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American Journal of Clinical Nutrition, Vol. 70, No. 5, 888-891, November 1999
© 1999 American Society for Clinical Nutrition

Original Research Communications

Urinary iodine concentrations and thyroid function in adult Zimbabweans during a period of transition in iodine status1,2,3

Zvenyika AR Gomo, Theresa J Allain, Jonathon A Matenga, Buxton Ndemere, Adrian Wilson and Peter Urdal

1 From the Department of Chemical Pathology and the Department of Medicine, University of Zimbabwe School of Medicine, Harare; the Elderly Care and Community Hospitals Directorate, Amersham Hospital, Bucks, United Kingdom; and the Department of Clinical Chemistry, Ullevaal Hospital, University of Oslo, Norway.

Background: In 1993 the compulsory iodization of salt was introduced in Zimbabwe, a country that was previously an area of severe iodine deficiency.

Objective: The objective of this study was to document urinary iodine excretion and biochemical thyroid function in seemingly healthy, community-dwelling adults after the introduction of iodization.

Design: A multistage, random sampling method was used in rural and urban settings to identify households from which the senior household member (aged >35 y) was recruited (alternating male and female recruits). Demographic data were collected for each subject and urinary and venous blood samples were taken. Urinary iodine excretion and serum thyroid hormone status (thyrotropin and total thyroxin) were evaluated according to age, sex, and area of residence.

Results: A total of 736 adults were recruited (253 men; mean age: 64 y). Urinary iodine concentrations were high [median (first and third quartiles): 4.41 (2.84, 6.78) µmol/L, or 560 (360, 860) µg/L] and were significantly higher in rural areas than in urban areas [4.73 (3.07, 7.14) µmol/L, or 600 (390, 906) µg/L, compared with 3.47 (2.05, 4.73) µmol/L, or 440 (260, 600) µg/L; P < 0.001]. Urinary iodine excretion declined significantly with increasing age (r = -0.29, P < 0.001). Serum thyroid status suggested that the prevalence of biochemical hyperthyroidism in the study was 3%, with 13 of 415 cases in rural and 3 of 149 cases in urban subjects.

Conclusion: This study reaffirms the need to continuously monitor iodine replacement programs to ensure efficacy.

Key Words: Thyroid hormones • iodine deficiency • iodization • hyperthyroidism • urinary iodine • Zimbabwe • humans






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