{"id":"90eb5283-e50b-58df-8fd4-486f42f19180","stable_key":"aaa7baba-8689-56ab-ba1e-b71542bcb8e9:iod-clin-dual-salt-thyroxine","predicate":"cofortification-increases","statement":"Serum thyroxine was higher with dual-fortified salt than with iodized salt alone (P<0.05), with lower reported hypothyroidism and goiter prevalence (P<0.01).","claim_class":"observational","status":"source_derived_draft","evidence_grade":"ungraded","direction":"positive","is_public":true,"mechanism_event_id":"425577cd-859a-5c56-bda0-9a51d0b4a717","mechanism_event_label":"This iron–iodine trial also found a hormone response.","subject":{"id":"89bcaf42-b4ab-5760-8c2e-44eace10cee0","slug":"iron","display_name":"Iron","entity_type_key":"nutrient_element"},"object":{"id":"90c33fc7-1fee-5949-a863-a7848a22123f","slug":"serum-total-t4-concentration","display_name":"Serum total thyroxine concentration","entity_type_key":"cellular_process"},"evidence_count":1,"mechanism_event":{"id":"425577cd-859a-5c56-bda0-9a51d0b4a717","stable_key":"aaa7baba-8689-56ab-ba1e-b71542bcb8e9:iod-clin-dual-salt-thyroxine-event","event_type":"observed_intervention","label":"This iron–iodine trial also found a hormone response.","description":"Serum thyroxine was higher with dual-fortified salt than with iodized salt alone (P<0.05), with lower reported hypothyroidism and goiter prevalence (P<0.01).","status":"provisional","compartment":null,"participants":[{"entity":{"id":"0e0ac6d1-3336-506a-9f69-5838ca1500ed","slug":"iodine","display_name":"Iodine","entity_type_key":"nutrient_element"},"role":"co-supplied nutrient","stoichiometry":null,"state_label":"","sequence_order":0,"notes":""},{"entity":{"id":"f20cb550-cb6b-5eab-a4d7-27537a5eb14b","slug":"ferrous-sulfate","display_name":"Ferrous sulfate","entity_type_key":"chemical_species"},"role":"iron preparation","stoichiometry":null,"state_label":"","sequence_order":1,"notes":""},{"entity":{"id":"2d1c1d41-eea1-5a33-9312-e1e94bcb2a15","slug":"iodized-salt","display_name":"Iodized salt preparation","entity_type_key":"chemical_species"},"role":"fortified food","stoichiometry":null,"state_label":"","sequence_order":2,"notes":""},{"entity":{"id":"f2b25f38-ec94-57d0-a46d-dd0fee45f01e","slug":"thyroxine","display_name":"T4","entity_type_key":"small_molecule"},"role":"measured hormone","stoichiometry":null,"state_label":"","sequence_order":3,"notes":""},{"entity":{"id":"079989e5-363b-572f-88a3-5ab9cc177694","slug":"goiter-prevalence","display_name":"Goiter prevalence","entity_type_key":"cellular_process"},"role":"additional reported clinical endpoint","stoichiometry":null,"state_label":"","sequence_order":4,"notes":""},{"entity":{"id":"89bcaf42-b4ab-5760-8c2e-44eace10cee0","slug":"iron","display_name":"Iron","entity_type_key":"nutrient_element"},"role":"subject","stoichiometry":null,"state_label":"","sequence_order":5,"notes":""},{"entity":{"id":"90c33fc7-1fee-5949-a863-a7848a22123f","slug":"serum-total-t4-concentration","display_name":"Serum total thyroxine concentration","entity_type_key":"cellular_process"},"role":"target","stoichiometry":null,"state_label":"","sequence_order":6,"notes":""}]},"contexts":[{"dimension":"availability_state","value_text":"nutrient_deficiency","comparator":null,"unit":null,"notes":"Imported condition classification; unverified.","entity":null},{"dimension":"cross_nutrient","value_text":"true","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"evidence_location","value_text":"Primary indexed abstract.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"experimental_model","value_text":"Nine-month randomized double-blind controlled trial in 377 goitrous children aged 6–15 with high anemia prevalence","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"exposure","value_text":"Iodized salt 25 micrograms iodine/g versus dual-fortified salt with the same iodine plus 1 mg iron/g as microencapsulated ferrous sulfate; 40-week measurements.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"limitations","value_text":"Clinical intervention and thyroid endpoints do not identify the exact iron-dependent step. Iodized-salt-only participants also improved. Related publications from this cohort are not independent trials. The abstract does not provide the exact between-group thyroxine effect size. The two iron trials have distinct populations and endpoints; their hormone results are not declared a contradiction.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"nutrient_topic","value_text":"Iodine research collection; topical membership is not evidence of a direct dietary effect.","comparator":null,"unit":null,"notes":"","entity":{"slug":"iodine","display_name":"Iodine","entity_type_key":"nutrient_element"}},{"dimension":"organism","value_text":"Homo sapiens","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"plain_language","value_text":"This iron–iodine trial also found a hormone response.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"primary_references","value_text":"[iod-clin-zimmer2002] Addition of microencapsulated iron to iodized salt improves the efficacy of iodine in goitrous, iron-deficient children: a randomized, double-blind, controlled trial. (2002). https://pubmed.ncbi.nlm.nih.gov/12457449/ DOI: 10.1530/eje.0.1470747","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"tissue_or_cell_type","value_text":"Thyroid volume, circulating thyroxine and iron indices","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"trigger_kind","value_text":"nutrient_deficiency","comparator":null,"unit":null,"notes":"Imported condition classification; unverified.","entity":null}],"evidence":[{"id":"21badfec-8c3d-5830-983d-4a9ff3ba2b74","evidence_kind":"source_excerpt","locator":"Lines 1244-1256","start_line":1244,"end_line":1256,"excerpt":"### iod-clin-dual-salt-thyroxine\nSerum thyroxine was higher with dual-fortified salt than with iodized salt alone (P<0.05), with lower reported hypothyroidism and goiter prevalence (P<0.01).\nCondition category: nutrient_deficiency\nnutrient_topic: Iodine research collection; topical membership is not evidence of a direct dietary effect.\nplain_language: This iron–iodine trial also found a hormone response.\norganism: Homo sapiens\ntissue_or_cell_type: Thyroid volume, circulating thyroxine and iron indices\nexperimental_model: Nine-month randomized double-blind controlled trial in 377 goitrous children aged 6–15 with high anemia prevalence\nlimitations: Clinical intervention and thyroid endpoints do not identify the exact iron-dependent step. Iodized-salt-only participants also improved. Related publications from this cohort are not independent trials. The abstract does not provide the exact between-group thyroxine effect size. The two iron trials have distinct populations and endpoints; their hormone results are not declared a contradiction.\nexposure: Iodized salt 25 micrograms iodine/g versus dual-fortified salt with the same iodine plus 1 mg iron/g as microencapsulated ferrous sulfate; 40-week measurements.\ncross_nutrient: true\nevidence_location: Primary indexed abstract.\n[iod-clin-zimmer2002] Addition of microencapsulated iron to iodized salt improves the efficacy of iodine in goitrous, iron-deficient children: a randomized, double-blind, controlled trial. 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