Endocrinology and Reproductive Physiology Laboratory, Department of Physiology, University of Calcutta, University College of Science and Technology, 92, APC Road, Kolkata, West Bengal, 700 009, India.
Dr. B.C. Roy Post Graduate Institute of Paediatrics, 111, Narikeldanga Main Road, Kolkata, 700 054, India.
Eur J Pediatr. 2018 Jan;177(1):39-45. doi: 10.1007/s00431-017-3025-6. Epub 2017 Oct 23.
Iodine nutritional status of 128 lactating mothers and their breast-fed infants (1-3 months) from iodine-replete villages during post-salt iodization period was evaluated. Mothers' urine, blood, and breast milk (BM) and infants' urine and blood were collected and analyzed for iodine and serum FT and TSH estimation. Mothers' and infants' age, parity, occupation, education, and household income were recorded. Median urinary iodine concentration (UIC) of infants was 250 μg/L, indicating their iodine intake was more than adequate. Mothers' median UIC was 185 μg/L, indicating adequate iodine nutrition; however, 13.28% had mild to severe deficiency. Median breast milk iodine concentration (BMIC) was 230 μg/L, which was more than their median UIC 185 μg/L. In iodine-deficient mothers, positive correlation was found between mothers' and infants' serum FT and TSH levels, and negative correlation was found between mothers' and infants' serum FT and TSH levels in excessive iodine nutrition group.
Iodine intake of breast-fed infants was at the limit of above requirement, and they are possibly at the risk of excess iodine intake. In iodine deficient and excessive iodine intake mothers, their infants' serum FT and TSH are independent on their iodine nutritional status but dependent on thyroid hormone profile of their mothers but differently. What is Known: • A median urinary iodine of 100 μg/L is used to define adequate iodine intake of lactating mothers and children < 2 years. However, adequate iodine intake in terms of urinary iodine of infants of age 1-3 months is not known. What is New: • Iodine intake of absolutely breast-fed infants (1-3 months) was more than adequate, though their mother's intake was adequate as breast milk contains more iodine than urine. The infants of iodine deficient and excessive iodine intake mothers, infants' hormonal profile is independent of their iodine nutritional status but dependent on their mothers thyroid hormone profile.
本研究评估了食盐碘化后碘营养充足地区 128 名哺乳期母亲及其 1-3 月龄母乳喂养婴儿的碘营养状况。采集母亲尿液、血液和母乳(BM)以及婴儿尿液和血液进行碘分析以及血清 FT 和 TSH 评估。记录母亲和婴儿的年龄、产次、职业、教育程度和家庭收入。婴儿的尿碘中位数(UIC)为 250μg/L,表明其碘摄入量充足。母亲的 UIC 中位数为 185μg/L,表明碘营养充足,但 13.28%存在轻至重度碘缺乏。母乳碘浓度中位数(BMIC)为 230μg/L,高于母亲的 185μg/L UIC。在碘缺乏的母亲中,母亲和婴儿的血清 FT 和 TSH 水平呈正相关,而在碘过量营养组中,母亲和婴儿的血清 FT 和 TSH 水平呈负相关。
母乳喂养婴儿的碘摄入量接近需求上限,可能有碘摄入过量的风险。在碘缺乏和碘过量摄入的母亲中,其婴儿的血清 FT 和 TSH 与其碘营养状况无关,而与其母亲的甲状腺激素谱有关,但方式不同。
• 100μg/L 的尿碘中位数用于定义哺乳期母亲和<2 岁儿童的碘摄入充足。然而,1-3 月龄婴儿的尿碘充足摄入水平尚不清楚。
• 1-3 月龄的完全母乳喂养婴儿的碘摄入量虽然充足,但母亲的碘摄入量也充足,因为母乳中的碘含量高于尿液。碘缺乏和碘过量摄入的母亲的婴儿,其激素谱与其碘营养状况无关,而与其母亲的甲状腺激素谱有关。