[Assessing of iodine consumption with iodized salt in organized nutrition of children of preschool and school age in the Tyumen region].

The territory of the Tyumen region is an endemic region with insufficient iodine content in the environment, in which, since the early 1990s, active preventive measures have been taken to increase the use of iodized salt (IS) in households, catering and the food industry. The purpose of the research was to assess the consumption of iodine with IS used in the organized nutrition of children in the Tyumen region. Material and methods. The assessment of iodine intake was carried out in preschool institutions and schools randomly selected the city of Tyumen and rural areas (village of Isetskoye). Modeling of iodine consumption in organized groups was carried out for children aged 1-3, 3-7, 7-11 and 12 years and older in urban and rural areas, respectively, using a standard menu and a technological map of dishes. Iodine intake was estimated based on the content of 40 µg of iodine in 1 g of salt and its 30% loss during cooking. Model 1 assumed the mandatory use of IS in the preparation of all salt-containing meals for preschoolers and schoolchildren. Model 2, in addition to the mandatory use of IS in school and preschool meals accounted the consumption of iodine with bakery products (BP) produced with IS. Results. The modeling showed that the average intake of iodine with meals (model 1) in preschool institutions in Tyumen was 89±16 µg/day for children aged 1-3 years. When BP with IS were included in the menu (model 2), iodine intake increased to 101±14 µg/day. In children aged 4-7 years iodine intake was 115±18 and 126±18 µg/day, respectively. In rural areas, iodine intake was lower: in children aged 1-3 years, under model 1, iodine intake was 66±3 µg/day, under model 2 - 76±4 µg/day. In children aged 4-7 years, these figures were 83±3 and 92±4 µg/day, respectively. Iodine consumption in a school in Tyumen under model 1 in children 7-11 years old was 24±5 µg/day, and in children 12 years and older - 27±6 µg/day. When BP with IS were included in the menu (model 2), iodine intake increased to 32±5 µg/day in children 7-11 years old and to 39±6 µg/day in children 12 years of age and older. In rural areas, when using model 1, iodine intake in children aged 7-11 years was 37±15 µg/day, in children aged 12 and over 40±21 µg/day. When BP with IS were included in the menu (model 2), iodine intake increased to 44±15 µg/day in children aged 7-11 years and to 50±21 µg/day in children 12 years of age and older. Conclusion. The use of IS in the preparation of salt-containing meals in preschool educational institutions of the Tyumen region fully covered the iodine requirements of preschool children, which confirms the effectiveness of the chosen strategy for the prevention of iodine deficiency and can be considered as an important part of the concept of universal salt iodization. The use of IS in preparation of school breakfast meals provides 23.5-36.9% of the recommended nutrient intake for iodine in rural schools and 15.4-26.4% of the recommended nutrient intake in urban schools, which can be a significant contribution to the total intake of this micronutrient.

[Neonatal thyrotropin - indicatior of monitoring of iodine deficiency severity. What's level is considered a «cutoff point¼?]

BACKGROUND: The issues of monitoring the effectiveness of iodine deficiency prevention programs are an important component in the process of iodine elimination. Neonatal thyrotropin (TSH) has been used as a criterion for the severity of iodine deficiency since 1994, however, the question of the "cut-off point" of the neonatal TSH level has been widely discussed in the recent literature. AIM: Evaluate the criterion for neonatal hyperthyroidism above 5 mIU/l from the perspective of monitoring iodine deficiency and establish a «cut-off point¼ on the model of healthy pregnant women with adequate iodine status. MATERIALS AND METHODS: A prospective study was conducted in a population of pregnant women in the city of Tyumen, with the formation of observation groups according to the level of iodine excretion in the urine - the main group (with adequate iodine status throughout the entire gestation period) and the comparison group (women with iodine levels less than 150 µg/l). The results of neonatal screening for congenital hypothyroidism in children of women participating in the study were evaluated. The frequency of neonatal TSH above 5mIU/l was assessed in the observation groups. ROC-analysis was performed and a «cut-off point¼ of the level of neonatal TSH was established as an indicator of iodine deficiency. RESULTS: The median urinary iodine concentration in the population of pregnant women in Tyumen was 159.05 µg/l, the incidence of goiter was 0.38%, the incidence of neonatal hyperthyroidism above 5 mIU/l was 2.88%, which characterizes adequate iodine intake in the pregnant population women. The frequency of neonatal TSH above 5 mIU/l in newborns from women from the main group was 1.47%, and in the comparison group - 9.3% (p = 0.076). ROC analysis revealed a threshold value of neonatal TSH of 2.77 mIU/l at the cut-off point, which corresponded to the highest value of the Youden index. Urinary iodine concentrations greater than 150 µg/l were predicted for nTSH values below this value. CONCLUSION: Analysis of databases of neonatal screening for congenital hypothyroidism makes it possible to effectively, quickly and at minimal cost annually assess the iodine status in the population. The established «cut-off point¼ of neonatal TSH in the model of healthy pregnant women with adequate iodine intake in our work is 2.77 mIU/l, the absence of statistically significant differences in the incidence of neonatal hyperthyroidism above 5 mIU/l from women with different iodine status during pregnancy indicate the need to revise the existing threshold of 5 mIU/l and may be an incentive to conduct large-scale studies in regions with different iodine supply.

[The role of food in prevention and correction of iodine deficiency in the endemic territory].

Iodine supply remains the global problem due to the wide prevalence and a wide range of clinical manifestations in all age groups of population. However, iodine deficiency is a nutritional deficiency and the solution of this problem lies in the organization of rational nutrition of the population. The purpose of this study was to examine the food features of the population of the mild iodine-deficient region from the standpoint of adequacy of iodine sufficiency. The analysis of nutrition of the population of Tyumen Region in 2005 and 2016 was carried out according to official statistics of Tyumenstat; results of sanitary-hygienic and biomedical monitoring for the period from 1994 to 2016. A sociological study was conducted on a representative nested sample using the questionnaire method. The study involved schoolchildren (n=744) and their parents (n=677), students and full-time students (n=623). Probabilistic was sampling and nesting. Statistical sampling error does not exceed 4%. Analysis of the level of food consumption by residents of the Tyumen region over the period from 2005 to 2016 showed an increase in consumption per capita of fish and fish products (from 23.8 kg in 2005 to 33.1 kg in 2016 at recommended level of 22 kg). At the same time, a sociological study showed that only 1-4% of the population consumed iodine-rich products daily and only 53% of respondents regularly used iodized salt. The analysis of the results of biomedical monitoring over the 20-year period of the existence of preventive programs in the Tyumen region showed significant improvements in the situation in the region: median of ioduria increased significantly from 77 to 125 µg/l and the incidence of goiter in pre-pubertal children decreased from 85% in 1994 to 6.8% in 2016 (р=0,001); the incidence of neonatal hyperthyrotropinemia significantly decreased from 44.3% in 1994 to 3.9% in 2017 (р=0,001). However, most indicators did not reach the target values recommended for iodine-rich region, which indicated the insufficient effectiveness of the existing voluntary prevention system. The solution of this problem is using of iodine-enriched foods of mass consumption, such as bread and bakery products.

[Assessment of the results of determination of the blood level of dehydroepiandrosterone sulfate by using various commercial reagents].

The results of determination of the blood levels of dehydroepiandrosterone (DHEA) sulfate (DHEA-S) were comparatively assessed, by using the test systems "Steroid-IEA-DHEA-sulfate" (ZAO "Alkor Bio" (Saint Petersburg, Russia)) and "DHEA-S ELISA ("DRG Instruments GmbH (Germany)). The studies were conducted in apparently healthy 19-59-year-old women living in the middle belt of Western Siberia. They revealed the high sensitivity of the study test systems to age-related changes in the blood concentration of DHEA-S. The normal blood DHEA-S concentrations levels given in the instruction to the "DHEA-S ELISA" test systems were found to be decreased in they are used to measure the content of the above analyzed parameter in women aged 19-39 years.