Journal of the Chinese Medical Association : JCMA · 2026
Empirical comparison of iodine excretion estimated from spot urine samples with measured 24-hour urinary iodine excretion in healthy adults.
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Huang Chun-Jui, Chen Yi-Wen, Yang Shun-Jie, Li Jia-Zhen, Hwu Chii-Min, Chen Harn-Shen, Wang Fan-Fen, Yang Chen-Chang
Аннотация
BACKGROUND: Ideally, 24-hour urine collections are the reference standard for assessing iodine status. While median urinary iodine concentration (UIC) from spot samples has commonly replaced 24-hour collections for assessments of iodine status within populations, the validity of spot samples remains unclear. This study aimed to validate the estimated 24-hour urinary iodine excretion (e24-h UIE) derived from spot urine samples as an alternative to actual 24-hour urinary iodine excretion (24-h UIE).
METHODS: Healthy volunteers aged ≥18 years without thyroid or kidney diseases were recruited from National Yang Ming Chiao Tung University and Taipei Veterans General Hospital, Taiwan. Participants were recruited from a pool of university students, hospital staff, local vendors, and their social networks. Each participant provided one 24-hour urine sample, and two-spot urine samples collected immediately before and after the 24-hour period. UIC was measured using inductively coupled plasma mass spectrometry. The e24-h UIE was calculated from spot urine UIC and creatinine (Cr) concentrations, adjusted by anthropometry-based predicted 24-hour Cr excretion.
RESULTS: Twenty-three healthy adults (mean age: 36.4 ± 10.1 years, 60.8% men) were enrolled between September 2022 and May 2024. Median e24-h UIE (154.3 μg/d, interquartile range [IQR] 114.2-201.2) did not differ significantly from measured 24-h UIE (158.3 μg/d, IQR 106.7-213.7; Pearson's r = 0.44, indicating a moderate correlation, p = 0.003). Passing-Bablok regression and Bland-Altman analysis indicated good agreement between methods, with a mean difference of 6.8 μg/d (regression line: Y = 0.92 × X + 9.53).
CONCLUSION: These findings suggest that e24-h UIE from spot samples reasonably estimates actual 24-h UIE, offering a practical alternative to avoid the inconvenience of complete 24-hour urine collections.
METHODS: Healthy volunteers aged ≥18 years without thyroid or kidney diseases were recruited from National Yang Ming Chiao Tung University and Taipei Veterans General Hospital, Taiwan. Participants were recruited from a pool of university students, hospital staff, local vendors, and their social networks. Each participant provided one 24-hour urine sample, and two-spot urine samples collected immediately before and after the 24-hour period. UIC was measured using inductively coupled plasma mass spectrometry. The e24-h UIE was calculated from spot urine UIC and creatinine (Cr) concentrations, adjusted by anthropometry-based predicted 24-hour Cr excretion.
RESULTS: Twenty-three healthy adults (mean age: 36.4 ± 10.1 years, 60.8% men) were enrolled between September 2022 and May 2024. Median e24-h UIE (154.3 μg/d, interquartile range [IQR] 114.2-201.2) did not differ significantly from measured 24-h UIE (158.3 μg/d, IQR 106.7-213.7; Pearson's r = 0.44, indicating a moderate correlation, p = 0.003). Passing-Bablok regression and Bland-Altman analysis indicated good agreement between methods, with a mean difference of 6.8 μg/d (regression line: Y = 0.92 × X + 9.53).
CONCLUSION: These findings suggest that e24-h UIE from spot samples reasonably estimates actual 24-h UIE, offering a practical alternative to avoid the inconvenience of complete 24-hour urine collections.