OBJECTIVE: Trace elements are essential for the biochemistry of the cell. Their reference values have been found to differ considerably in pregnant women stratified by age, place of residence, anthropometric status, and length of pregnancy. In optimal amounts, these elements reduce the risk of pregnancy complications. Subclinical hypothyroidism in pregnancy is associated with adverse maternal and neonatal outcomes. The aim of the study was to determine the effects of zinc (Zn), copper (Cu), magnesium (Mg), and rubidium (Rb) on pregnant women in an iodine deficiency region and find the relationship with the thyroid status and nutrition. METHODS: We evaluated the iodine status of 61 healthy pregnant women from an iodine deficient region in Bulgaria. Thyroid stimulating hormone (TSH) and thyroxin free (FT4) levels were measured using ELISA. RESULTS: We found elevated levels of copper that differed the most between the first and second trimesters; Cu and TSH were found to be positively correlated (р < 0.05). Lower Cu levels were found in pregnant women consuming pulses more than 2-3 times a week (р = 0.033). The women consuming fish more than 2-3 times a week had higher levels of Rb. We found a pronounced iodine deficiency in more than half of the examined women in the first to third trimesters, without any effect of pregnancy on the ioduria (р=0.834). All second and third trimester cases were associated with severe ioduria (< 150 µg/L). CONCLUSION: The high Cu levels were associated with subclinical hypothyroidism (SCH) and less pulse consumption during pregnancy in an iodine deficiency endemic area. SCH was found in 24% of the pregnant women in such an area while in 13% of them SCH had progressed to overt hypothyroidism.

• Klíčová slova
• iodine-endemic area, pregnant women, subclinical hypothyroidism, trace elements,
• MeSH
• dospělí MeSH
• hořčík krev   analýza   aplikace a dávkování   MeSH
• hypotyreóza epidemiologie   MeSH
• jod * nedostatek   aplikace a dávkování   MeSH
• komplikace těhotenství epidemiologie   MeSH
• lidé MeSH
• měď * nedostatek   krev   MeSH
• nutriční stav * MeSH
• stopové prvky nedostatek   MeSH
• těhotenství MeSH
• thyreotropin krev   MeSH
• zinek * nedostatek   krev   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Bulharsko epidemiologie   MeSH
• Názvy látek
• hořčík MeSH
• jod * MeSH
• měď * MeSH
• stopové prvky MeSH
• thyreotropin MeSH
• zinek * MeSH

Background: Knowledge about the population's iodine status is important, because it allows adjustment of iodine supply and prevention of iodine deficiency. The validity and comparability of iodine-related population studies can be improved by standardization, which was one of the goals of the EUthyroid project. The aim of this study was to establish the first standardized map of iodine status in Europe by using standardized urinary iodine concentration (UIC) data. Materials and Methods: We established a gold-standard laboratory in Helsinki measuring UIC by inductively coupled plasma mass spectrometry. A total of 40 studies from 23 European countries provided 75 urine samples covering the whole range of concentrations. Conversion formulas for UIC derived from the gold-standard values were established by linear regression models and were used to postharmonize the studies by standardizing the UIC data of the individual studies. Results: In comparison with the EUthyroid gold-standard, mean UIC measurements were higher in 11 laboratories and lower in 10 laboratories. The mean differences ranged from -36.6% to 49.5%. Of the 40 postharmonized studies providing data for the standardization, 16 were conducted in schoolchildren, 13 in adults, and 11 in pregnant women. Median standardized UIC was <100 μg/L in 1 out of 16 (6.3%) studies in schoolchildren, while in adults 7 out of 13 (53.8%) studies had a median standardized UIC <100 μg/L. Seven out of 11 (63.6%) studies in pregnant women revealed a median UIC <150 μg/L. Conclusions: We demonstrate that iodine deficiency is still present in Europe, using standardized data from a large number of studies. Adults and pregnant women, particularly, are at risk for iodine deficiency, which calls for action. For instance, a more uniform European legislation on iodine fortification is warranted to ensure that noniodized salt is replaced by iodized salt more often. In addition, further efforts should be put on harmonizing iodine-related studies and iodine measurements to improve the validity and comparability of results.

• Klíčová slova
• epidemiology, iodine, iodine supply, method comparison,
• MeSH
• algoritmy MeSH
• dítě MeSH
• fortifikované potraviny MeSH
• hmotnostní spektrometrie metody   MeSH
• jod nedostatek   moč   MeSH
• lidé MeSH
• lineární modely MeSH
• mladý dospělý MeSH
• nutriční stav MeSH
• regresní analýza MeSH
• reprodukovatelnost výsledků MeSH
• těhotenství MeSH
• těhotné ženy MeSH
• zeměpis MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Evropa epidemiologie   MeSH
• Finsko MeSH
• Názvy látek
• jod MeSH

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.

• MeSH
• dítě MeSH
• dospělí MeSH
• jod nedostatek   MeSH
• kojení MeSH
• kuchyňská sůl * MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mléčné výrobky MeSH
• mléko MeSH
• nemoci štítné žlázy etiologie   prevence a kontrola   MeSH
• novorozenec MeSH
• podvýživa komplikace   prevence a kontrola   MeSH
• senioři MeSH
• těhotenství MeSH
• zvířata MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• novorozenec MeSH
• senioři MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH
• Názvy látek
• iodized salt MeSH Prohlížeč
• jod MeSH
• kuchyňská sůl * MeSH

INTRODUCTION: In patients with type 1 and 2 diabetes mellitus only rare data concerning the status of iodine supplementation and impact of possible iodine deficiency is available. AIM: To get basic information about (a) state of supply with iodine in patients with type 1 diabetes mellitus (DM1T), (b) the difference from non-diabetic population, (c) possible association of iodine saturation with some clinical and laboratory features of the diabetic syndrome, including the state of thyroid gland. SUBJECTS AND METHODS: We examined 54 men and 51 women treated with DM1T in a cross-sectional study. Age: median 42 years (25th quartil 31, 75th quartil 55), DM1T duration: 18 years (13, 23), BMI: 25.9 (23.3, 29.7), HbA1c: 61 mmol/mol (51, 71), creatinine: 71 μmol/l (61, 83), micro-albuminuria 4.3 μg/min (1.9, 11.8), TSH: 1.77 mIU/l (1.12, 2.80). The iodine saturation was evaluated using iodine concentration in a sample of first morning urine. RESULTS: Urinary iodine concentration in the whole group: median 152 μg/l, 25th quartile 117 μg/l, 75th quartile 219 μg/l. More than 50 % of the urinary iodine samples fell within range of optimal saturation (100-200 μg/l), 13 % within insufficient saturation (< 100 μg/l), 35 % of the samples showed increased saturation (> 200 μg/l), in which 2/3 were men. Using multiple regression analysis we found significant positive association of urinary iodine concentration and male gender, body weight, stature, and serum creatinine. No relation between urinary iodine and clinical and laboratory features of the diabetic syndrome was found. CONCLUSIONS: Iodine saturation in examined patients with DM1T was in accordance with ICCIDD (WHO) requirements for optimal/good saturation in non-diabetic population. With respect to the chosen normal urinary iodine concentration, eg. 100, resp. 150 μg/l the features of diabetic syndrome were not different. The question whether other factors than general measures taken in the past for solution of the iodine deficiency in the Czech Republic are involved in good level of iodine saturation in patients with DM1T should be addressed in further investigations comprising larger cohorts of patients.Key words: diabetes mellitus - urinary iodine concentration.

• MeSH
• albuminurie epidemiologie   moč   MeSH
• diabetes mellitus 1. typu epidemiologie   moč   MeSH
• dospělí MeSH
• jod nedostatek   moč   MeSH
• kreatinin moč   MeSH
• lidé středního věku MeSH
• lidé MeSH
• podvýživa epidemiologie   moč   MeSH
• průřezové studie MeSH
• štítná žláza MeSH
• tělesná hmotnost MeSH
• tělesná výška MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH
• Názvy látek
• jod MeSH
• kreatinin MeSH

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.

• MeSH
• dospělí MeSH
• jod nedostatek   moč   MeSH
• lidé středního věku MeSH
• lidé MeSH
• podvýživa epidemiologie   moč   MeSH
• předškolní dítě MeSH
• senioři MeSH
• těhotenství MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• senioři MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH
• Názvy látek
• jod MeSH

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.

• MeSH
• dospělí MeSH
• hmotnostní spektrometrie MeSH
• jod nedostatek   moč   MeSH
• komplikace těhotenství epidemiologie   moč   MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• nutriční stav * MeSH
• podvýživa epidemiologie   moč   MeSH
• první trimestr těhotenství MeSH
• spektrofotometrie MeSH
• těhotenství MeSH
• třetí trimestr těhotenství MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH
• Názvy látek
• jod MeSH

BACKGROUND: Programs initiated to prevent iodine deficiency disorders (IDD) may not remain effective due to changes in government policies, commercial factors, and human behavior that may affect the efficacy of IDD prevention programs in unpredictable directions. Monitoring and outcome studies are needed to optimize the effectiveness of IDD prevention. SUMMARY: Although the need for monitoring is compelling, the current reality in Europe is less than optimal. Regular and systematic monitoring surveys have only been established in a few countries, and comparability across the studies is hampered by the lack of centralized standardization procedures. In addition, data on outcomes and the cost of achieving them are needed in order to provide evidence of the beneficial effects of IDD prevention in countries with mild iodine deficiency. CONCLUSION: Monitoring studies can be optimized by including centralized standardization procedures that improve the comparison between studies. No study of iodine consumption can replace the direct measurement of health outcomes and the evaluation of the costs and benefits of the program. It is particularly important that health economic evaluation should be conducted in mildly iodine-deficient areas and that it should include populations from regions with different environmental, ethnic, and cultural backgrounds.

• MeSH
• dieta MeSH
• hodnocení výsledků zdravotní péče MeSH
• hypotyreóza epidemiologie   prevence a kontrola   MeSH
• jod škodlivé účinky   nedostatek   terapeutické užití   MeSH
• lidé MeSH
• mezinárodní spolupráce MeSH
• náklady na zdravotní péči MeSH
• nemoci štítné žlázy epidemiologie   prevence a kontrola   MeSH
• preventivní lékařství ekonomika   metody   MeSH
• výzkumný projekt MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Evropa MeSH
• Názvy látek
• jod MeSH

The relationship is shown between a concentration of urinary iodine and serum thyroglobulin in population studies carried out on a general population that was randomly selected from the registry of the General Health Insurance Company (individuals aged 6-98 years, 1751 males, 2420 females). The individuals were divided into subgroups with a urinary iodine concentration of <50, 50-99, 100-199, 200-299 and >/=300 microg/l. The mean and median of thyroglobulin were calculated in these subgroups. Tg concentrations were dependent on gender (males

• MeSH
• aplikace orální MeSH
• dítě MeSH
• dospělí MeSH
• jod aplikace a dávkování   nedostatek   moč   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• pohlavní dimorfismus MeSH
• registrace * MeSH
• reprodukovatelnost výsledků MeSH
• rozložení podle pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• senzitivita a specificita MeSH
• stárnutí krev   MeSH
• thyreoglobulin krev   MeSH
• věkové rozložení MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH
• Názvy látek
• jod MeSH
• thyreoglobulin MeSH

OBJECTIVE: Iodine deficiency is associated with thyroid dysfunction and adverse pregnancy outcomes. The aim of our study was to investigate the status of iodine saturation in women after spontaneous abortion (SpA) residing in an iodine-sufficient area and to evaluate their subsequent reproductive health. DESIGN: Nonrandomized prospective follow-up study. PATIENTS AND METHODS: We compared urinary iodine concentration (UIC) in 171 women 2-8 weeks (median 4) after an early SpA with age-matched controls. Women with known thyroid diseases were excluded. We also analysed a relationship of UIC to serum thyroid-stimulating hormone, free thyroxine, antibodies against thyroid peroxidase and thyroid ultrasound. Afterwards, we followed the women for a median of 38 months (range 12-47). We used a multivariate regression analysis to assess the influence of iodine status and other thyroid biochemical and ultrasound parameters on their subsequent reproductive health. RESULTS: Women after SpA were almost twice as likely to suffer from mild iodine deficiency and had lower median UIC as compared to age-matched controls [rate 105/181 (58·0%) vs 57/181 (31·5%), P < 0·001, medians UIC 92·00 vs 117·80 mcg/l, P < 0·001]. UIC was not influenced by the use of iodine supplements in the previous pregnancy. We did not find any association neither between UIC and thyroid dysfunction and/or thyroid antibodies, nor between UIC and rates of subsequent successful pregnancies or obstetric complications. CONCLUSIONS: More than half of women after SpA residing in an iodine-sufficient area are suffering from mild iodine deficiency. However, it does not seem to have a negative impact on their subsequent reproductive health.

• MeSH
• dospělí MeSH
• jod nedostatek   zásobování a distribuce   moč   MeSH
• karenční nemoci komplikace   epidemiologie   MeSH
• lidé MeSH
• následné studie MeSH
• prevalence MeSH
• reprodukční zdraví statistika a číselné údaje   MeSH
• samovolný potrat epidemiologie   etiologie   moč   MeSH
• studie případů a kontrol MeSH
• stupeň závažnosti nemoci MeSH
• těhotenství MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH
• Názvy látek
• jod MeSH

Iodopenia is importance world-wide problem--the cause of spectrum of iodine deficiency disorders (IDD). The "simple" way for its compensation is iodine supplementation--preferably by iodinization of salt: in the Czech Republic prevalence of IDD was very high in the past. The complex program for compensation of iodine deficiency realized in the CR includes improvement of salt iodization, supplementation of pregnant and lactating women, fortification of products for babies' nutrition and increasing use of iodinized salt in general population incl. food industry. Thus CR is country with compensated iodine deficiency according to criteria WHO, UNICEF, ICCIDD. In future, however, systematic interest should be focused on optimalization of iodine saturation, esp. in pregnant women and evaluation of possible risk of supranormal iodine intake (impairment of thyroid function, activation of thyroid autoimmunity). Taking in account, the changes of nutrition and life style systematic monitoring of quality of iodine supplementation seems to be essential.

• MeSH
• celosvětové zdraví MeSH
• jod nedostatek   moč   MeSH
• lidé MeSH
• těhotenství MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH
• Názvy látek
• jod MeSH