans MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH
• Review MeSH
• Names of Substances
• Iodine MeSH
• Thyroglobulin MeSH

OBJECTIVE: Patients with type 2 diabetes (T2DM) generally experience a higher incidence of cancer. However, the association between T2DM and thyroid cancer is inconclusive. METHODS: Case-control prospective study, where 722 patients were screened for T2DM and prediabetes (PDM) and underwent thyroid ultrasound and biochemical tests. The patients were assigned to groups of PDM (n = 55), T2DM (n = 79) or a non-diabetes group (NDM) (n = 588). Fine-needle aspiration biopsy was carried out in 263 patients. Histological examinations were done for 109 patients after surgery, with findings of 52 benign (BS) and 57 malignant tumors (MS). RESULTS: Thirty-three percent of patients with T2DM and especially PDM were newly diagnosed by our screening: 6.5% with T2DM and 72% with PDM, respectively. The percentage of thyroid cancers did not significantly differ between the groups (χ2 test = 0.461; P = 0.794). Relevant positive thyroid predictors for T2DM (t-statistic = 25.87; P < 0.01) and PDM (21.69; P < 0.01) contrary to NDM (-26.9; P < 0.01) were thyroid volume (4.79; P < 0.01), thyroid nodule volume (3.25; P < 0.01) and multinodular thyroid gland (4.83; P < 0.01), while negative relevant predictors included the occurrence of autoimmune thyroid disease (AITD) (-2.01; P < 0.05). CONCLUSION: In general, we did not observe an increased risk for thyroid cancer in the diabetic and prediabetic groups in comparison to controls, in spite of well-established increased risk for other malignancies. Structural and benign changes such as larger and multinodular thyroid glands, in comparison to autoimmune thyroid disease, are present more often in diabetics.

• Keywords
• insulin resistance, obesity, prediabetes, thyroid cancer, thyroid disease, type 2 diabetes mellitus,
• Publication type
• Journal Article MeSH

BACKGROUND: To establish maternal thyroid-stimulating hormone (TSH) reference ranges for first trimester screening from 11 + 0 to 13 + 6 weeks of gestation. METHODS: A total of 10 592 singleton and 201 twin consecutive Caucasian pregnant women who underwent simultaneously prenatal first trimester Down's syndrome screening and thyroid function screening from January 2010 to November 2017 were included in the study. Women with positive antithyroid peroxidase antibody (TPOAb) and positive personal history of thyroid disease were previously excluded. TSH was measured by immunochemiluminescent assay on ci 16200 Abbott Architect analyzer. Nonparametric percentile method (also known as CLSI C28.A3) was used for the determination of reference ranges. RESULTS: We established reference ranges of TSH for the period of gestation from 11 + 0 to 13 + 6 weeks of pregnancy as 0.16-3.43 mU/L for singleton Caucasian pregnancies and 0.02-2.95 mU/L for twin Caucasian pregnancies. The median (IQR) of TSH for singleton pregnancies was higher than that for twin pregnancies (1.25 mU/L (0.83-1.81) vs 0.84 (0.37-1.47), respectively; P < .0001). CONCLUSIONS: Each first trimester screening center should be aware of which type of immunoassay their laboratory uses. TSH reference ranges in women during the first trimester of pregnancy are lower than those for general population. Twin pregnancies have lower TSH than singleton pregnancies.

• Keywords
• gestation, immunoassay, pregnancy, reference interval, thyroid disease,
• Publication type
• Journal Article MeSH

BACKGROUND: The relationship between low iodine status and pregnancy-associated comorbidities has been known for decades. The relationship between iodine intake and placental pathologies is, however, far less clear. This study was designed to examine the relationship between dietary iodine intake and placental size while also focusing on typical adverse pregnancy outcomes. METHOD: The dietary iodine intake of 4711 pregnant women enrolled in the Czech part of the European Longitudinal Study of Pregnancy and Childhood (ELSPAC) in 1990-1991 was established using a 145-item food frequency questionnaire. Multivariate linear regression models were used to estimate the relationship between dietary iodine intake during pregnancy and placental weight. Additional models were constructed to investigate the relationship between estimated dietary iodine intake and adverse birth outcomes. RESULTS: The estimated average iodine intake in the ELSPAC cohort was 106.6 μg/day. In the fully adjusted model, estimated dietary iodine intake was found to be significantly negatively associated with placental weight (β = -0.025, 95% CI: -0.044; -0.006, p = 0.011). Moreover, estimated dietary iodine intake was found to be significantly positively associated with the birth weight / placental weight ratio in the fully adjusted model (β = -0.024, 95% CI: 0.004; 0.043, p = 0.016). CONCLUSIONS: This study provides evidence of a relationship between estimated dietary iodine intake and placental weight and the birth weight / placental weight ratio. Additional research is warranted to provide more insight into the role of iodine in early as well as late placentation.

• Keywords
• Birth outcome, Birth weight / placental weight, ELSPAC, Iodine intake, Placental weight,
• Publication type
• Journal Article MeSH

BACKGROUND: Hypothyroidism and/or autoimmune thyroid disorders (AITD) may contribute to spontaneous abortions (SpA). Cost-effectiveness analyses of thyroid screening in women after SpA are lacking. Our aim was to evaluate the cost-effectiveness of screening for AITD and/or hypothyroidism and their treatment in women after SpA with regard to their reproductive health. METHODS: We performed a cross-sectional non-randomized study with follow-up in 2008-2011 in the settings of Departments of Endocrinology and Obstetrics/Gynecology of a university hospital. We enrolled 258 women after SpA before the 12th gestational week and followed them for a median of 3 years. At enrollment, serum concentrations of thyroid stimulatory hormone (TSH), antibodies to thyroid peroxidase (TPOAb) and free thyroxine (FT4) were measured and thyroid ultrasound performed. Women with overt hypothyroidism were treated with levothyroxine (n = 45; 61.6%) and women with subclinical hypothyroidism or euthyroid AITD were treated (n = 28; 38.4%) or left untreated (n = 38; 14.7%). Euthyroid women without signs of AITD served as controls (n = 147; 57.0%). RESULTS: Of the 38 untreated women with AITD and/or subclinical hypothyroidism, 8 (21.1%) reported secondary infertility as compared to 16/147 (10.9%) controls and 3/73 (4.1%) treated women (p = 0.021). Treatment was associated with an increased rate of successfully completed subsequent pregnancies (increment of 6 newborns/100 women) and a savings of €19,539/100 women. Total costs per successfully completed pregnancy were €1,189 in controls, €1,564 in the treated, and €2,488 in the untreated women. CONCLUSIONS: Screening for thyroid disorders in women after SpA and treatment with levothyroxine is cost-saving and it improves the subsequent pregnancy rate.

• MeSH
• Cost-Benefit Analysis MeSH
• Autoimmune Diseases complications   diagnosis   drug therapy   MeSH
• Autoantibodies blood   MeSH
• Adult MeSH
• Hypothyroidism complications   diagnosis   drug therapy   MeSH
• Iodide Peroxidase immunology   MeSH
• Humans MeSH
• Follow-Up Studies MeSH
• Mass Screening economics   MeSH
• Cross-Sectional Studies MeSH
• Abortion, Spontaneous etiology   MeSH
• Pregnancy MeSH
• Thyrotropin blood   MeSH
• Thyroxine blood   economics   therapeutic use   MeSH
• Pregnancy Rate MeSH
• Infertility, Female etiology   MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Pregnancy MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Controlled Clinical Trial MeSH
• Research Support, Non-U.S. Gov't MeSH
• Names of Substances
• Autoantibodies MeSH
• Iodide Peroxidase MeSH
• Thyrotropin MeSH
• Thyroxine MeSH