ETA2023 Poster Presentations Basic Thyroid Gland, Iodine & Autoimmunity Basic (9 abstracts)
Nutritional iodine status & thyroid homeostasis in pregnant women from iodine-deficient environments in india
Asha Chandola 1 , Jayanti Semwal 2 , Snehlata Tendi 3 , Atul Kathait 3 , Graham R. Ball 4 , Nikku Yadav 5 , Srishti Agarwal 2 & Akanksha Uniyal 5
1Department of Community Medicine, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Uttarakhand, Dehradun, India; 2Department of Community Medicine, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Jolly Grant, Dehradun 248016, India; 3School of Biosciences, Apeejay Stya University, Sohna-Gurgaon, Haryana 122102, India; 4Medical Technology Research Centre, Anglia Ruskin University, Chemsford, UK Cm1 1sq, United Kingdom; 5Department of Community Medicine, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Jolly Grant, Dehradun 248016, India
Ample literature exists on thyroid functioning and adjustments in Iodine-sufficient pregnant women. But information from endemic-iodine zones is meagre. In this study we attempt to understand how the thyroid copes with the dual challenge of iodine deficiency posed by physiological status of pregnancy and that by Iodine-deficient environment.
Objective: To compare TSH and FT4 profiles and their mutual correlation in iodine-deficient and iodine-sufficient subjects during progressive trimesters of pregnancy.
Methods: Study design: Epidemiological observational survey. Study populations were derived from rural Himalayan foothills in two States Uttarakhand UK, Bihar. BR. Blood & urine samples collected from women 18-45years. UK n =125, longitudinal study. BR n=425 cross sectional. Information on socioeconomic status, maternal thyroid history, dietary-iodine intake, smoking habits and BMI were generated. IEC approval & informed consent were taken. On the first visit, using UIC as biomarker (WHO) pregnant women were categorised into iodine-sufficient (ISS,>150 ug/l) and Iodine-deficient subjects (IDS,<150 ug/l). Table 1 summarises results.
Results: UIC significantly declined in UK longitudinal study despite 77% iodised-salt use. FT4 declined and TSH increased (P < 0.001) in both IDS and ISS, in UK & BR. TSH and FT4 levels were near-normal. ‘r’ was higher in IDS from UK (r=0.51, 0.66, 0.61) as well as BR (0,72, 0,65, 0.636) as compared to that in ISS (UK r=0.17,0.24,0.27 and BR r= 0.07,0.12,0.04) in Trimester I, II, III.
| Tri I (n) Mean | Tri II (n) Mean | Tri III (n) Mean | Tri I Median | Tri II Median | Tri III Median | |
| UK IDS TSH mIU/l | 2.34 | 3.11 | 3.90 | 2.18 | 2.93 | 3.46 |
| FT4 pm/l | 14.69+0.30 (78) | 12.74+0.29 (78) | 11.09+0.27 (78) | 14.41 | 12.5 | 10.54 |
| UIC ug/l | (78) | (78) | (78) | 138 | 128 | 108 |
| UK ISS TSH mIU/l | 2.25 | 2.76 | 3.41 | 2.25 | 2.85 | 3.44 |
| FT4 pm/l | 15.09 | 13.26 | 11.70 | 14.85 | 13.1 | 11.85 |
| UIC ug/l | (47) | (47) | (47) | 161 | 133 | 118 |
| BR IDS TSH mIU/l | 2.62 | 3.64 | 4.21 | 2.17 | 3.32 | 4.0 |
| FT4 pm/l | 14.25 | 12.37 | 11.4 | 14.47 | 12.4 | 11.2 |
| UIC ug/l | (68) | (147) | (160) | 80 | 80 | 84 |
| BIHAR ISS TSH mIU/l | 2.99 | 3.83 | 3.96 | 3.05 | 3.80 | 3.70 |
| FT4 pm/l | 13.94 | 11.87 | 11.48 | 13.67 | 11.6 | 11.0 |
| UIC ug/l | (31) | (16) | (17) | 168.5 | 172 | 170 |
| NOTE: UK=Uttarakhand longitudinal study, BR= Bihar, cross-sectional study IDS=Iodine-deficient pregnant subjects, ISS=Iodine-sufficient pregnant subjects. | ||||||
Conclusion: The pituitary-thyroid axis appears to become more sensitive in iodine deficiency resulting in near normal levels of free thyroxine despite consistent UIC decline. Also UIC may not be an ideal biomarker of iodine-deficiency. Intramural grant from SRHU o JS, ACS & AK and UGC JRF to SLT are acknowledged.
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