{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T17:06:31Z","timestamp":1778691991276,"version":"3.51.4"},"reference-count":47,"publisher":"Cambridge University Press (CUP)","issue":"8","license":[{"start":{"date-parts":[[2020,5,21]],"date-time":"2020-05-21T00:00:00Z","timestamp":1590019200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Br J Nutr"],"published-print":{"date-parts":[[2020,10,28]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The present study aimed to evaluate the status of iodine nutrition and thyroid function in adults, to understand the distribution of thyroid disease in people with autoimmune thyroid disease (AITD) in different water iodine areas and to explore the relationship between serum iodine, urine iodine and thyroid function in people with AITD. A cross-sectional survey was conducted in areas of Shandong Province with different water iodine levels, and subsequently 1225 adults were enrolled from iodine-deficient (ID), iodine-adequate (IA) and iodine-excess (IE) areas. Urinary iodine, water iodine, salt iodine, serum iodine and thyroid function were measured. According to the urine iodine concentration, the ID and IA areas were defined as iodine sufficient and the IE area as iodine excessive. Urine iodine, serum iodine, free thyroxine (FT<jats:sub>4<\/jats:sub>) and thyroid-stimulating hormone (TSH) levels were comparatively higher in the IE area. The positive rate of thyroglobulin antibody (19\u00b71 %) and the prevalence of AITD (21\u00b78 %) were higher in the ID areas; the prevalence of subclinical hypothyroidism was lowest in the ID areas (7\u00b73 %) and highest in the IE area (16\u00b73 %). Among the AITD population, urinary iodine concentration, free triiodothyronine, FT<jats:sub>4<\/jats:sub> and TSH had a non-linear correlation with serum iodine; abnormal TSH level, serum iodine concentration &gt; 110 \u00b5g\/l and goitre were risk factors for AITD in adults, especially females. Our data collectively suggest that universal salt iodisation has improved the iodine nutritional status of the population in ID areas in China. Non-step-by-step iodine fortification may induce the transformation of thyroid autoimmune diseases from recessive-to-dominant in susceptible people. Moreover, enhanced monitoring of thyroid function in people with AITD is important.<\/jats:p>","DOI":"10.1017\/s0007114520001786","type":"journal-article","created":{"date-parts":[[2020,5,21]],"date-time":"2020-05-21T09:25:16Z","timestamp":1590053116000},"page":"853-864","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":23,"title":["Autoimmune thyroid diseases after 25 years of universal salt iodisation: an epidemiological study of Chinese adults in areas with different water iodine levels"],"prefix":"10.1017","volume":"124","author":[{"given":"Siyuan","family":"Wan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mengying","family":"Qu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huaiyong","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bingxuan","family":"Ren","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoming","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lixiang","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8807-9897","authenticated-orcid":false,"given":"Hongmei","family":"Shen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2020,5,21]]},"reference":[{"key":"S0007114520001786_ref16","volume-title":"Delimitation for the Endemic Areas of Iodine Deficiency Disorders (IDD)","author":"Shen","year":"2009"},{"key":"S0007114520001786_ref47","first-page":"64","article-title":"A five-year follow-up study of thyroid peroxidase antibody and thyroglobulin antibody in communities with different iodine intake","volume":"48","author":"Li","year":"2009","journal-title":"Chin J Intern Med"},{"key":"S0007114520001786_ref8","first-page":"45","article-title":"Epidemiological investigation on thyroid disease among fertile women in different iodine intake","volume":"35","author":"Ren","year":"2014","journal-title":"Chin J Epidemiol"},{"key":"S0007114520001786_ref7","doi-asserted-by":"publisher","DOI":"10.3390\/ijms150712895"},{"key":"S0007114520001786_ref18","unstructured":"18. Chinese Bureau of Disease Control and Prevention (2019) Survey report on iodine content in drinking water. http:\/\/www.nhc.gov.cn\/jkj\/s5874\/201905\/bb1da1f5e47040e8820b9378e6db4bd3.shtml (accessed November 2019)."},{"key":"S0007114520001786_ref44","first-page":"112","article-title":"Iodine nutrition and thyroid disease","volume":"5","author":"Teng","year":"2010","journal-title":"J Intern Med Concepts Pract"},{"key":"S0007114520001786_ref34","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980010000650"},{"key":"S0007114520001786_ref13","doi-asserted-by":"publisher","DOI":"10.1089\/105072502761016539"},{"key":"S0007114520001786_ref40","first-page":"355","article-title":"Research of epidemiology of serum TSH levels of healthy people in area with different iodine intake in China","volume":"18","author":"Wang","year":"2002","journal-title":"Chin J Endocrinol Metab"},{"key":"S0007114520001786_ref2","volume-title":"The Iodine Deficiency Disorders. Endotext","author":"Eastman","year":"2018"},{"key":"S0007114520001786_ref38","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2015.0338"},{"key":"S0007114520001786_ref31","unstructured":"31. Zhang, YP , Yan, YQ , Liu, LJ , et al. (2016) Method for Determination of Iodine in Urine By As3+ \u2013 Ce4+ Catalytic Spectrophotometry (WS\/T 107.1-2016). Beijing: Health Standard of China. (in Chinese)"},{"key":"S0007114520001786_ref22","volume-title":"Designing and Conducting Health Surveys","author":"Aday","year":"2006"},{"key":"S0007114520001786_ref35","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa054022"},{"key":"S0007114520001786_ref32","first-page":"221","article-title":"Values of iodine metabolism biomarkers in assessing the iodine nutrition status in surgically treated patients with thyroid disease","volume":"37","author":"Han","year":"2015","journal-title":"Acta Acad Med Sin"},{"key":"S0007114520001786_ref19","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/1705478"},{"key":"S0007114520001786_ref11","first-page":"73","article-title":"Iodine causes sexual hyperthyroidism","volume":"19","author":"Chen","year":"2000","journal-title":"Chin J Endemiol"},{"key":"S0007114520001786_ref41","first-page":"71","article-title":"Comparative epidemiologic study on the prevalence of iodine-induced hypothyroidism","volume":"17","author":"Shan","year":"2001","journal-title":"Chin J Endocrinol Metab"},{"key":"S0007114520001786_ref20","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0111937"},{"key":"S0007114520001786_ref27","first-page":"508","article-title":"Serum thyroglobulin-a sensitive biomarker of iodine nutrition status and affected by thyroid abnormalities and disease in adult populations","volume":"30","author":"Du","year":"2017","journal-title":"Biomed Environ Sci"},{"key":"S0007114520001786_ref1","volume-title":"Iodine Deficiency Disorders and their Elimination","author":"Ma","year":"2017"},{"key":"S0007114520001786_ref14","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2265.2003.01633.x"},{"key":"S0007114520001786_ref10","first-page":"10","article-title":"Iodine-induced hyperthyroidism","volume":"14","year":"1998","journal-title":"ICCIDD Newslett"},{"key":"S0007114520001786_ref5","first-page":"239","article-title":"Current situation and countermeasures of iodine deficiency disorders and iodine excess in China","volume":"31","author":"Shen","year":"2012","journal-title":"Chin J Endemiol"},{"key":"S0007114520001786_ref12","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980019001915"},{"key":"S0007114520001786_ref33","doi-asserted-by":"publisher","DOI":"10.1080\/08916930410001705394"},{"key":"S0007114520001786_ref26","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2014.0052"},{"key":"S0007114520001786_ref24","volume-title":"Assessment of Iodine Deficiency Disorders and Monitoring Their Elimination, A Guide For Program Managers","year":"2007"},{"key":"S0007114520001786_ref37","doi-asserted-by":"publisher","DOI":"10.1172\/JCI102060"},{"key":"S0007114520001786_ref23","volume-title":"Criteria of Weight for Adults","author":"Chen","year":"2013"},{"key":"S0007114520001786_ref25","doi-asserted-by":"publisher","DOI":"10.1111\/cen.13421"},{"key":"S0007114520001786_ref4","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2013.251"},{"key":"S0007114520001786_ref9","first-page":"918","article-title":"Prevalence of autoimmune thyroiditis and thyroid dysfunction in healthy adult Mexicans with a slightly excessive iodine intake","volume":"32","author":"Armando","year":"2015","journal-title":"Nutr Hosp"},{"key":"S0007114520001786_ref21","first-page":"839","article-title":"Surveys on iodine nutritional status and thyroid related diseases among adults in areas with different water iodine levels in Tianjin","volume":"16","author":"Hou","year":"2015","journal-title":"Chin Prev Med"},{"key":"S0007114520001786_ref28","year":"2017"},{"key":"S0007114520001786_ref46","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2011.04008.x"},{"key":"S0007114520001786_ref6","doi-asserted-by":"publisher","DOI":"10.1017\/S0007114515003128"},{"key":"S0007114520001786_ref39","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.83.3.4624"},{"key":"S0007114520001786_ref36","first-page":"429","article-title":"The metabolism of iodine in man as disclosed with the use of radioiodine","volume":"4","author":"Keating","year":"1949","journal-title":"Recent Prog Horm Res"},{"key":"S0007114520001786_ref30","volume-title":"General Test Method in Salt Industry \u2013 Determination of Iodine","author":"Tong","year":"2012"},{"key":"S0007114520001786_ref15","volume-title":"Definition and Demarcation of Water-borne Iodine-excess Areas Endemial Areas","author":"Jia","year":"2016"},{"key":"S0007114520001786_ref17","volume-title":"Criteria for the Elimination of Iodine Deficiency Disorders in China","author":"Zhang","year":"2008"},{"key":"S0007114520001786_ref3","doi-asserted-by":"publisher","DOI":"10.4103\/ijmr.IJMR_1717_18"},{"key":"S0007114520001786_ref29","first-page":"333","article-title":"Study on the method of water iodine detection in areas lacking iodine and high iodine","volume":"26","author":"Wang","year":"2007","journal-title":"Chin J Endemiol"},{"key":"S0007114520001786_ref43","first-page":"15","article-title":"The relationship between the increase of TGAb or TPOAb antibody and the change of thyroid hormone","volume":"3","author":"Wang","year":"2018","journal-title":"Syst Med"},{"key":"S0007114520001786_ref45","first-page":"780","article-title":"Determination of cut-off points of thyroid peroxidase antibody and thyroglobulin antibody and their clinical significance","volume":"29","author":"Li","year":"2006","journal-title":"Chin J Lab Med"},{"key":"S0007114520001786_ref42","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-012-9703-2"}],"container-title":["British Journal of Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0007114520001786","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,11,6]],"date-time":"2020-11-06T08:37:07Z","timestamp":1604651827000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0007114520001786\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,21]]},"references-count":47,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2020,10,28]]}},"alternative-id":["S0007114520001786"],"URL":"https:\/\/doi.org\/10.1017\/s0007114520001786","relation":{},"ISSN":["0007-1145","1475-2662"],"issn-type":[{"value":"0007-1145","type":"print"},{"value":"1475-2662","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,21]]},"assertion":[{"value":"\u00a9 The Author(s), 2020. Published by Cambridge University Press on behalf of The Nutrition Society","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}