Human Nutrition Laboratory, Swiss Federal Institute of Technology Zürich, Zürich, Switzerland.
Best Pract Res Clin Endocrinol Metab. 2010 Feb;24(1):143-58. doi: 10.1016/j.beem.2009.09.003.
Iodine deficiency (ID) has multiple adverse effects on growth and development due to inadequate thyroid hormone production. Methods for assessment of iodine nutrition in individuals include the urinary iodine concentration (UI), thyroid size and thyroid function tests. The UI measured in several repeat 24-h urine samples can detect inadequate iodine intake in individuals receiving enteral or parenteral nutrition (PN) and allow for iodine supplementation before the onset of hypothyroidism. A daily dose of 1 microg iodine/kg body weight is currently recommended for children receiving PN, but this is far below their requirements. Daily iodine requirements in adults receiving enteral nutrition or PN are estimated to be 70-150 microg, but most PN formulations do not contain iodine. Despite this, ID has been unlikely because absorption from iodine-containing skin antiseptics and other adventitious sources can provide sufficient iodine. However, if chlorhexidine replaces iodine-containing antiseptics for catheter care, ID may occur during long-term PN, and periodic testing of UI and thyroid function may be prudent. Infants may be particularly vulnerable to ID because of their small thyroidal iodine store. In this review, we describe three recent patients (an infant, a child and an adult) who developed ID and thyroid hypofunction during PN.
碘缺乏 (ID) 会因甲状腺激素产生不足而对生长和发育造成多种不良影响。评估个体碘营养状况的方法包括尿碘浓度 (UI)、甲状腺大小和甲状腺功能测试。多次重复 24 小时尿液样本的 UI 可检测到接受肠内或肠外营养 (PN) 的个体摄入碘不足，并可在发生甲状腺功能减退症之前进行碘补充。目前建议接受 PN 的儿童每日补充 1 微克碘/公斤体重，但这远远低于他们的需求。接受肠内营养或 PN 的成人的每日碘需求量估计为 70-150 微克，但大多数 PN 配方不含碘。尽管如此，ID 不太可能发生，因为含碘皮肤消毒剂和其他偶然来源的吸收可以提供足够的碘。然而，如果含氯己定代替含碘消毒剂用于导管护理，在长期 PN 期间可能会发生 ID，定期检测 UI 和甲状腺功能可能是明智的。婴儿可能特别容易受到 ID 的影响，因为他们的甲状腺碘储备量较小。在这篇综述中，我们描述了最近出现 ID 和甲状腺功能减退症的 3 名患者（一名婴儿、一名儿童和一名成人），他们在 PN 期间发生了 ID 和甲状腺功能减退症。
