Higher urine volume results in additional renal iodine loss

Abstract

Background: For some endocrine and nutritional biomarkers, for example, cortisol and vitamin B(12), significant associations between 24-hour renal analyte excretion and the respective 24-hour urine volume (U-Vol) have been reported. Therefore, our objective was to investigate whether 24-hour U-Vol (a marker of fluid intake) is also a relevant influencing factor of absolute daily iodine excretion.

Methods: Urinary iodine excretion rates were measured in repeatedly collected 24-hour urine samples of (i) 9 healthy women participating in a controlled diet experiment with constant iodine intake and (ii) 204 healthy free-living adolescents (aged 13-18 years) who performed the respective urine collection during 2003-2008. Associations between U-Vol (L) and renal iodine excretion (μg/24 h) were investigated cross sectionally (multiple linear regression model, PROC GLM) and longitudinally (repeated-measures regression models, PROC MIXED). The major iodine sources in the adolescent's diet (iodized salt, milk, fish, eggs, and meat) were controlled for.

Results: Urinary iodine excretion was significantly associated with 24-hour U-Vol in all performed fully adjusted regression models. A 1-L increase of U-Vol predicted an additional 15.0 μg/day (adolescents, 95% confidence interval: [9.8, 20.0], p < 0.0001) and 16.5 μg/day (women, 95% confidence interval: [9.2, 23.7], p = 0.0002) increase in iodine excretion. The longitudinal analysis in adolescents revealed a stronger relation of iodine excretion with U-Vol in girls than in boys (β = 17.1 vs. β = 10.5).

Conclusion: A high fluid consumption, and thus a high U-Vol, could lead to an additional renal iodine loss that obviously cannot be compensated by the iodine contents of non-milk-based beverages, reported to amount to ∼4 μg/L, on average. For specific research questions using the biomarker 24-hour urinary iodine excretion, U-Vol should therefore be considered as a potential confounder.