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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT06074770
Other study ID # NSFC-8227121511
Secondary ID
Status Recruiting
Phase
First received
Last updated
Start date May 5, 2023
Est. completion date December 31, 2026

Study information

Verified date October 2023
Source Tianjin Medical University
Contact wen Chen, Master
Phone 022-83336610
Email wenchen@tmu.edu.cn
Is FDA regulated No
Health authority
Study type Observational

Clinical Trial Summary

Iodine as an essential trace element for human, both excessive and insufficient intake would be harmful for human health. As susceptible population, children will be more sensitive to adverse effects caused by inadequate intake of iodine since they are at the peak of growth and development. Meanwhile, there are few direct evidence to establish dietary intakes levels of iodine for 3-6 years old pre-school children.


Description:

This study plan to conduct iodine balance experiment by providing devised diet consist of different iodine contents, in order to simulate iodine equilibrium of iodine deficiency to iodine excess in children and find the lowest iodine requirement of iodine for pre-school children, then aim to provide data to establish recommend nutrient intake of iodine for 3-6-year-old pre-school children. On the other hand, this study will make use of natural geographic environment with high water iodine in China. The investigators will conduct big-scale epidemiologic study in areas with high water iodine levels in Shandong and areas with adequate iodine in Tianjin, to enroll pre-school children with various iodine intake levels. The investigators will collect 24-hour urine samples as well as dietary records to evaluate iodine intake levels, and detect thyroid volume and thyroglobulin to evaluate the effects of various iodine intake on pre-school children, aiming to find the lowest safe intake level of iodine and then establish the tolerable upper intake level (UL) of iodine for 3-6-year-old pre-school children. This study aims to define the RNI and UL of iodine for 3-6-year-old pre-school children, to provide data for revision of Chinese dietary intake levels of iodine, and to guide children safe and scientifical iodine fortification.


Recruitment information / eligibility

Status Recruiting
Enrollment 2650
Est. completion date December 31, 2026
Est. primary completion date December 31, 2026
Accepts healthy volunteers Accepts Healthy Volunteers
Gender All
Age group 3 Years to 6 Years
Eligibility Inclusion Criteria: - for children with mild malnutrition: hemoglobin <110g / L, or weight for age <P50 according to the Chinese 2009 child growth and development reference standard, or BMI z score <-1 according to the WHO Child Growth Assessment Software (version 3.2.2 ) ; have not been treated for thyroid disease; have not used amiodarone and other drugs (including iodine supplements) during the investigation; have no major diseases ,chronic diseases and family history. - for children with good nutritional status: healthy,-1 <BMI z score <1; have not been treated for thyroid disease; have not used amiodarone and other drugs (including iodine supplements) during the investigation; have no major diseases ,chronic diseases and family history; Exclusion Criteria: long-term low-protein; long-term low-heat energy malnutrition

Study Design


Related Conditions & MeSH terms


Intervention

Other:
no intervention
Natural exposure of iodine

Locations

Country Name City State
China Shandong Institute for Endemic Disease Control and Research Yuncheng Shandong

Sponsors (2)

Lead Sponsor Collaborator
Chen Wen Shandong Institute for Endemic Disease Control and Research

Country where clinical trial is conducted

China, 

References & Publications (29)

Andersen S, Noahsen P, Westergaard L, Laurberg P. Reliability of thyroglobulin in serum compared with urinary iodine when assessing individual and population iodine nutrition status. Br J Nutr. 2017 Feb;117(3):441-449. doi: 10.1017/S0007114517000162. Epub 2017 Feb 22. — View Citation

Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, de Onis M, Ezzati M, Grantham-McGregor S, Katz J, Martorell R, Uauy R; Maternal and Child Nutrition Study Group. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013 Aug 3;382(9890):427-451. doi: 10.1016/S0140-6736(13)60937-X. Epub 2013 Jun 6. Erratum In: Lancet. 2013. 2013 Aug 3;382(9890):396. — View Citation

Bougma K, Aboud FE, Harding KB, Marquis GS. Iodine and mental development of children 5 years old and under: a systematic review and meta-analysis. Nutrients. 2013 Apr 22;5(4):1384-416. doi: 10.3390/nu5041384. Erratum In: Nutrients. 2014 Dec;6(12):5770-1. — View Citation

Chen W, Li X, Wu Y, Bian J, Shen J, Jiang W, Tan L, Wang X, Wang W, Pearce EN, Zimmermann MB, Carriquiry AL, Zhang W. Associations between iodine intake, thyroid volume, and goiter rate in school-aged Chinese children from areas with high iodine drinking water concentrations. Am J Clin Nutr. 2017 Jan;105(1):228-233. doi: 10.3945/ajcn.116.139725. Epub 2016 Dec 7. — View Citation

Chen W, Zhang Q, Wu Y, Wang W, Wang X, Pearce EN, Tan L, Shen J, Zhang W. Shift of Reference Values for Thyroid Volume by Ultrasound in 8- to 13-Year-Olds with Sufficient Iodine Intake in China. Thyroid. 2019 Mar;29(3):405-411. doi: 10.1089/thy.2018.0412. — View Citation

Chen W, Zhang Y, Hao Y, Wang W, Tan L, Bian J, Pearce EN, Zimmermann MB, Shen J, Zhang W. Adverse effects on thyroid of Chinese children exposed to long-term iodine excess: optimal and safe Tolerable Upper Intake Levels of iodine for 7- to 14-y-old children. Am J Clin Nutr. 2018 May 1;107(5):780-788. doi: 10.1093/ajcn/nqy011. — View Citation

Dold S, Zimmermann MB, Baumgartner J, Davaz T, Galetti V, Braegger C, Andersson M. A dose-response crossover iodine balance study to determine iodine requirements in early infancy. Am J Clin Nutr. 2016 Sep;104(3):620-8. doi: 10.3945/ajcn.116.134049. Epub 2016 Jul 27. — View Citation

DU Y, Gao YH, Feng ZY, Meng FG, Fan LJ, Sun DJ. Serum Thyroglobulin-A Sensitive Biomarker of Iodine Nutrition Status and Affected by Thyroid Abnormalities and Disease in Adult Populations. Biomed Environ Sci. 2017 Jul;30(7):508-516. doi: 10.3967/bes2017.067. — View Citation

Farebrother J, Zimmermann MB, Assey V, Castro MC, Cherkaoui M, Fingerhut R, Jia Q, Jukic T, Makokha A, San Luis TO, Wegmuller R, Andersson M. Thyroglobulin Is Markedly Elevated in 6- to 24-Month-Old Infants at Both Low and High Iodine Intakes and Suggests a Narrow Optimal Iodine Intake Range. Thyroid. 2019 Feb;29(2):268-277. doi: 10.1089/thy.2018.0321. — View Citation

Gardner DF, Centor RM, Utiger RD. Effects of low dose oral iodide supplementation on thyroid function in normal men. Clin Endocrinol (Oxf). 1988 Mar;28(3):283-8. doi: 10.1111/j.1365-2265.1988.tb01214.x. — View Citation

Harika R, Faber M, Samuel F, Mulugeta A, Kimiywe J, Eilander A. Are Low Intakes and Deficiencies in Iron, Vitamin A, Zinc, and Iodine of Public Health Concern in Ethiopian, Kenyan, Nigerian, and South African Children and Adolescents? Food Nutr Bull. 2017 Sep;38(3):405-427. doi: 10.1177/0379572117715818. Epub 2017 Jul 6. — View Citation

Laurberg P, Cerqueira C, Ovesen L, Rasmussen LB, Perrild H, Andersen S, Pedersen IB, Carle A. Iodine intake as a determinant of thyroid disorders in populations. Best Pract Res Clin Endocrinol Metab. 2010 Feb;24(1):13-27. doi: 10.1016/j.beem.2009.08.013. — View Citation

Lee J, Kim JH, Lee SY, Lee JH. Iodine status in Korean preschool children as determined by urinary iodine excretion. Eur J Nutr. 2014;53(2):683-8. doi: 10.1007/s00394-013-0558-y. Epub 2013 Jul 24. Erratum In: Eur J Nutr. 2014 Mar;53(2):689. Lee, Jeehhun [corrected to Lee, Jeehun]. — View Citation

Lee SY, Pearce EN. Reproductive endocrinology: Iodine intake in pregnancy--even a little excess is too much. Nat Rev Endocrinol. 2015 May;11(5):260-1. doi: 10.1038/nrendo.2015.28. Epub 2015 Feb 24. — View Citation

Li Y, Teng D, Ba J, Chen B, Du J, He L, Lai X, Teng X, Shi X, Li Y, Chi H, Liao E, Liu C, Liu L, Qin G, Qin Y, Quan H, Shi B, Sun H, Tang X, Tong N, Wang G, Zhang JA, Wang Y, Xue Y, Yan L, Yang J, Yang L, Yao Y, Ye Z, Zhang Q, Zhang L, Zhu J, Zhu M, Ning G, Mu Y, Zhao J, Shan Z, Teng W. Efficacy and Safety of Long-Term Universal Salt Iodization on Thyroid Disorders: Epidemiological Evidence from 31 Provinces of Mainland China. Thyroid. 2020 Apr;30(4):568-579. doi: 10.1089/thy.2019.0067. Epub 2020 Mar 24. — View Citation

Malvaux P, Beckers C, De Visscher M. Iodine balance studies in nongoitrous children and in adolescents on low iodine intake. J Clin Endocrinol Metab. 1969 Jan;29(1):79-84. doi: 10.1210/jcem-29-1-79. No abstract available. — View Citation

Nakatsuka H, Watanabe T, Shimbo S, Sawatari H, Izumi K, Yaginuma-Sakurai K, Ikeda M. High iodine intake by preschool children in Miyagi prefecture, Japan. Environ Health Prev Med. 2014 Sep;19(5):330-8. doi: 10.1007/s12199-014-0394-6. Epub 2014 Jun 28. — View Citation

Paul T, Meyers B, Witorsch RJ, Pino S, Chipkin S, Ingbar SH, Braverman LE. The effect of small increases in dietary iodine on thyroid function in euthyroid subjects. Metabolism. 1988 Feb;37(2):121-4. doi: 10.1016/s0026-0495(98)90004-x. — View Citation

Pearce EN, Lazarus JH, Moreno-Reyes R, Zimmermann MB. Consequences of iodine deficiency and excess in pregnant women: an overview of current knowns and unknowns. Am J Clin Nutr. 2016 Sep;104 Suppl 3(Suppl 3):918S-23S. doi: 10.3945/ajcn.115.110429. Epub 2016 Aug 17. — View Citation

RIGGS DS. Quantitative aspects of iodine metabolism in man. Pharmacol Rev. 1952 Sep;4(3):284-370. No abstract available. — View Citation

Sang Z, Chen W, Shen J, Tan L, Zhao N, Liu H, Wen S, Wei W, Zhang G, Zhang W. Long-term exposure to excessive iodine from water is associated with thyroid dysfunction in children. J Nutr. 2013 Dec;143(12):2038-43. doi: 10.3945/jn.113.179135. Epub 2013 Oct 9. — View Citation

Sang Z, Wang PP, Yao Z, Shen J, Halfyard B, Tan L, Zhao N, Wu Y, Gao S, Tan J, Liu J, Chen Z, Zhang W. Exploration of the safe upper level of iodine intake in euthyroid Chinese adults: a randomized double-blind trial. Am J Clin Nutr. 2012 Feb;95(2):367-73. doi: 10.3945/ajcn.111.028001. Epub 2011 Dec 28. — View Citation

Stinca S, Andersson M, Erhardt J, Zimmermann MB. Development and Validation of a New Low-Cost Enzyme-Linked Immunoassay for Serum and Dried Blood Spot Thyroglobulin. Thyroid. 2015 Dec;25(12):1297-305. doi: 10.1089/thy.2015.0428. Epub 2015 Dec 1. — View Citation

Tan L, Tian X, Wang W, Guo X, Sang Z, Li X, Zhang P, Sun Y, Tang C, Xu Z, Shen J, Zhang W. Exploration of the appropriate recommended nutrient intake of iodine in healthy Chinese women: an iodine balance experiment. Br J Nutr. 2019 Mar 14;121(5):519-528. doi: 10.1017/S0007114518003653. Epub 2018 Dec 11. — View Citation

Wang Y, Cui Y, Chen C, Duan Y, Wu Y, Li W, Zhang D, Li F, Hou C. Stopping the supply of iodized salt alone is not enough to make iodine nutrition suitable for children in higher water iodine areas: A cross-sectional study in northern China. Ecotoxicol Environ Saf. 2020 Jan 30;188:109930. doi: 10.1016/j.ecoenv.2019.109930. Epub 2019 Nov 11. — View Citation

Xu T, Ren Z, Li S, Tan L, Zhang W. The relationship of different levels of high iodine and goiter in school children: a meta-analysis. Nutr Metab (Lond). 2021 May 3;18(1):46. doi: 10.1186/s12986-021-00563-2. — View Citation

Yang L, Wang J, Yang J, Zhang H, Liu X, Mao D, Lu J, Gu Y, Li X, Wang H, Xu J, Tan H, Zhang H, Yu W, Tao X, Fan Y, Cai Q, Liu X, Yang X. An iodine balance study to explore the recommended nutrient intake of iodine in Chinese young adults. Br J Nutr. 2020 Dec 14;124(11):1156-1165. doi: 10.1017/S0007114520002196. Epub 2020 Jun 22. — View Citation

Zimmermann MB, Boelaert K. Iodine deficiency and thyroid disorders. Lancet Diabetes Endocrinol. 2015 Apr;3(4):286-95. doi: 10.1016/S2213-8587(14)70225-6. Epub 2015 Jan 13. — View Citation

Zimmermann MB, Jooste PL, Mabapa NS, Mbhenyane X, Schoeman S, Biebinger R, Chaouki N, Bozo M, Grimci L, Bridson J. Treatment of iodine deficiency in school-age children increases insulin-like growth factor (IGF)-I and IGF binding protein-3 concentrations and improves somatic growth. J Clin Endocrinol Metab. 2007 Feb;92(2):437-42. doi: 10.1210/jc.2006-1901. Epub 2006 Nov 21. — View Citation

* Note: There are 29 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Primary urinary iodine concentration µg/L 2 weeks
Primary diet iodine intake µg/day 2 weeks
Primary urinary iodine excretion µg/day 2 weeks
Primary thyroglobulin antibody IU/mL 2 weeks
Primary salt iodine concentration µg/L 2 weeks
Primary water iodine intake µg/day 2 weeks
Primary thyroid volume ml 2 weeks
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