{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T11:35:32Z","timestamp":1789472132808,"version":"build-2803163510"},"reference-count":52,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T00:00:00Z","timestamp":1765929600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Chinese Association for Student Nutrition and Health Promotion\u2013Mead Johnson Nutritional\u2019s","award":["CASNHP-MJN2023-11"],"award-info":[{"award-number":["CASNHP-MJN2023-11"]}]},{"DOI":"10.13039\/501100004826","name":"Beijing Natural Science Foundation","doi-asserted-by":"publisher","award":["7242187"],"award-info":[{"award-number":["7242187"]}],"id":[{"id":"10.13039\/501100004826","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Iodine deficiency remains a significant public health concern worldwide and may contribute to metabolic disorders beyond thyroid dysfunction. Emerging evidence suggests that nutritional factors, such as vitamin A, may influence the health effects of iodine deficiency, yet population-based evidence remains limited. This study aimed to investigate the associations between iodine deficiency and cardiometabolic risk factors (blood pressure, glucose, and lipids) and to explore whether these associations are different between adults with different vitamin A levels. Methods: A total of 4723 adults (1895 males and 2828 females) were included in this cross-sectional study. Participants were categorized based on iodine status and serum vitamin A levels. Demographic, anthropometric, and biochemical indicators were assessed through standardized examinations. Multivariable linear and logistic regression models were used to evaluate the associations between iodine deficiency and continuous (systolic blood pressure [SBP], diastolic blood pressure [DBP], fasting blood glucose [FBG], total cholesterol [TC], high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol [LDL-C], triglycerides [TGs]) and binary outcomes (hypertension, hyperglycemia, and dyslipidemia), with stratified analyses by gender, age, and vitamin A status. Results: Iodine deficiency was significantly associated with higher SBP (\u03b2 = 2.89, 95% confidence interval [CI]: 2.00\u20133.77), DBP (\u03b2 = 1.08, 0.55\u20131.60), FBG (\u03b2 = 0.06, 0.01\u20130.12) and TC (\u03b2 = 0.05, 0.00\u20130.10). The odds of hypertension (odds ratio [OR] = 1.41, 1.23\u20131.63) and hyperglycemia (OR = 1.39, 1.17\u20131.65) were also increased. Stratified analyses indicated that these associations were more pronounced among participants with vitamin A deficiency than those with sufficient vitamin A. In this subgroup, iodine deficiency was positively associated with FBG (\u03b2 = 0.14, 0.03\u20130.25), TC (\u03b2 = 0.08, 0.00\u20130.15), and hyperglycemia (OR = 1.35, 1.04\u20131.76). Conclusions: The findings suggest that the association of iodine deficiency with adverse cardiometabolic risk factors may be stronger in individuals with concurrent vitamin A deficiency. This highlights the potential value of integrated nutritional assessments and supports the need for longitudinal studies to confirm these interactions and assess the effects of combined micronutrient supplementation.<\/jats:p>","DOI":"10.3390\/nu17243948","type":"journal-article","created":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T13:42:52Z","timestamp":1765978972000},"page":"3948","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Effects of Iodine Status and Vitamin A Level on Blood Pressure, Blood Glucose, and Blood Lipid Levels in Chinese Adults: A Cross-Sectional Study"],"prefix":"10.3390","volume":"17","author":[{"given":"Jingtao","family":"Zhao","sequence":"first","affiliation":[{"name":"School of Business, Jiangxi Institute of Fashion Technology, Nanchang 330201, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manman","family":"Chen","sequence":"additional","affiliation":[{"name":"School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9119-5506","authenticated-orcid":false,"given":"Yang","family":"Peng","sequence":"additional","affiliation":[{"name":"Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland, Brisbane, QLD 4072, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3509-891X","authenticated-orcid":false,"given":"Keyu","family":"Han","sequence":"additional","affiliation":[{"name":"School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8681-9233","authenticated-orcid":false,"given":"Qu","family":"Lu","sequence":"additional","affiliation":[{"name":"School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8123-4401","authenticated-orcid":false,"given":"Bin","family":"Dong","sequence":"additional","affiliation":[{"name":"Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1093\/nutrit\/nuy008","article-title":"Micronutrients, iodine status and concentrations of thyroid hormones: A systematic review","volume":"76","author":"Mulhern","year":"2018","journal-title":"Nutr. Rev."},{"key":"ref_2","first-page":"582","article-title":"Iodine status in intestinal failure in adults","volume":"18","author":"Pironi","year":"2015","journal-title":"Curr. Opin. Clin. Nutr. Metab. Care"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Winder, M., Koszty\u0142a, Z., Boral, A., Koce\u0142ak, P., and Chudek, J. (2022). The Impact of Iodine Concentration Disorders on Health and Cancer. Nutrients, 14.","DOI":"10.3390\/nu14112209"},{"key":"ref_4","unstructured":"World Health Organization (WHO) (2001). Assessment of Iodine Deficiency Disorders and Monitoring Their Elimination: A Guide for Programme Managers."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"918s","DOI":"10.3945\/ajcn.115.110429","article-title":"Consequences of iodine deficiency and excess in pregnant women: An overview of current knowns and unknowns","volume":"104","author":"Pearce","year":"2016","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1155","DOI":"10.3945\/jn.113.176289","article-title":"Intakes of dairy products and dietary supplements are positively associated with iodine status among U.S. children","volume":"143","author":"Perrine","year":"2013","journal-title":"J. Nutr."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/s13044-021-00105-1","article-title":"Associations between maternal urinary iodine assessment, dietary iodine intakes and neurodevelopmental outcomes in the child: A systematic review","volume":"14","author":"Monaghan","year":"2021","journal-title":"Thyroid Res."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Baldini, E., Lauro, A., Tripodi, D., Pironi, D., Amabile, M.I., Ferent, I.C., Lori, E., Gagliardi, F., Bellini, M.I., and Forte, F. (2022). Thyroid Diseases and Breast Cancer. J. Pers. Med., 12.","DOI":"10.3389\/fonc.2022.951976"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1007\/s42000-025-00653-3","article-title":"Relationship between urinary iodine concentration and all-cause mortality in individuals with diabetes: An analysis of National Health and Nutrition Examination Survey 2005\u2013\u20092018","volume":"24","author":"Lai","year":"2025","journal-title":"Hormones"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Candido, A.C., Azevedo, F.M., Ribeiro, S.A.V., Navarro, A.M., Macedo, M.S., Fontes, E.A.F., Crispim, S.P., Carvalho, C.A., Pizato, N., and da Silva, D.G. (2025). Iodine Deficiency and Excess in Brazilian Pregnant Women: A Multicenter Cross-Sectional Study (EMDI-Brazil). Nutrients, 17.","DOI":"10.3390\/nu17172753"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1530\/eje.1.02333","article-title":"The association between TSH within the reference range and serum lipid concentrations in a population-based study. The HUNT Study","volume":"156","author":"Asvold","year":"2007","journal-title":"Eur. J. Endocrinol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"4019","DOI":"10.1210\/jc.2004-2225","article-title":"Small differences in thyroid function may be important for body mass index and the occurrence of obesity in the population","volume":"90","author":"Knudsen","year":"2005","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1001\/archinte.168.8.855","article-title":"Thyrotropin levels and risk of fatal coronary heart disease: The HUNT study","volume":"168","author":"Nilsen","year":"2008","journal-title":"Arch. Intern. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2067","DOI":"10.3945\/jn.115.213439","article-title":"Iodine Supplementation Decreases Hypercholesterolemia in Iodine-Deficient, Overweight Women: A Randomized Controlled Trial1,2","volume":"145","author":"Cherkaoui","year":"2015","journal-title":"J. Nutr."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1111\/j.1365-2265.1995.tb01894.x","article-title":"The incidence of thyroid disorders in the community: A twenty-year follow-up of the Whickham Survey","volume":"43","author":"Vanderpump","year":"1995","journal-title":"Clin. Endocrinol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Lopes, S.O., Mayer, E.M., Azevedo, F.M., Candido, A.C., Bittencourt, J.M., Morais, D.C., Franceschini, S., and Priore, S.E. (2025). Nutritional Status of Iodine and Association with Iron, Selenium, and Zinc in Population Studies: A Systematic Review and Meta-Analysis. Nutrients, 17.","DOI":"10.3390\/nu17213432"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Dargenio, V.N., Sgarro, N., Grasta, G., Begucci, M., Castellaneta, S.P., Dargenio, C., Paulucci, L., Francavilla, R., and Cristofori, F. (2025). Hidden Hunger in Pediatric Obesity: Redefining Malnutrition Through Macronutrient Quality and Micronutrient Deficiency. Nutrients, 17.","DOI":"10.3390\/nu17223601"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"107664","DOI":"10.5662\/wjm.v15.i4.107664","article-title":"Scoping review of micronutrient imbalances, clinical manifestations, and interventions","volume":"15","author":"English","year":"2025","journal-title":"World J. Methodol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"453","DOI":"10.3390\/jcm3020453","article-title":"The Roles of Vitamin A in the Regulation of Carbohydrate, Lipid, and Protein Metabolism","volume":"3","author":"Chen","year":"2014","journal-title":"J. Clin. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"604","DOI":"10.7326\/M18-2478","article-title":"Association Among Dietary Supplement Use, Nutrient Intake, and Mortality Among U.S. Adults","volume":"170","author":"Chen","year":"2019","journal-title":"Ann. Intern. Med."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Feng, Y., Li, Y., Chen, S., Hu, N., and Liao, D. (2024). Vitamin A is associated with all-cause mortality in patients with chronic kidney disease: A population-based cohort study. Front. Nutr., 11.","DOI":"10.3389\/fnut.2024.1469844"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"100087","DOI":"10.1016\/j.obpill.2023.100087","article-title":"Obesity and malnutrition in children and adults: A clinical review","volume":"8","author":"Bradley","year":"2023","journal-title":"Obes. Pillars"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1590\/2359-3997000000125","article-title":"Vitamin A supplementation reduces the Th17-Treg-Related cytokines in obese and non-obese women","volume":"60","author":"Farhangi","year":"2016","journal-title":"Arch. Endocrinol. Metab."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Mao, G., Zhou, C., Huang, L., Mo, Z., Su, D., Gu, S., Guo, F., Wang, Y., Chen, Z., and Zhang, R. (2024). Role of Iodine Status and Lifestyle Behaviors on Goiter among Children and Adolescents: A Cross-Sectional Study in Zhejiang Province, China. Nutrients, 16.","DOI":"10.3390\/nu16172910"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Mao, G., Chen, M., Huang, L., Mo, Z., Su, D., Gu, S., Guo, F., Wang, Y., Chen, Z., and Zhang, R. (2024). Differences in Vitamin A Levels and Their Association with the Atherogenic Index of Plasma and Subclinical Hypothyroidism in Adults: A Cross-Sectional Analysis in China. Nutrients, 16.","DOI":"10.3390\/nu16162613"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1874","DOI":"10.1097\/HJH.0000000000003480","article-title":"2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension: Endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA)","volume":"41","author":"Mancia","year":"2023","journal-title":"J. Hypertens."},{"key":"ref_27","first-page":"33","article-title":"The thyroid gland in postmenopausal women: Physiology and diseases","volume":"16","year":"2017","journal-title":"Prz. Menopauzalny"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/j.chom.2020.07.013","article-title":"The gut microbiota and unhealthy aging: Disentangling cause from consequence","volume":"28","author":"DeJong","year":"2020","journal-title":"Cell Host Microbe"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1186\/s13293-021-00367-2","article-title":"Thyroid hormone: Sex-dependent role in nervous system regulation and disease","volume":"12","author":"Baksi","year":"2021","journal-title":"Biol. Sex Differ."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.copbio.2020.11.001","article-title":"Understanding the impact of age-related changes in the gut microbiome on chronic diseases and the prospect of elderly-specific dietary interventions","volume":"70","author":"Pellanda","year":"2021","journal-title":"Curr. Opin. Biotechnol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1194","DOI":"10.1016\/j.cell.2013.05.039","article-title":"The hallmarks of aging","volume":"153","author":"Blasco","year":"2013","journal-title":"Cell"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1038\/nature15766","article-title":"Disentangling the effects of type 2 diabetes and metformin on the human gut microbiota","volume":"528","author":"Kristoffer","year":"2015","journal-title":"Nature"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1007\/s00018-017-2673-z","article-title":"Microbiome\u2013Health interactions in older people","volume":"75","author":"Jeffery","year":"2018","journal-title":"Cell. Mol. Life Sci."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1007\/s00432-018-2816-0","article-title":"Microbiota in cancer development and treatment","volume":"145","author":"Raza","year":"2019","journal-title":"J. Cancer Res. Clin. Oncol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1750","DOI":"10.1001\/jama.2025.13559","article-title":"Hypothyroidism: A Review","volume":"334","author":"Chaker","year":"2025","journal-title":"JAMA"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"K\u00f6hrle, J. (2023). Selenium, Iodine and Iron-Essential Trace Elements for Thyroid Hormone Synthesis and Metabolism. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms24043393"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1016\/S2213-8587(23)00005-0","article-title":"Hyperthyroidism: Aetiology, pathogenesis, diagnosis, management, complications, and prognosis","volume":"11","author":"Wiersinga","year":"2023","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1089\/thy.2006.0302","article-title":"Lipoprotein alterations, hepatic lipase activity, and insulin sensitivity in subclinical hypothyroidism: Response to L-T4 treatment","volume":"17","author":"Brenta","year":"2007","journal-title":"Thyroid"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Varlamov, O., Bethea, C.L., and Roberts, C.T. (2014). Sex-specific differences in lipid and glucose metabolism. Front. Endocrinol., 5.","DOI":"10.3389\/fendo.2014.00241"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1007\/s00125-002-0980-9","article-title":"The CAG repeat polymorphism in the androgen receptor gene modulates body fat mass and serum concentrations of leptin and insulin in men","volume":"46","author":"Zitzmann","year":"2003","journal-title":"Diabetologia"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"H524","DOI":"10.1152\/ajpheart.00217.2016","article-title":"Sex differences in vascular physiology and pathophysiology: Estrogen and androgen signaling in health and disease","volume":"313","author":"Boese","year":"2017","journal-title":"Am. J. Physiol. Heart Circ. Physiol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1210\/jc.2007-1792","article-title":"Low serum testosterone and mortality in older men","volume":"93","author":"Laughlin","year":"2008","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1002\/j.1550-8528.1993.tb00618.x","article-title":"Androgen treatment of abdominally obese men","volume":"1","author":"Gustafsson","year":"1993","journal-title":"Obes. Res."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1093\/gerona\/61.10.1059","article-title":"The loss of skeletal muscle strength, mass, and quality in older adults: The health, aging and body composition study","volume":"61","author":"Goodpaster","year":"2006","journal-title":"J. Gerontol. A Biol. Sci. Med. Sci."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"115","DOI":"10.3945\/ajcn.114.105833","article-title":"Fish oil-derived n-3 PUFA therapy increases muscle mass and function in healthy older adults","volume":"102","author":"Smith","year":"2015","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1080\/20477724.2016.1261489","article-title":"Improved infant hemoglobin (Hb) and blood glucose concentrations: The beneficial effect of maternal vitamin A supplementation of malaria-infected mothers in Ebonyi State, Nigeria","volume":"111","author":"Elom","year":"2017","journal-title":"Pathog. Glob. Health"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Ji, S., Zhou, Y., Zhao, Q., Chen, R., and Su, Z. (2024). Trends in three malnutrition factors in the global burden of disease: Iodine deficiency, vitamin A deficiency, and protein-energy malnutrition (1990\u20132019). Front. Nutr., 11.","DOI":"10.3389\/fnut.2024.1426790"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Capriello, S., Stramazzo, I., Bagaglini, M.F., Brusca, N., Virili, C., and Centanni, M. (2022). The relationship between thyroid disorders and vitamin A: A narrative minireview. Front. Endocrinol., 13.","DOI":"10.3389\/fendo.2022.968215"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"R121","DOI":"10.1530\/EC-17-0101","article-title":"Vitamin A, endocrine tissues and hormones: Interplay and interactions","volume":"6","author":"Brossaud","year":"2017","journal-title":"Endocr. Connect."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"5441","DOI":"10.1210\/jc.2004-0862","article-title":"The effects of vitamin A deficiency and vitamin A supplementation on thyroid function in goitrous children","volume":"89","author":"Zimmermann","year":"2004","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"107608","DOI":"10.1016\/j.aquatox.2025.107608","article-title":"Refining the AOP for retinoid-induced teratogenicity: Insights into RAR\/RXR overactivation and RXR cross-talk with retinoic acid and thyroid hormone signaling","volume":"289","author":"Phan","year":"2025","journal-title":"Aquat. Toxicol."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Shulhai, A.M., Rotondo, R., Petraroli, M., Patianna, V., Predieri, B., Iughetti, L., Esposito, S., and Street, M.E. (2024). The Role of Nutrition on Thyroid Function. Nutrients, 16.","DOI":"10.3390\/nu16152496"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/24\/3948\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T13:46:43Z","timestamp":1765979203000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/24\/3948"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,17]]},"references-count":52,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["nu17243948"],"URL":"https:\/\/doi.org\/10.3390\/nu17243948","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,17]]}}}