Nejvíce citovaný článek - PubMed ID 27734685
Zásobení jodem u těhotných žen v České republice
[Iodine supply of pregnant women in the Czech Republic]
The physical and chemical properties of iodine, the importance of iodine for human health, iodine deficiency in the world and in Europe, the cycle of iodine in nature, values of iodine concentration in urine describing iodine deficiency, and the adequate or excessive supply of iodine to the body are presented in the work. The iodine intake of pregnant and lactating women and the state of iodine intake of these women in the Czech Republic are discussed. The history of iodine deficiency as well as the first mentions of the role of iodine in the thyroid gland and the first mentions of iodine prophylaxis in the world are explained. The present section describes the activities in the Czech Republic since the end of the Second World War, which contributed to the elimination of the iodine deficiency, including the establishment of the Interdepartmental Commission for Solving Iodine Deficiency. Population and other studies carried out in this period, which were related to the issue of iodine supply, are described. It was recorded that officially since 2004, the Czech Republic is among the countries where iodine deficiency is not currently a general problem. The future part is based on the Krakow appeal to leaders, politicians, scientists and officials, but also to the general population, to support actions leading to the elimination of iodine deficiency in Europe.
- MeSH
- jod * nedostatek aplikace a dávkování moč MeSH
- lidé MeSH
- nutriční stav * fyziologie MeSH
- těhotenství MeSH
- Check Tag
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
- Názvy látek
- jod * MeSH
INTRODUCTION: Maternal urinary iodine concentration and blood neonatal thyroid-stimulating hormone (TSH) concentration reflect iodine status in pregnancy and serve as markers of iodine deficiency. As dietary measures in gestational diabetes mellitus (GDM) could affect iodine intake, our study aimed to investigate iodine supply in women with GDM compared to healthy pregnant women and to evaluate its relationship to maternal and neonatal thyroid function. METHODS: Urinary iodine concentration (UIC) and serum TSH, free thyroxine (FT4), and autoantibodies against thyroid peroxidase (TPOAb) were analyzed in 195 women with GDM and 88 healthy pregnant women in the second trimester. Subsequently, neonatal TSH concentrations measured 72 h after delivery in a subgroup of 154 newborns (115 of mothers with GDM and 39 controls) from the national register were analyzed. RESULTS: Median UIC was significantly lower in women with GDM compared to controls (89.50 µg/L vs. 150.05 µg/L; P < 0.001). Optimal iodine intake was found only in nine women with GDM (4.6%) and 33 healthy pregnant women (37.5%) (P < 0.001). Most pregnant women with GDM (88.7%) compared to one half of controls (50%) had iodine deficiency (P < 0.001). Although serum TSH and the prevalence of hypothyroidism (TSH > 4.0 mIU/L) were not different in both groups, hypothyroxinaemia was more prevalent in GDM compared to controls (12.3% vs 3.4%, P = 0.032). Consistently, neonatal TSH > 5.0 mIU/L indicating iodine deficiency, was found in 6 (5.2%) newborns of women with GDM as compared to none in controls. In women with GDM, the prevalence of perinatal complications was significantly lower in those who were taking dietary iodine supplements compared to those who were not (3/39 (7.69%) vs 46/156 (28.85%), P <0.001). In the multiple logistic and linear regression models in women with GDM, hypothyroxinaemia was associated with preterm births, and a negative association of serum FT4 and HbA1c was found. CONCLUSION: Iodine deficiency in pregnancy was more prevalent among women with GDM compared to healthy pregnant controls. Serum FT4 negatively correlated with HbA1c, and hypothyroxinaemia was associated with preterm births in women with GDM. Conversely, women with GDM who used dietary iodine supplements had a lower risk of perinatal complications.
- Klíčová slova
- diabetes, iodine, metabolism, pregnancy, thyroid,
- Publikační typ
- časopisecké články MeSH
Iodine is essential in the biosynthesis of thyroid hormones that affect metabolic processes in the organism from the prenatal state to the elderly. The immediate indicator of iodine intake is the concentration of iodine in urine, but the indicator of iodine intake in the longer term of several months is thyroglobulin (Tg). Tg negatively correlated with increasing intake of iodine in population that do not suffer from thyroid disease, while a more than adequate to excessive iodine intake leads to an increase in Tg. The dependence of Tg on iodine can be described by a U-shaped curve. Thyroglobulin in serum is elevated in thyroid disease mainly in hyperthyroidism (diagnosis E05 of WHO ICD-10 codes) and in goiter (diagnosis E04 of WHO ICD-10 codes). Tg values decrease below 20 microg/l after effective treatment of patients with thyroid disease. Thyroglobulin may thus be an indicator of thyroid stabilization and the success of the thyroid gland treatment.
- MeSH
- jod aplikace a dávkování škodlivé účinky MeSH
- lidé MeSH
- nemoci štítné žlázy chemicky indukované metabolismus patologie MeSH
- štítná žláza účinky léků metabolismus patologie MeSH
- thyreoglobulin metabolismus MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Názvy látek
- jod MeSH
- thyreoglobulin MeSH
BACKGROUND: The relationship between low iodine status and pregnancy-associated comorbidities has been known for decades. The relationship between iodine intake and placental pathologies is, however, far less clear. This study was designed to examine the relationship between dietary iodine intake and placental size while also focusing on typical adverse pregnancy outcomes. METHOD: The dietary iodine intake of 4711 pregnant women enrolled in the Czech part of the European Longitudinal Study of Pregnancy and Childhood (ELSPAC) in 1990-1991 was established using a 145-item food frequency questionnaire. Multivariate linear regression models were used to estimate the relationship between dietary iodine intake during pregnancy and placental weight. Additional models were constructed to investigate the relationship between estimated dietary iodine intake and adverse birth outcomes. RESULTS: The estimated average iodine intake in the ELSPAC cohort was 106.6 μg/day. In the fully adjusted model, estimated dietary iodine intake was found to be significantly negatively associated with placental weight (β = -0.025, 95% CI: -0.044; -0.006, p = 0.011). Moreover, estimated dietary iodine intake was found to be significantly positively associated with the birth weight / placental weight ratio in the fully adjusted model (β = -0.024, 95% CI: 0.004; 0.043, p = 0.016). CONCLUSIONS: This study provides evidence of a relationship between estimated dietary iodine intake and placental weight and the birth weight / placental weight ratio. Additional research is warranted to provide more insight into the role of iodine in early as well as late placentation.
- Klíčová slova
- Birth outcome, Birth weight / placental weight, ELSPAC, Iodine intake, Placental weight,
- Publikační typ
- časopisecké články MeSH