Prevalence of thyroid dysfunction in neonates receiving parenteral nutrition in the intensive care unit

Abstract Objective: The use of parenteral nutrition (PN) formulations that do not contain iodine can contribute to the deficiency of this mineral, potentially leading to hypothyroidism and, ultimately, neurocognitive impairments. This study aimed to evaluate TSH alterations in newborns receiving PN. Methods: Retrospective study of neonatal intensive care unit patients receiving PN for > 15 days. Nutritional, anthropometric, and biochemical variables (TSH, T4, CRP) were analyzed. Hypothyroidism was defined by TSH > 10 mU/L. Results: Two hundred newborns were evaluated [156 (78%) preterm, 31±5 weeks of gestational age, 112 (56%) with very or extremely low birth weight]. The median (IQR) hospital stay was 68 (42-110) days, PN duration was 31 (21-47) days, and 188 (94%) patients also received enteral nutrition. Overall, 143 (71.5%) newborns underwent at least one TSH measurement. The prevalence of hypothyroidism was 10.5%. The Median PN duration in this group was 51 (34-109) days. Among those with hypothyroidism, 10 received Lugol's solution and six levothyroxine. Thirteen patients received prophylactic Lugol's solution with a median PN duration of 63 (48-197) days. TSH levels correlated positively with PN duration (r = 0.19, p = .02). Conclusions: The present data suggest that changes in TSH and T4 levels are present in neonates receiving PN for > 15 days, suggesting this population may be at risk for developing hypothyroid-ism. Therefore, the authors suggest that TSH and T4 measurements should be included as routine in neonatal patients receiving PN for > 15 days if PN formulations are not supplemented with iodine, and that iodine supplementation be provided as necessary.

Assessing the iodine status of children, availability and awareness of iodised salt, use of salty condiments and flavoring in households in Zia community, Huon District, Morobe Province Papua New Guinea

@#The strategy of fortifying food grade salt with iodine has been globally successful in increasing iodine intake and significantly reducing the prevalence of iodine deficiency. In addition, the consumption of salt through processed foods is increasing in many countries. The major objectives of the current study were to assess the iodine nutritional status among school children, the availability and awareness of iodized salt, the use of salty condiments and flavorings in households in a remote Zia community. This was a school and community based prospective cross-sectional study carried out in February 2020. The study population included 6 to 12 years old school children in five schools in Zia. Simple random sampling was used to select the children. Salt samples were collected from randomly selected households in the community. Discretionary salt intake was also assessed in a sub-set of households. The size of the thyroid gland of the children was assessed by a single specialist endocrinologist using the standardized procedure for palpation and grading, after which a single urine sample was collected from the children after obtaining informed consent from their parents. A pre-tested questionnaire was used to assess the awareness and use of iodized salt in the households. The iodine content in salt samples was measured using the single wavelength semi-automated WYD Iodine Checker Photometer. The urinary iodine concentration (UIC) was measured by isotopic dilution, using 129I as a spike. The 127I/129I ratio was measured by Inductively Coupled Plasma Mass Spectrometry (ICPMS) (quadrupole ICP-MS iCap). The volume of urine required per run was 0.3ml. The mean iodine content of the salt samples from the Households was 31.7 ± 5.9mg/kg. The daily per capita discretionary intake of salt was 5.7 ± 2.2g. The calculated per capita discretionary intake of iodine was 126.5 ± 48.8μg per day. The Median UIC among the children was 147.5μg/L, which indicates normal iodine status at the time of this study. A total of 44.5% of all the children had palpable goiter (grade 1). This may indicate long-standing prevalence of mild status of iodine deficiency. Majority of the households (93.9%) used Maggi Kakaruk stock cubes to make their food salty compared to 90.9% that used salt. Instant noodles/2-minute noodles are the best wheat based alternative processed foods that should be fortified with iodine. Salt and Maggi Kakaruk stock cubes are the two optimal food vehicles for fortification with iodine in this remote community.

Survey on iodine deficiency disorders awareness, education status and willingness of pupils in Guizhou Province / 中华地方病学杂志

Objective:To learn about the awareness, education status and willingness of iodine deficiency disorders (IDD) among elementary school students in Guizhou Province, and to provide a scientific basis for exploring intervention strategies for health education of iodine deficiency in the future.Methods:From June 2021 to May 2022, each IDD monitoring county was selected from the east, south, west, north and middle directions of Guizhou Province, and one elementary school was selected from each county. All students in two classes of Grade 5 and Grade 6 were selected in whole groups to conduct on-site questionnaire surveys in the form of anonymous examinations. The survey mainly included general demographic information and IDD awareness, education status and willingness, and binary logistic regression was used to analyze the relevant influencing factors.Results:A total of 1 259 elementary school students in Guizhou Province were investigated, the rates of awareness of IDD, acceptance of IDD publicity and education, and willingness to accept IDD publicity and education among elementary school students were 37.7% (1 900/5 036), 25.1% (316/1 259) and 69.6% (876/1 259), respectively. By binary logistic regression analysis, gender, residence, grade and father's education level were the influencing factors of pupils' awareness of iodine deficiency ( P < 0.05); residence, age and father's education level were the influential factors of elementary school students receiving iodine deficiency education ( P < 0.05); gender, residence, ethnicity and whether the child was the only child or not were the influential factors of elementary school students' willingness to accept IDD education ( P < 0.05). Conclusions:The elementary school students in Guizhou Province have insufficient knowledge about IDD. The publicity and education for iodine deficiency prevention is limited, and the students' willingness to learn is not high. The publicity, education and intervention for iodine deficiency prevention among elementary school students should be comprehensively strengthened.

A cross-sectional study of iodine nutrition status in pregnant women in Zhejiang Province in 2021 / 中华地方病学杂志

Objective:To evaluate the current situation of prevention and control of iodine deficiency disorders (IDD), and to describe the iodine nutrition level of pregnant women in key population in Zhejiang Province.Methods:In 2021, a cross-sectional survey on iodine nutrition status of the population was conducted in all 90 counties (cities, districts) in Zhejiang Province. Each county (city, district) was divided into five districts: east, west, south, north, and central. One township (street) was selected from each district, and 20 pregnant women were selected from each township (street) to collect edible salt samples and one random urine sample for salt and urinary iodine testing. The above indicators were stratified and analyzed according to urban, rural, coastal, inland, early pregnancy, mid pregnancy, and late pregnancy.Results:A total of 9 679 pregnant women's salt samples were tested, with a salt iodine content of (20.2 ± 9.2) mg/kg, an iodized salt coverage rate of 84.2% (8 153/9 679), and a qualified iodized salt consumption rate of 80.4% (7 785/9 679). Among them, the qualified iodized salt consumption rate of pregnant women in coastal areas was 69.4% (3 175/4 575), significantly lower than that in inland areas [90.3% (4 610/5 104)]; and the proportion of non iodized salt consumption in coastal areas [25.8% (1 181/4 575)] was significantly higher than inland areas [6.8% (345/5 104)]. A total of 9 679 pregnant women's urine samples were tested, with a median urinary iodine of 133.0 μg/L ( < 150 μg/L). In urban areas, the median urinary iodine (129.8 μg/L) was lower than that in rural areas (135.0 μg/L). Likewise, the median urinary iodine was 126.0 μg/L, lower than inland areas (140.3 μg/L). And as pregnancy progressed, the iodine nutrition level of pregnant women gradually decreased (the median urinary iodine: 137.0 μg/L in early pregnancy, 134.1 μg/L in mid pregnancy, and 129.4 μg/L in late pregnancy).Conclusion:In 2021, pregnant women in Zhejiang Province are in a state of iodine deficiency, and there is a greater risk in urban areas compared to rural areas and coastal areas compared to inland areas.

Exploring the Status of Iodine Deficiency Disorders Control Program in Nagaland

Globally, 1.9 billion individuals have inadequate iodine nutrition, of whom 285 million are school?aged children. Universal salt iodization is the favored preventive strategy for iodine deficiency disorders (IDD), the single largest cause of preventable mental retardation. Two thousand and twenty estimates show nearly 1 billion people do not consume iodized salt. When at least 90% of households consume adequately iodized salt (?15 ppm), a country is said to have attained USI. Only 23 countries had household coverage of 90% or higher. India has a household coverage of 76.3%. One 67 million people are at risk of IDD, 54 million suffer from goiter, and 2 million from cretinism. Yearly, 9 million pregnant women and 8 million newborns are at risk. Nagaland, with the second highest coverage of iodized salt in India, the study aims to assess the state?specific approach, track various mitigating measures that effectively sustained the gains of the program.

Sal rosa do Himalaia: determinação do teor de iodo, pesquisa de corantes e avaliação da rotulagem / Himalayan pink salt: iodine, colorants research and labeling evaluation

Introdução: O sal rosa do Himalaia tem se destacado no mercado brasileiro por sua coloração atrativa, além dos apelos ao consumidor que o destacam como um produto "mais natural" e com grande diversidade de minerais por ser um sal de rocha. O teor de iodo no sal rosa consumido no país ainda é pouco discutido, mas vital para manter sob controle os distúrbios por deficiência de iodo (DDI).  Objetivo: Avaliar amostras de sal rosa do Himalaia quanto aos teores de iodo, à presença de corantes e à rotulagem. Método: Foram analisadas 71 amostras em 13 cidades do estado de São Paulo para determinação de iodo adicionado na forma de iodato, prova qualitativa para corantes artificiais e avaliação da rotulagem com base na legislação brasileira. Resultados: Um elevado índice de  insatisfatoriedade dos teores de iodo foi encontrado (56%) e um percentual ainda maior nos sais comercializados a granel (74%). Verificou-se que, dentre as amostras insatisfatórias, o maior percentual de inadequação (28%) foi a ausência de iodo, colocando a população consumidora deste produto em risco para as DDI. A irregularidade de rotulagem mais encontrada foi a ausência da declaração da adição de iodo (46%), com contradições entre a declaração no rótulo e a efetiva presença avaliada analiticamente. Foram verificadas expressões de qualidade não previstas (27%) ou superlativas (14%), assim como alegações não comprovadas por estudos científicos, como a redução de 60% de sódio e a presença de 84 minerais. Nenhuma amostra apresentou adição de corante. Conclusões: O sal rosa do Himalaia analisado apresentou irregularidades importantes para a saúde da população, em especial quanto ao teor de iodo, mas também não conformidades de rotulagem que comprometem o acesso à informação correta sobre o produto.

Introduction: Himalayan pink salt has stood out in the Brazilian market for its attractive colors, in addition to appeals to the consumer that highlight it as a "more natural" product and with a great diversity of minerals as it is a rock salt. The iodine content in pink salt consumed in the country is still little discussed, but vital to keep Iodine Deficiency Disorders (DDIs) under control. Objective: Evaluate Himalayan pink salt samples for iodine contents, presence of artificial colorants and labeling. Method: Seventy-one samples from thirteen cities of the São Paulo State were analyzed for determination of iodine added as iodate, qualitative testing colorants, and labeling evaluation based on Brazilian legislation. Results: A high rate of unsatisfactory iodine content was found (56%), even higher in salts sold in bulk (74%). It was found that among the unsatisfactory samples, the highest percentage of inadequacy (28%) was the absence of iodine, exposing the consumers of this product at risk for DDIs. The most frequent labeling irregularity was the absence of iodine declaration (46%), with contradictions between label declaration and effective presence evaluated analytically. Unforeseen (27%) or superlative (14%) quality expressions were verified, as well as claims not supported by scientific studies, such as 60% reduction in sodium and presence of 84 minerals. No sample showed colorants addition. Conclusions: Himalayan pink salt samples analyzed showed important irregularities for health of the population, especially regarding the iodine content, but also labeling inaccuracies that compromise access to correct information about the product.

Dietary diversity as a sustainable approach towards micronutrient Deficiencies in India

The silent epidemic of micronutrient deficiencies (MNDs) continues to be a major public health challenge in the developing world, including India. The prevalence of iron, iodine, zinc, vitamin A and folate deficiencies is alarmingly high worldwide. India is additionally facing a high prevalence of vitamin D and B12 deficiencies. To combat the hidden epidemic of MNDs, various governments around the world have mostly relied on supplementation or fortification-based interventions. India launched salt iodization programme in 1962 and vitamin A and iron-folate supplementation programmes in 1970. Yet, even after decades of these programmes, MNDs are still widespread in the country. Due to slow progress in alleviating the burden of most MNDs, the Government of India aims to scale up fortification-based intervention programmes. However, there are safety and effectiveness concerns with such approaches. Hence, overdependence on supplementation and fortification alone may be counterproductive. Instead, food based dietary diversification approach can be the way forward. In this article, we list the common MNDs in India, evaluate major policy interventions, discuss concerns pertaining to fortification and suggest the need for a concurrent food-based approach, in particular dietary diversification, as a long-term and sustainable strategy to address population-based MNDs.

Iodine Status of Pregnant Women in Iodine-Sufficient Regions: A Tertiary Care Unit Experience

Background: The recommended urinary iodine concentration (UIC) levels in the overall adult population is 100–199 µg/L whereas 150–249 µg/L in pregnant women. Objectives: The objective is to determine the prevalence and severity of iodine deficiency in pregnant women in Amasya, which is located in the Western Black Sea region in Turkey, where sufficient iodine levels were achieved in the normal population. Methods: In this single‑center study, we retrospectively searched hospital patient records and identified pregnant women who were assessed for iodine levels between January 2019 and January 2021. A total of 408 pregnant women were found eligible for the study. Thyroid‑stimulating hormone (TSH), free triiodothyronine, free thyroxine, antithyroid peroxidase antibodies, and antithyroglobulin antibodies in serum samples and UIC were evaluated and compared between the trimesters. Insufficient iodine intake in pregnancy was defined as UIC <150 µg/L. Results: Median UIC and median TSH levels were 129 (range 45–452) µg/L and 2.98 (range 0.01–71.2) µIU/ml, respectively. 81.1% of pregnant women had UIC <150 µg/L. Iodine intake was adequate in 17.4% of pregnant whereas excessive in 1.5%. Prevalence of iodine deficiency during 1st, 2nd, and 3rd trimesters were 82.1%, 82.4%, and 74.5%, respectively. There was no significant difference in UIC levels between trimesters (P = 0.399). 72.9% of pregnant womens had TSH >2.5 mIU/L in the 1st trimester. Conclusion: Iodine deficiency in pregnancy may exist in an iodine‑sufficient population. Appropriate measures must be taken to ensure sufficient iodine levels in these individuals.

Study results of the prevalence for thyroid disorders / Монголын Анагаах Ухаан

Introduction@#Among the endocrine, nutritional, and metabolic disease and thyroid disorders occupy a significant place. According to the World Health Organization, 8-18% of the world’s population suffer from thyroid disorders. In our country, no research on the prevalence of the disorders has been conducted before, and this research methodology was discussed by the Scientific committee of the National Center for Public Health and was approved by resolution No.156 of the Ethics Committee of the Ministry of Health on 2020. @*Materials and Methods@#In order to determine the prevalence of thyroid disease in the country, we collected the actual number of thyroid disorders registered in 9 districts of the capital city and 330 soums of 21 aimags for a total of 10 years from 2011 to 2020. The prevalence of thyroid disorders was mapped using Arc view and GIS software.@*Results@#Endocrine, nutritional and metabolic disease account for 2.3% of all outpatient cases. Endocrine, nutritional, and metabolic disease accounted for an average of 168.3 per 10000 population over the past 10 years, and thyroid disorders accounted for 45 or 26.7% of endocrine, nutritional, and metabolic diseases. Thyroid disorders are highest in people aged 40-49 years. </br>Thyroid toxicity is the most common type of thyroid disease in Mongolia, accounting for 56.2%, with an average of 17.2 per 10000 population in 2011-2020. However, iodine deficiency-related thyroid disease accounts for 5.5% of all thyroid disorders, with an average of 2.5 per 10000 population in 2011-2020. In 2011, it decreased by 2.2 per 10000 population, and by 2020, it decreased by 0.2 per thousand to 2.0, but in the last 5 years, it has increased by an average of 2.4 per 10,000 population, and in the last 5 years it has increased by 0.2 per thousand, or 2.6 per 10,000 population. Morbidity is high in the Khangai and Central regions.

Research progress on the relationship between iodine, thyroid function and lipid metabolism / 中华地方病学杂志

Iodine is an essential component of thyroid hormone biosynthesis. It plays an important role in the growth, development, maturation and the function of organs and systems. Epidemiological and animal studies have shown that the effect of iodine on human body is bidirectional. Insufficient and excessive intake of iodine will cause adverse consequences and affect human health. At present, the research on the harm of iodine nutritional abnormalities to human health mostly focuses on morphology and function of thyroid. In fact, iodine nutritional abnormalities not only affect thyroid, but also have many adverse effects on other aspects of the body. There is evidence of a link between abnormal iodine nutrition, dyslipidemia and cardiovascular disease, which will lead to abnormal levels of triglycerides, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol in the body. This paper reviews the research progress on the relationship between iodine nutrition, thyroid function and body lipid metabolism, in order to provide a theoretical basis for the "scientific and precise" prevention and treatment of iodine deficiency disorders in China.

Iodine nutrition and goiter prevalence among children at ages of 8 to 10 years in Zhejiang Province / 预防医学

Objective@#To investigate the status of iodine nutrition and prevalence of goiter among children at ages of 8 to 10 years in Zhejiang Province in 2021, so as to provide insights into the management of iodine deficiency in children.@*Methods @#A total of 90 counties (districts) were sampled as field survey sites from 11 cities of Zhejiang Province using a multi-stage stratified random sampling method in 2021, and non-residential children at ages of 8 to 10 years in these sites were sampled as study subjects. Subjects' household edible salt samples and random urine samples were collected. The iodine content in salt and urinary iodine level were determined using the direct titration method and arsenic-cerium catalytic spectrophotometry for evaluation of iodine nutrition among children. In addition, the lateral lobe of the thyroid gland was measured using ultrasound, and the prevalence of goiter was estimated. @*Results@#A total of 19 363 children were recruited, including 9 710 male children and 9 653 female children, with a male to female ratio of 1.01︰1, and there were 10 704 urban children (55.28%) and 8 659 rural children (44.72%), 9 149 children living in coastal areas (47.25%) and 10 214 children in inland regions (52.75%). The mean iodine content was (19.79±9.25) mg/kg in salt, and the coverage of qualified iodized salt (15 252) was 78.77%. The coverage of qualified iodized salt was significantly lower in urban children than in rural children (76.70% vs. 81.21%; χ2=68.301, P<0.001), and was lower in children living in coastal regions than in inland regions (68.05% vs. 88.27%; χ2=1 270.769, P<0.001). The median urinary iodine concentration was 195.1 μg/L, and the household iodine content in salt correlated positively with urinary iodine concentration in children (rs=0.383, P<0.001). There were 2 885 children with iodine deficiency (14.90%), 7 137 children with adequate iodine (36.86%), 5 414 children with excessive iodine intake (27.96%), and 3 927 children with iodine overdose (20.28%), and the distribution of iodine nutrition in children varied significantly in regions (χ2=283.277, P<0.001) and gender (χ2=126.349, P<0.001). The prevalence of goiter was 2.45% among 7 195 children receiving ultrasound examinations, and a higher prevalence rate of goiter was detected in urban children than in rural children (2.76% vs. 2.00%; χ2=3.962, P=0.047). @*Conclusions @#The overall urinary iodine nutrition was adequate among children at ages of 8 to 10 years in Zhejiang Province in 2021, and the prevalence of goiter in children fell within the threshold defined in the criteria of elimination of iodine deficiency. However, the supervision of the iodized salt quality remains to be improved and iodine deficiency control remains to be reinforced.

Nutritional status of iodine in pregnant and non-pregnant adolescents assisted at the Family Health Strategy in Vespasiano, MG / Estado nutricional de iodo em adolescentes gestantes e não gestantes assistidas na ESF em Vespasiano, MG

Abstract Objectives: to evaluate the nutritional status of iodine in pregnant adolescents, taking into account the increase in the demand for iodine during pregnancy and the absence of iodization strategies for this population. Methods: cross-sectional study conducted with 62 pregnant and 71 non-pregnant adolescents assisted in primary care. The nutritional status of iodine was determined by urinary samples. The iodine concentration in the consumed culinary salt was also evaluated. For the comparative analyses of categorical variables, the Chi-square test was used and for the continuous variables, the Kruskal-Wallis test, considering a 95% confidence interval (CI) and significance level of 5%. Results: the mean iodine concentration in household salt was 25.1 mg/kg (CI95%= 11.1-67.5 mg/kg), with higher mean content in culinary salt in the group of pregnant women (p<0.028). Regarding the nutritional status of iodine, 71% of pregnant adolescents were deficient and 29% iodine-sufficient, with significant difference when compared to 38% of deficiency and 62% of sufficiency in the control group (p<0.001). Conclusions: there was an iodic deficiency among pregnant adolescents, even in the face of higher concentrations of iode in household salt, exposing a paradox between higher consumption and lower sufficiency in this group. Thus, it is suggested to consider iodine supplementation during pregnancy, seeking to minimize the effects of this deficiency on maternal and child health.

Resumo Objetivos: avaliar o estado nutricional de iodo em adolescentes gestantes, levando-se em consideração o aumento na demanda de iodo na gestação e a ausência de estratégias de iodização para essa população. Métodos: estudo transversal realizado com 62 adolescentes gestantes e 71 não gestantes assistidas na atenção primária. O estado nutricional de iodo foi determinado pela concentração de iodo em amostras urinárias. O teor de iodo no sal culinário também foi avaliado. Para as análises comparativas das variáveis categóricas utilizou-se o teste de qui-quadrado e para as variáveis contínuas o teste Kruskal-Wallis, considerando intervalo de confiança (IC) de 95% e nível de significância de 5%. Resultados: a média da concentração de iodo no sal domiciliar foi de 25,1 mg/kg (IC95%= 11,1-67,5 mg/kg), com maior teor médio no sal culinário de gestantes (p<0,028). Em relação ao estado nutricional de iodo, 71% das adolescentes gestantes mostraram-se deficientes e 29% iodo-suficientes, com diferença significativa quando comparadas aos 38% de deficiência e 62% de suficiência no grupo controle (p<0,001). Conclusões: observou-se deficiência iódica entre adolescentes gestantes, mesmo diante de maiores concentrações de iodo no sal domiciliar, expondo um paradoxo entre maior consumo e menor suficiência neste grupo. Assim, sugere-se considerar a suplementação de iodo na gestação, buscando-se minimizar os efeitos desta carência sobre a saúde maternoinfantil.

Iodine deficiency in women of childbearing age in Brazil: systematic review and meta-analysis / Deficiencia de yodo en mujeres en edad fabricante en Brasil: revisión sistemática y metanálisis

Background: Despite current policies of salt iodination, iodine deficiency is still a global public health problem, especially in women. So far, conflicting evidence has been suggested for the prevalence of iodine deficiency in Brazil. Objective: To estimate the prevalence of iodine deficiency and associated factors in women of childbearing age in Brazil. Methods: A systematic review was conducted using databases (PubMed, LILACS, WHO, Scopus, and Capes' dissertation and thesis), from inception to May 2020. Meta-analyses of proportions were performed using the variance inverse for the fixed model. Reporting and methodological quality were assessed using the Joanna Briggs Institute tool to prevalence studies. Results: Our review identified seven studies published between 2002 e 2017, including 1354 participants, especially pregnant women. All studies presented at least one quality limitation, mainly regarding the sampling method (i.e., convenience) and small sample size. The prevalence of iodine deficiency ranged among studies from 16% to 62%. In contrast, the meta-analysis identified a mean prevalence of 40% (95% confidence interval, CI 37%-43%) for pregnant women and 13% (95% CI 4%-24%) for non-pregnant women. Cumulative meta-analysis suggests a tendency of higher iodine deficiency prevalence from 2018 in pregnant women. Conclusions: Although this systematic review identified studies with poor methodological and reporting quality, a high prevalence of iodine deficiency was identified in pregnant women, reinforcing the importance of national nutritional policies for monitoring iodine status in this population. Future studies should consider random probabilistic sampling, appropriate sample size, and pre-defined subgroup analysis to adequately inform the prevalence of iodine deficiency and associated factors in women of childbearing age and support health policies

Antecedentes: A pesar de las políticas actuales de yodación de la sal, la deficiencia de yodo sigue siendo un problema de salud pública mundial, especialmente en las mujeres. Hasta ahora, se han sugerido pruebas contradictorias sobre la prevalencia de la deficiencia de yodo en Brasil. Objetivo: Estimar la prevalencia de deficiencia de yodo y factores asociados en mujeres en edad fértil, en Brasil. Métodos: Se realizó una revisión sistemática, buscando en PubMed, LILACS, OMS, Scopus y la base de datos de disertaciones y tesis de Capes desde el inicio hasta mayo de 2020. Se realizaron metanálisis de proporciones utilizando la variancia inversa para el modelo fijo. La calidad de información y metodológica se evaluó utilizando la herramienta del Institute Joanna Briggs para estudios de prevalencia. Resultados: Nuestra revisión identificó siete estudios publicados entre 2002 y 2017, incluyendo 1354 participantes, especialmente mujeres embarazadas. Todos los estudios presentaron al menos una limitación de calidad, principalmente con respecto al método de muestreo (es decir, la conveniencia) y el pequeño tamaño de la muestra. La prevalencia de la deficiencia de yodo varió entre los estudios del 16% y el 62%, mientras que el metanálisis identificó una prevalencia media del 40% (intervalo de confianza del 95%, IC 37%-43%) para las mujeres embarazadas y del 13% (IC del 95% 4%-24%) para mujeres no embarazadas. El metanálisis acumulativo sugiere una tendencia a una mayor prevalencia de deficiencia de yodo a partir de 2018 en mujeres embarazadas. Conclusiones: Si bien esta revisión sistemática identificó estudios con mala calidad metodológica y de reporte, se identificó una alta prevalencia de deficiencia de yodo en mujeres embarazadas, lo que refuerza la importancia de las políticas nutricionales nacionales para monitorear el estado de yodo en esta población. Los estudios futuros deben considerar el muestreo probabilístico aleatorio, el tamaño de muestra apropiado y el análisis de subgrupos predefinidos para informar adecuadamente la prevalencia de la deficiencia de yodo y los factores asociados en mujeres en edad fértil y para respaldar las políticas de salud

Características de las concentraciones elevadas de yoduria en escolares y adolescentes de Colombia / Characteristics of the high ioduria concentrations in schoolchildren and adolescents in Colombia

RESUMEN Objetivos: Determinar las características de las concentraciones elevadas de yoduria en escolares y adolescentes de Colombia. Materiales y métodos: Análisis secundario de la Encuesta Nacional de la Situación Nutricional en Colombia del 2015 en participantes de 5 a 17 años que incluyó la medición de yoduria. Los criterios para medir el estado nutricional del yodo se basaron en la mediana de la concentración de yodo urinario en µg/L definido por la Organización Mundial de la Salud (OMS), donde valores <100 son considerados como deficientes, entre 100-199 adecuada, 200-299 arriba de los requerimientos y >300 excesiva. Se realizaron además mediciones de razón de probabilidades a través de un análisis de regresión logística. Resultados: La mediana de yoduria nacional para escolares y adolescentes fue 406,8 µg/L y 410,8 μg/L respectivamente, mayor en el área urbana (410,5 µg/L); en la región Atlántica se encontró el mayor nivel para escolares (423,7 µg/L) y en la central para adolescentes (427,7 µg/L). El 4,4% de escolares y el 2,2% de adolescentes presentaron deficiencia y en más del 75% de la población, hubo ingesta excesiva de yodo. Los factores asociados a la ingesta excesiva de yodo en escolares fueron edad, etnia, región e índice de riqueza; y para adolescentes el sexo y área geográfica. Conclusiones: Las concentraciones de yoduria en escolares y adolescentes colombianos es superior al adecuado según OMS, la deficiencia es muy baja y se presenta un grave problema de salud pública por ingesta excesiva de yodo en tres cuartas partes de la población.

ABSTRACT Objetives: To determine the characteristics of high ioduria concentrations in schoolchildren and adolescents in Colombia. Materials and methods: Secondary analysis of the 2015 National Survey of the Nutritional Situation in Colombia in participants aged 5 to 17 years, which included the measurement of ioduria. The criteria to measure the nutritional status of iodine were based on the median urinary iodine concentration in µg / L defined by the World Health Organization (WHO), where values ​​<100 are considered deficient, between 100-199 adequate, 200-299 above the requirements and> 300 excessive. Odds ratio measurements were also performed through logistic regression analysis. Results: The national median iodine for schoolchildren and adolescents was 406.8 µg / L and 410.8 µg / L respectively, higher in the urban area (410.5 µg / L), in the Atlantic region the highest level was found for schoolchildren (423.7 µg / L) and in the central for adolescents (427.7 µg / L). 4.4% of schoolchildren and 2.2% of adolescents presented deficiency and in more than 75% of the population, there was excessive intake of iodine. The factors associated with excessive iodine intake in schoolchildren were age, ethnicity, region and wealth index, and for adolescents gender and geographic area. Conclusions: The iodine concentrations in Colombian schoolchildren and adolescents are higher than adequate according to WHO, the deficiency is very low and a serious public health problem occurs due to excessive iodine intake in three-quarters of the population.

Características de las concentraciones elevadas de yoduria en escolares y adolescentes de Colombia / Characteristics of the high ioduria concentrations in schoolchildren and adolescents in Colombia

RESUMEN Objetivos: Determinar las características de las concentraciones elevadas de yoduria en escolares y adolescentes de Colombia. Materiales y métodos: Análisis secundario de la Encuesta Nacional de la Situación Nutricional en Colombia del 2015 en participantes de 5 a 17 años que incluyó la medición de yoduria. Los criterios para medir el estado nutricional del yodo se basaron en la mediana de la concentración de yodo urinario en µg/L definido por la Organización Mundial de la Salud (OMS), donde valores <100 son considerados como deficientes, entre 100-199 adecuada, 200-299 arriba de los requerimientos y >300 excesiva. Se realizaron además mediciones de razón de probabilidades a través de un análisis de regresión logística. Resultados: La mediana de yoduria nacional para escolares y adolescentes fue 406,8 µg/L y 410,8 μg/L respectivamente, mayor en el área urbana (410,5 µg/L); en la región Atlántica se encontró el mayor nivel para escolares (423,7 µg/L) y en la central para adolescentes (427,7 µg/L). El 4,4% de escolares y el 2,2% de adolescentes presentaron deficiencia y en más del 75% de la población, hubo ingesta excesiva de yodo. Los factores asociados a la ingesta excesiva de yodo en escolares fueron edad, etnia, región e índice de riqueza; y para adolescentes el sexo y área geográfica. Conclusiones: Las concentraciones de yoduria en escolares y adolescentes colombianos es superior al adecuado según OMS, la deficiencia es muy baja y se presenta un grave problema de salud pública por ingesta excesiva de yodo en tres cuartas partes de la población.

ABSTRACT Objetives: To determine the characteristics of high ioduria concentrations in schoolchildren and adolescents in Colombia. Materials and methods: Secondary analysis of the 2015 National Survey of the Nutritional Situation in Colombia in participants aged 5 to 17 years, which included the measurement of ioduria. The criteria to measure the nutritional status of iodine were based on the median urinary iodine concentration in µg / L defined by the World Health Organization (WHO), where values ​​<100 are considered deficient, between 100-199 adequate, 200-299 above the requirements and> 300 excessive. Odds ratio measurements were also performed through logistic regression analysis. Results: The national median iodine for schoolchildren and adolescents was 406.8 µg / L and 410.8 µg / L respectively, higher in the urban area (410.5 µg / L), in the Atlantic region the highest level was found for schoolchildren (423.7 µg / L) and in the central for adolescents (427.7 µg / L). 4.4% of schoolchildren and 2.2% of adolescents presented deficiency and in more than 75% of the population, there was excessive intake of iodine. The factors associated with excessive iodine intake in schoolchildren were age, ethnicity, region and wealth index, and for adolescents gender and geographic area. Conclusions: The iodine concentrations in Colombian schoolchildren and adolescents are higher than adequate according to WHO, the deficiency is very low and a serious public health problem occurs due to excessive iodine intake in three-quarters of the population.

Implications of iodine deficiency by gestational trimester: a systematic review

ABSTRACT As pregnant women are susceptible to changes in iodine, which can cause miscarriage, goiter, thyroid nodules, hypothyroidism, in addition to fetal neurological impairment or development. The aim of this study was to verify the implications of the iodine alteration in each gestational trimester and its consequences of physiological justification. The review was based on PRISMA. Searching for articles that took place in March 2020 without delimiting data. As bases consulted were the Clinical Trials, Cochrane Library, Lilacs and Medline (PubMed). The descriptors were combined as follows: "pregnancy" AND "iodine deficiency". Articles that addressed iodine deficiency and its implications were included. The selection followed the steps of reading the titles, abstracts and full articles. To assess the methodological quality of the studies, the STROBE Instruction instrument was used. The research resulted in 1,266 studies and 11 were included. In assessing methodological quality, the lowest score was and the maximum 20. According to studies, the fourth most affected by iodine loss are the second and third, it is possible to increase the volume and pneumatic nodules, subclinical hypothyroidism, pre-eclampsia, among others. The damages caused by iodine deficiency in the first or second trimester are still reversible, therefore, they need to be diagnosed early, to guarantee an iodic homeostasis and prevent damage to the health of the mother-child binomial.

Determining the relationship between dietary iodine intake, urinary iodine excretion and thyroid functions in people with type 2 diabetes mellitus

ABSTRACT Objective Type 2 diabetes mellitus (T2DM) is a worldwide health problem, and medical nutrition therapy is essential for improving the quality of life of patients with type 2 diabetes. Salt restriction may lead to iodine deficiency in these patients. Moreover, type 2 diabetes can be an indirect reason for thyroid disorders. This study was conducted to determine the relationship between dietary iodine intake, urinary iodine excretion and thyroid functions in people with T2DM. Materials and methods Iodine nutritional status was determined by a one day 24-h dietary recall and food-frequency questionnaire. Iodine status was detemined by urinary iodine excretion with morning urine sample. Results Iodine intake according to one day 24-h dietary recall was lower in T2DM patients [94.8 (76.0-112.0) μg] than people in control group [137.1 (123.1-165.4) μg] (p < 0.05). Iodine intake determined by food-frequency questionnaire rich in iodine was lower in T2DM patients [93.1 (84.4-113.9) μg] than people in control group [140.2 (125.1-166.1) μg] (p < 0.05). Mild iodine deficiency was found in %38.8 of diabetic and %55.1 of healthy individuals (p < 0.05). No significant relationship was found between urinary iodine excretion and thyroid function tests in groups (p > 0.05). However, the relationship between dietary iodine excretion and urinary iodine intake in the diabetic group was lower than in the control group (p < 0.05). Conclusion With this respect, the results showed that while planning medical nutrition therapy for diabetic individuals, the risk of iodine deficiency should be considered.

Análise de teor de iodo em diferentes tipos de sal comercializados na cidade de Taubaté - São Paulo / Analysis of iodine content in different types of salt marketing in Taubaté - São Paulo

Objetivo ­ Determinar o teor de iodo presente em diferentes tipos de sal comercializados no município de Taubaté - SP, afim de verificar o cumprimento imposto pela RDC n. o 23, publicada no mês de abril de 2013. Métodos ­ Foi analisado o teor de iodo em cinco (5) amostras coletadas de diferentes tipos e marcas de sal comercializado no município de Taubaté ­ SP, sendo uma amostra do sal do Atacama, duas do sal do Himalaia vendidos selados com as informações da iodação, sendo um tipo moído e outro tipo grosso e duas amostras do sal do Himalaia vendido a granel, a análise foi feita através do método proposto pelo manual do Instituto Adolfo Lutz (2008). Resultados ­ Das 5 amostras analisadas, foram obtidos os seguintes resultados, 40% das amostras estão de acordo com legislação e 60% não atendem as exigências. As amostras A, B e E, sendo elas do sal do Atacama, sal do Himalaia moído e sal do Himalaia a granel II, respectivamente apresentaram valores fora do exigido pela legislação, sendo os seus resultados superiores ao limite máximo de 45 miligramas e apenas 2 amostras, C e D estão dentro do que é exigido pela RDC nº 23, de 24 de abril de 2013. Conclusão ­ Com os resultados obtidos neste trabalho evidenciaram a existência de problemas em relação à concentração de iodo em amostras comercializadas na cidade de Taubaté - SP, sendo que os 60% das amostras apresentam teor de iodo acima do recomendado, portanto não atendem e pode acarretar problemas de saúde aos consumidores, já que seu excesso está associado as doenças como hipertireoidismo, hipertensão arterial e doença de Hashimoto para a população em geral.

Objective ­ To determine the iodine content present in different types of salt sold in the city of Taubaté - SP, in order to verify the compliance imposed by RDC No. 23, published in April 2013. Methods ­ Iodine content was analyzed in five (5) samples collected from different types and brands of salt sold in Taubaté - SP, one sample from Atacama salt, two from Himalayan salt sold sealed with iodation information, one ground and one coarse type. and two samples of Himalayan salt sold in bulk, the analysis was made using the method proposed by the manual of the Adolfo Lutz Institute (2008). Results ­ Of the 5 samples analyzed, the following results were obtained, 40% of the samples are in accordance with legislation and 60% do not meet the requirements. Samples A, B and E, being from Atacama salt, ground Himalayan salt and bulk Himalayan salt II, respectively, presented values outside the required by the legislation, and their results exceeded the maximum limit of 45 milligrams and only 2 samples, C and D are within what is required by RDC No. 23 of April 24, 2013. Conclusion ­ With the results obtained in this work showed the existence of problems regarding the concentration of iodine in samples sold in the city of Taubaté - The 60% of the samples have higher than recommended iodine content, so they do not meet and may cause health problems to consumers, since their excess is associated with diseases such as hyperthyroidism, high blood pressure and Hashimoto disease for the population general.

Assessment of iodine deficiency disorders among population of district Chamba, Himachal Pradesh

Background: Iodine insufficiency is prevalent throughout the world, and is rated as one of the most significant public health concerns in more than 125 countries. Secondary to the insufficient dietary consumption of iodine, almost two billion individuals are prone to suffer from iodine deficiency disorders worldwide. The present survey was conducted in district Chamba of Himachal Pradesh in order to assess the extent of iodine deficiency disorders, 55 years after the initiation of salt iodisation programme.Methods: A cross sectional survey was conducted in district Chamba of Himachal Pradesh. A close ended pretested questionnaire was used to collect the socio-demographic information of the participants. Iodine content of salt and water was assessed with the use of I-Check and AQUA test kits in the households.Results: A total of 230 households were surveyed for the consumption of iodised salt which showed that 100% of the study population was using packet iodised salt for consumption. Majority of the population (92.6%) were placing their salt container near chulah in their kitchen and 73.5% were adding the salt in the beginning of the cooking followed by 16.1% in the middle of the cooking. Iodine content of salt sample collected revealed that 95.7% contain only 7 ppm iodine and 99.6% of the water sample contains less than 0.1 level iodine in water testing.Conclusions: The results of study indicated that population of district Chamba is using iodised salt but there is still need of strengthening of monitoring system as well as health education regarding the cooking practices in the households.

A comprehensive evaluation of the effects of health education on iodine deficiency disorders based on the fuzzy combined RSR-TOPSIS methods / 公共卫生与预防医学

Objective To comprehensively evaluate the health education effects of iodine deficiency disorders in different areas of Tianjin, and to provide a reference for improving the quality of iodine deficiency disorders health education. Methods The rank sum ratio method (RSR), TOPSIS and fuzzy combination were used to comprehensively evaluate the effect of health education intervention on iodine deficiency disorders in 16 areas of Tianjin. Results The evaluation results of RSR, TOPSIS and fuzzy combination method ranked N, D, and E areas in the last three places, while G, F, and P areas ranked first, second, and third. Combined with the RSR method, it was shown that in the evaluation of the effects of iodine deficiency health education interventions in 16 areas, the health education effect in G, F and P areas was classified as superior, the health education effect in D ,E and N areas was classified as inferior, and other areas were moderate. Conclusion The fuzzy combined RSR-TOPSIS method avoided the limitation of using either RSR or TOPSIS alone and made the conclusion more objective and accurate, and provided comprehensive quantitative results for the health education of iodine deficiency diseases in different areas of Tianjin. This fuzzy combination method objectively evaluated the intervention effect of health education in different areas, which provides a reference for improving the quality of health education for iodine deficiency disorders.