https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5058927/
Iodine is an essential substrate for thyroid hormone production. The recommended daily intake of iodine is 150 μg.1 Excessive ingestion of or exposure to iodine is well-tolerated by the human body because of its intrinsic autoregulatory mechanisms. However, susceptible individuals, such as patients with known thyroid diseases, may fail to adapt to the iodine overload, resulting in hypo- or hyperthyroidism.2,3 The major sources of excess iodine in clinical practice are iodinated contrast medium (ICM), amiodarone, and povidone-iodine. ICM is widely used in imaging procedures, including cardiac catheterization and computed tomography (CT). A usual ICM dose for CT contains approximately 13,500 μg of free iodide and 15 to 60 g of bound iodine, several thousand times higher than the recommended daily intake dose.4,5 Bolus loading of these iodine-rich substances may induce transient or prolonged thyroid dysfunction even in patients without known thyroid disease.2 Although the use of modern diagnostic modalities with contrast has increased substantially, large nationwide studies with long-term follow-up to investigate the risk of thyroid disorder development after ICM exposure are lacking.
Hyper- and hypothyroidism increase the risk of cardiovascular diseases and associated mortality.6–13 Although the incidence rate (IR) of ICM exposure-related thyroid disorder is low, ICM is frequently used in modern diagnostic modalities and thus its occurrence becomes an important issue.
Taiwan is an iodine-sufficient area.14 For the present study, we aimed to determine the association between ICM exposure during CT and the subsequent development of thyroid disorders in patients without known thyroid disease by using the Taiwan National Health Insurance Research Database (NHIRD).
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