Marchioni Enrico, Fumarola Angela, Calvanese Anna, Piccirilli Francesca, Tommasi Valentina, Cugini Pietro, Ulisse Salvatore, Rossi Fanelli Filippo, D'Armiento Massimino
Department of Experimental Medicine, Section of Endocrinology, Sapienza University of Rome, Italy.
Nutrition. 2008 May;24(5):458-61. doi: 10.1016/j.nut.2008.01.015. Epub 2008 Mar 12.
To prevent iodine deficiency disorders, the World Health Organization, United Nations Children's Fund, and International Council for the Control of Iodine Deficiency Disorders established that for a given population median urinary iodine concentrations (UIC) must be 100-199 microg/L in clinically healthy subjects and 150-249 microg/L in clinically healthy pregnant women. We evaluated whether in the urban area of Rome, Italy, where a salt iodination program (30 mg/kg) was introduced since 2005, an increased demand of iodine during pregnancy is guaranteed.
During 2006, 51 pregnant women at first trimester of a physiologic gestation were consecutively enrolled on presentation to evaluate UIC in morning spot urine samples. As controls, 100 age-matched clinically healthy non-pregnant women were evaluated.
The median UICs were 182 microg/L (range 85-340 microg/L) and 74 microg/L (range 17-243 microg/L), respectively, in the control and pregnant groups. This difference was highly significant (P < 0.001). In particular, the UIC was found to be lower than adequate in 4% of control women compared with 92% of pregnant women. This difference of occurrences was highly significant (P < 0.001).
This observational study demonstrated that, despite the adequate supplementation of iodine intake, most pregnant women appear not to be protected against iodine deficiency. If confirmed in larger case studies, this finding claims the attention of relevant professionals to monitor iodine nutrition during gestation, assuming that ordinary supplementation of iodine intake seems to be sufficient only in non-gestational conditions.
为预防碘缺乏症，世界卫生组织、联合国儿童基金会以及国际碘缺乏病控制理事会规定，对于特定人群，临床健康受试者的尿碘中位数浓度（UIC）必须为100 - 199微克/升，临床健康孕妇的UIC必须为150 - 249微克/升。我们评估了自2005年起实施食盐碘化计划（30毫克/千克）的意大利罗马市区，孕期碘需求增加的情况是否得到保障。
2006年期间，连续纳入了51名处于生理性妊娠早期的孕妇，以评估晨尿样本中的UIC。作为对照，评估了100名年龄匹配的临床健康非孕妇。
对照组和孕妇组的UIC中位数分别为每升182微克（范围85 - 340微克/升）和每升74微克（范围17 - 243微克/升）。这种差异具有高度统计学意义（P < 0.001）。特别是，4%的对照女性的UIC低于适宜水平，而孕妇中的这一比例为92%。这种发生率的差异具有高度统计学意义（P < 0.001）。
这项观察性研究表明，尽管碘摄入量得到了充分补充，但大多数孕妇似乎并未得到碘缺乏的保护。如果在更大规模的案例研究中得到证实，这一发现需要相关专业人员关注孕期碘营养监测，因为普通的碘摄入补充似乎仅在非孕期条件下才足够。
