[Iodine supply of pregnant women in the Czech Republic]. / Zásobení jodem u tehotných zen v Ceské republice.

INTRODUCTION: Iodine deficiency is a global public health problem which is particularly noticeable in pregnant or breastfeeding women and their children. Even mild iodine deficiency during pregnancy can lead to damage to the developing brain and thus affecting the fetus intelligence, his cognitive and neurological function, embryogenesis and growth. PATIENTS: In the period 2010-2015 was determined by spectrophotometry at the Institute of Endocrinology the basal urinary iodine in 532 pregnant women at the age of 32 ± 5 (18-44) years, which came from Prague, Hradec Kralove and Mlada Boleslav. It was located 349 women in the first trimester, 112 in the second trimester, and 71 women in the third trimester. In the monitoring of pregnant women in the first trimester 218 basal urine samples of women were determined by mass spectrometry with inductively coupled plasma (ICP MS) in The National Institute of Public Health (NIPH). Women came from the 6 areas in the Czech Republic. Development of urinary iodine in the general population in the period 1994-2015 was observed in patients who underwent Institute of Endocrinology and from population studies conducted in 7 regions of the Czech Republic. It performed 52 648 spectrophotometric analysis of urinary iodine in the general population. METHODS: Urinary iodine was determined by alkali melting of urine samples, followed by spectrophotometric determination of iodine in the form of iodide using the Sandell-Kolthoff reaction in the Institute of Endocrinology or determination was performed by ICP-MS in the laboratory of NIPH. RESULTS: On average, only 21.8 % of pregnant women had urinary iodine values determined by spectrophotometry higher than 150 µg/L. The results of iodine nutrition of pregnant women in the first trimester analyzed using ICP-MS are better, but even so, only 50.5 % of pregnant women have urinary iodine higher than 150 µg/L. CONCLUSION: The results of iodine nutrition of pregnant women are alarming, on average, only 30 % of the total of 750 examined women have urinary iodine values greater than 150 µg/L and therefore meet the requirements of the WHO for pregnant women. Our results, however, show that iodine deficiency is not major public health problem in the general population.Key words: ICP-MS - pregnant women - Sandell-Kolthoff reaction - urinary iodine.

[Iodine supply and iodinuria among the Czech population between the years 1995 and 2016]. / Zásobení jodem a jodurie obyvatel v Ceské republice v letech 1995-2016.

Monitoring of Ioduria and Iodine saturation are essential tools for evaluation of effectivness of measures aimed at elimination of diseases caused by iodine deficiency. Between 1995 and 2016 monitoring of ioduria was udertaken in various population groups in Czech Republic. The most recent study (2015) found only 37 % of pregnant women in optimal range of ioduria (150-300 mcg/l), in iodopenic range 27 %, while 6 % of these had severe iodopenia below 50 mcg/l. In a group of 3y old children investigated in the same year, 57 % were found to have Ioduria within the recommended range (90-299 mcg/l), 24 % had higher than recommended Ioduria (300-499 mcg/l) and 8 % excessive saturation (over 500 mcg/l). Observed group of seniors (60-75 years) satisfied criteria for maintenance of elimination of iodine deficit of International Council for Control of Iodine Deficiency Disorders (ICCIDD), the advisory institution to World Health Organisation (WHO), as only 9 % of participants were found to have Ioduria less than 100 mcg/l and no participant had Ioduria below 50 mcg/l. Main challenges are currently stabilisation of Iodine content in milk and ensuring optimal saturation of pregnant and breast feeding women with Iodine. On-going ambition of the Inter-resort Commission for Solution of Iodine Deficit (MKJD) affiliated to the National Health Institute in Prague is to reduce and eventually eliminate diseases caused by Iodine deficiency or excess. Also, to achieve Ioduria between 100-300 mcg/l in majority of population, which would indicate adequate Iodine supply, while median of Iodurias should remain below 300 mcg/l.Key words: iodine deficiency - iodine supply - ioduria.

[Solution of Iodine deficiency in the Czech Republic - history and current situation20 years of work of prof. Václav Zamrazil for Commission for the solution of Iodine deficiency]. / Resení jodového deficitu v Ceské republice - historie a soucasný stav20 let práce prof. MUDr. Václava Zamrazila v Meziresortní komisi pro resení jodového deficitu.

Diseases caused by Iodine deficit are preventable. Inter resort Commission for the solution of Iodine deficiency (MKJD) at State Institute for Health (SZU) in Prague has been taking effective measures which satisfied requirements of the Principles for sustainable elimination of diseases caused by Iodine deficiency ICCD WHO: 96 % of households is using iodized salt, average Iodine content is 25 mg/1 kg of salt. Data from studies show ioduria less 100 mcg/l in only 9 per cent of seniors, 5 % of children 7-10 years, 3 % of children 10-12 years. Under 50 mcg only 1 % of children 10-12 years. Median of iodurias is below 300 mcg/l (seniors 185 mcg/l, children 7-10 years 277 mcg/l, children 10-12 years 252 mcg/l). We satisfy 8 of 10 indicators of Principles for Sustainable elimination of diseases caused by Iodine deficiency. Results of screening for congenital hypothyroidism are in keeping with sufficient iodine intake in newborns. Unsatisfactory situation however persist in expectant and breast feeding mothers 16 % [11] 6 % [10] of women included in the respective studies had ioduria below 50 mpg/l. Milk and dairy produce became a rich dietary source of Iodine as cattle feeds are fortified with Iodine. No part of observed human population is exposed Iodine doses higher than 17 mcg/kg. Next target for prevention will be achieving optimal iodine concentration in milk and improvement of iodine saturation of expectant and nursing mothers. Integral part is the monitoring of iodine saturation of population.Key words: dietary exposition - dietary sources of iodine - Inter resort commission for elimination of iodine deficit - iodine deficiency - iodine supply - iodized salt - ioduria.