Urinary iodine concentration (UIC) could be a promising biomarker for predicting goiter among school-age children: A systematic review and meta-analysis

OBJECTIVES To evaluate whether urinary iodine concentration (UIC) can predict goiter among school-age children, and to assess the association between UIC and goiter prevalence. METHODS We searched the MEDLINE, EMBASE, Cochrane Library (Cochrane Database of Systematic Reviews), Web of Science, CNKI, VIP, and Wan Fang databases for relevant reports in both English and Chinese up to August 25, 2016. The mean differences (MD) and 95% confidence intervals (CI) were calculated for the UIC and goiter prevalence assessments. Pooled odds ratios and 95% CIs were used to compare the prevalences of goiter in the different UIC groups. RESULTS We identified 11 case-control studies, and found that children with goiter had lower UIC values, compared to children without goiter (MD: -1.82, 95% CI: -3.24, -0.40, p < 0.05). An increased risk of goiter was associated with UIC values of < 20 μg/L or > 200 μg/L. CONCLUSION The results of our meta-analysis suggest that lower UIC values were associated with an increased risk of goiter, and that iodine deficiency may lead to an increased risk of goiter. Furthermore, we observed U-shaped relationships between UIC and the prevalence of goiter, which suggests that both severe iodine deficiency and excessive iodine intake may lead to increased risks of goiter.