Breast Milk Iodine and Iodine Status of Breast-Fed Infants.

Background: Breast milk is the only source of iodine for exclusively breast-fed infants. Iodine status of breast-fed infants depends on iodine in breast milk and also number of feeding in 24 hours. Iodine deficiency and iodine excess both have bad impact on infant’s health. Objective: To measure the iodine in breast milk and to evaluate iodine status of their breast-fed infants. Materials and method: This observational analytical study was carried out in the department of Biochemistry, Bangabandhu Sheikh Mujib Medical University, Dhaka with active cooperation of Kumudini Women’s Medical College Hospital, Mirzapur, Tangail involving fifty lactating mothers and their exclusively breast-fed infants. Early morning urine and breast milk samples were collected in dry and clean plastic container free from any chemical contamination. Urinary iodine was used as indicator for assessing iodine status. All statistical analyses were done by using SPSS (statistical programme for social science) 12 version software package for Windows. Results: The median (range) urinary iodine concentration of lactating mothers and their breast-fed infants were 225.25 μg/L (61.50-530.00) and 225.75 μg/L (100.50-526.00) respectively. The median (range) breast-milk iodine concentration was 157 μg/L (54.50-431.50) which was more than three times of recommended minimum concentration (50 μg/L). Only 2 (4%) lactating mothers had mild biochemical iodine deficiency (UIE, 50-99 μg/L). There was no biochemical iodine deficiency of breast-fed infants. Iodine in breast milk of lactating mothers was positively correlated with their urinary iodine excretion (p<0.01). Infant’s urinary iodine was positively correlated with iodine concentration in breast milk (p<0.01) and with urinary iodine of lactating mothers (p<0.01). Conclusion: Lactating mothers and their breast-fed infants in this study were iodine sufficient. If iodine content of breast-milk is within normal range, 10-12 numbers of feeding in 24 hours for infants is enough to get sufficient iodine from their mother’s milk.

Diabetic Retinopathy and Homocysteine in Newly Diagnosed Type 2 Diabetes Mellitus.

Background: Diabetic retinopathy is the commonest complication that occurs from the very beginning in patients with diabetes mellitus (DM). DM itself leads to increased homocysteine (Hcy) level. It is postulated that hyperhomocysteinaemia causes retinal vascular damage as Hcy is an established vasculotoxic agent and auto-oxidation of Hcy leads to oxidative stress, endothelial dysfunction, platelet activation and thrombus formation. Objective: The aim of the study was to evaluate the serum Hcy in newly diagnosed type 2 diabetic subjects with diabetic retinopathy. Materials and method: A case control study was carried out in the department of Biochemistry, Bangabandhu Sheikh Mujib Medical University, Dhaka, during the period of January 2006 to December 2007. Total 85 newly diagnosed type 2 diabetic subjects were included in this study, 40 were case having retinopathy and 45 were age and sex matched control without retinopathy. Serum Hcy was measured and compared between case and control. Results: Serum Hcy level in cases was significantly higher (p<0.05) compared to that of control (15.11±5.49 μmol/L vs. 12.59±4.01 μmol/L). Odds ratio was also determined for hyperhomocysteinemia (OR=2.23; CI 0.9-5.45). Conclusion: Hyperhomocysteinaemia is associated with diabetic retinopathy in newly diagnosed type 2 diabetes.

Serum Lipids and Diabetic Retinopathy in Newly Diagnosed Type 2 Diabetic Subjects.

Background: Diabetic retinopathy is the commonest and usually the first observable vascular complication of diabetes mellitus. Along with hyperglycaemia, dyslipidaemia is a contributing factor for the occurrence of diabetic retinopathy. It is postulated that dyslipidaemia results in formation of hard exudate by increasing blood viscosity and altering the fibrinolytic system. A case control study was carried out in the department of Biochemistry, Bangabandhu Sheikh Mujib Medical University, Dhaka during the period of January 2006 to December 2007 to evaluate the serum lipid profile in newly diagnosed type 2 diabetic subjects with diabetic retinopathy. Materials and Methods: Total 85 newly diagnosed type 2 diabetic subjects were included in this study, 40 were cases having retinopathy and 45 were age and sex matched controls without retinopathy. Serum triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) were compared between cases and controls. Unpaired t-test and chi-square test were done between groups as tests of significance. Results: All the parameters of lipid profile showed dyslipidaemic trend both in cases and controls. In the cases TG was significantly higher and HDL-C was significantly lower than that of controls (p < 0.05) whereas no significant difference was found between cases and controls with respect to serum TC and LDL-C. Conclusion: It can be concluded that high TG and low HDL-C are associated with diabetic retinopathy in newly diagnosed type 2 diabetes.

Urinary Iodine Excretion of Lactating Mothers Predicts the Iodine Content of Their Breast Milk.

Background: Iodine is essential for normal growth, mental development and survival of infants. Bangladesh is an iodine deficient region. Breast milk is the only source of iodine for exclusively breast-fed infants. Routine measurement of breast milk iodine concentration is very difficult in our country due to some social and religious barriers. So, we designed this study in our population using urinary iodine as the indicator for assessing iodine status. Objectives: To assess the iodine status of lactating mothers and their breast-fed infants and to propose a method on how to predict the iodine concentration in breast milk. Materials and Methods: This observational analytical study was carried out in the department of Biochemistry, Bangabandhu Sheikh Mujib Medical University, Dhaka with active cooperation of Kumudini Women’s Medical College Hospital, Mirzapur, Tangail involving fifty lactating mothers and their exclusively breast-fed infants. Early morning urine and breast milk samples were collected in dry and clean plastic container free from any chemical contamination. All statistical analyses were done by using SPSS (Statistical Programme for Social Science) 12 version software package for windows. Results: The median (range) urinary iodine concentration of lactating mothers and their breast-fed infants were 225.25 μg/L (61.50-530.00) and 225.75 μg/L (100.50-526.50). 96% (48) mothers had no biochemical iodine deficiency (UIE ≥100μg/L), only 4% (2) mothers had mild biochemical iodine deficiency (UIE 50-99μg/L). There was no biochemical deficiency of breast-fed infants. The median (range) breast-milk iodine concentration was 157 μg/L (54.50-431.50) which was more than three times of recommended minimum concentration (50 μg/L). Iodine in breast milk of lactating mothers positively correlated with their urinary iodine excretion (P<0.01). Infant’s urinary iodine positively correlated with iodine concentration in breast milk (P<0.01) and also positively correlated with urinary iodine excretion of lactating mothers. Conclusion: Lactating mothers and their breast-fed infants in this study were found iodine sufficient. Urinary iodine concentration of lactating mothers predicts the iodine content of their breast milk.