Thomassen Rut Anne, Kvammen Janne Anita, Eskerud Mari Borge, Júlíusson Pétur Benedikt, Henriksen Christine, Rugtveit Jarle
*Department of Paediatric Medicine, Division of Paediatric and Adolescent Medicine, Oslo University Hospital †Department of Internal Medicine, Clinical Nutrition, Lovisenberg Diaconal Hospital, Oslo ‡Department of Clinical Science, University of Bergen, Bergen §Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo.
J Pediatr Gastroenterol Nutr. 2017 May;64(5):806-811. doi: 10.1097/MPG.0000000000001434.
The aim of the present article was to investigate iodine status and growth in cow's milk protein allergic infants and to identify potential predictors of iodine status and growth.
Fifty-seven infants under 2 years of age were included in an observational cross-sectional study. Two spot urine samples were collected and analyzed for iodine, together with a 3-day food record and a food frequency questionnaire. Urine iodine concentrations were compared with the WHO cut-off values for iodine deficiency. Measurements of weight, length, and head circumference at birth and study inclusion were converted to standard deviation scores. Subgroup analyses were performed on different feeding patterns, according to weaning status.
Median age was 9 months. Median urinary iodine concentration was 159 ug/L. One third of the children had urine iodine concentrations indicating iodine deficiency. Infants who were mainly breastfed were at highest risk and 58% were classified as deficient. Dietary factors positively associated with iodine excretion were intake of enriched baby cereals and meeting the dietary requirement for iodine. Stunting was present in 5%. Underweight and wasting was frequent at 11% and this was associated with food refusal and poor appetite, but not with iodine status. Growth failure was detected among boys.
The present study suggests that cow's milk protein allergy children have high prevalence of iodine deficiency and poor growth, however the 2 conditions were not associated. The subgroup of mainly breastfed infants was at higher risk of iodine deficiency compared to weaned infants. Subjects with feeding problems had increased risk of malnutrition.
本文旨在调查牛奶蛋白过敏婴儿的碘营养状况和生长情况，并确定碘营养状况和生长的潜在预测因素。
一项观察性横断面研究纳入了57名2岁以下的婴儿。收集两份随机尿样并分析其中的碘含量，同时记录3天的食物摄入情况并填写食物频率问卷。将尿碘浓度与世界卫生组织碘缺乏的临界值进行比较。将出生时和纳入研究时的体重、身长和头围测量值转换为标准差分数。根据断奶状态对不同喂养方式进行亚组分析。
中位年龄为9个月。尿碘浓度中位数为159μg/L。三分之一的儿童尿碘浓度表明存在碘缺乏。主要进行母乳喂养的婴儿风险最高，58%被归类为碘缺乏。与碘排泄呈正相关的饮食因素是强化婴儿谷物的摄入量和满足碘的饮食需求。5%的儿童存在发育迟缓。体重不足和消瘦较为常见，分别为11%，这与拒食和食欲不佳有关，但与碘营养状况无关。在男孩中检测到生长发育不良。
本研究表明，牛奶蛋白过敏儿童碘缺乏和生长发育不良的患病率较高，但这两种情况并无关联。与断奶婴儿相比，主要进行母乳喂养的婴儿亚组碘缺乏风险更高。有喂养问题的儿童营养不良风险增加。
