Ershow Abby G, Goodman Gay, Coates Paul M, Swanson Christine A
Office of Dietary Supplements, NIH, Bethesda, MD; and
Human Health Risk Research, Seattle, WA.
Am J Clin Nutr. 2016 Sep;104 Suppl 3(Suppl 3):941S-9S. doi: 10.3945/ajcn.116.134858. Epub 2016 Aug 17.
The Office of Dietary Supplements of the NIH convened 3 workshops on iodine nutrition in Rockville, Maryland, in 2014. The purpose of the current article is to summarize and briefly discuss a list of research and resource needs developed with the input of workshop participants. This list is composed of the basic, clinical, translational, and population studies required for characterizing the benefits and risks of iodine supplementation, along with related data, analyses, evaluations, methods development, and supporting activities. Ancillary studies designed to use the participant, biological sample, and data resources of ongoing and completed studies (including those not originally concerned with iodine) may provide an efficient, cost-effective means to address some of these research and resource needs. In the United States, the foremost question is whether neurobehavioral development in the offspring of mildly to moderately iodine-deficient women is improved by maternal iodine supplementation during pregnancy. It is important to identify the benefits and risks of iodine supplementation in all population subgroups so that supplementation can be targeted, if necessary, to avoid increasing the risk of thyroid dysfunction and related adverse health effects in those with high iodine intakes. Ultimately, there will be a need for well-designed trials and other studies to assess the impact of maternal supplementation on neurodevelopmental outcomes in the offspring. However, 2 basic information gaps loom ahead of such a study: the development of robust, valid, and convenient biomarkers of individual iodine status and the identification of infant and toddler neurobehavioral development endpoints that are sensitive to mild maternal iodine deficiency during pregnancy and its reversal by supplementation.
美国国立卫生研究院膳食补充剂办公室于2014年在马里兰州罗克维尔召开了3次关于碘营养的研讨会。本文的目的是总结并简要讨论一份在研讨会参与者的参与下制定的研究和资源需求清单。这份清单包括确定碘补充剂的益处和风险所需的基础研究、临床研究、转化研究和人群研究,以及相关数据、分析、评估、方法开发和支持活动。旨在利用正在进行和已完成研究(包括那些最初与碘无关的研究)的参与者、生物样本和数据资源进行的辅助研究,可能为满足其中一些研究和资源需求提供一种高效且具成本效益的方法。在美国,首要问题是孕期母亲补充碘是否能改善轻度至中度碘缺乏女性后代的神经行为发育。确定所有人群亚组中碘补充剂的益处和风险非常重要,以便在必要时进行有针对性的补充,避免增加碘摄入量高的人群出现甲状腺功能障碍及相关不良健康影响的风险。最终,将需要精心设计的试验和其他研究来评估母亲补充碘对后代神经发育结局的影响。然而,在进行此类研究之前,有两个基本信息缺口亟待填补:开发强大、有效且便捷的个体碘状态生物标志物,以及确定对孕期母亲轻度碘缺乏及其通过补充碘得到改善敏感的婴幼儿神经行为发育终点。