1Department of Oncology and Nuclear Medicine, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 2School of Medicine, University of Zagreb, Zagreb, Croatia; 3Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 4Division of Gastroenterology and Nutrition, Zurich University Children's Hospital, Zurich, Switzerland; 5Iodine Global Network, Ottawa, Ontario, Canada; 6Human Nutrition Laboratory, Institute of Food, Nutrition and Health, Zurich ETH, Zurich, Switzerland; 7University of Zagreb, School of Medicine, Andrija Štampar School of Public Health, WHO Collaborative Centre for Occupational Health, Zagreb, Croatia; 8Croatian Academy of Sciences and Arts, Zagreb, Croatia.
Acta Clin Croat. 2021 Jun;60(2):259-267. doi: 10.20471/acc.2021.60.02.12.
Lactating women (LW) and infants have high dietary iodine requirements and are at risk of iodine deficiency. The aim of the study was to assess iodine status and thyroid function in LW and their breastfed infants in Zagreb, Croatia. The study included 133 LW and breastfed infant pairs. Urinary iodine concentration (UIC) and thyroid function parameters were measured in all subjects. In LW, breast milk iodine concentration (BMIC) was measured and iodine and salt rich food frequency questionnaire data were collected. Results of analysis indicated that 99.2% of the LW used iodized salt in household and 20.4% used iodine-containing vitamin and mineral supplements. Median (IQR) UIC was 75 µg/L (19.0-180.5 µg/L) in LW and 234 µg/L (151.0-367.5 µg/L) in infants, whereas BMIC was 121 µg/kg (87.8-170.8 µg/kg). Multivariate regression analysis revealed BMIC to be a significant predictor of infant UIC (p<0.001). Positive correlation was recorded between LW and infant thyroid function. This was the first study in Croatia demonstrating BMIC to be a reliable biomarker of iodine status during lactation and predicting iodine intake in breastfed infants. The study confirmed that mandatory salt iodization in Croatia ensured sufficient dietary iodine for LW and optimal iodine intake for breastfed infants breast milk.
哺乳期妇女（LW）和婴儿对碘的需求量很高，存在碘缺乏的风险。本研究旨在评估克罗地亚萨格勒布地区哺乳期妇女及其母乳喂养婴儿的碘营养状况和甲状腺功能。研究纳入了 133 对哺乳期妇女及其母乳喂养婴儿。所有研究对象均检测了尿碘浓度（UIC）和甲状腺功能参数。对哺乳期妇女还检测了母乳碘浓度（BMIC），并收集了富含碘和盐的食物频率问卷数据。分析结果表明，99.2%的哺乳期妇女在家中使用加碘盐，20.4%的哺乳期妇女使用含碘的维生素和矿物质补充剂。哺乳期妇女的 UIC 中位数（IQR）为 75μg/L（19.0-180.5μg/L），婴儿的 UIC 中位数（IQR）为 234μg/L（151.0-367.5μg/L），而婴儿的 BMIC 中位数（IQR）为 121μg/kg（87.8-170.8μg/kg）。多元回归分析显示，BMIC 是婴儿 UIC 的显著预测因子（p<0.001）。LW 和婴儿的甲状腺功能之间存在正相关。这是克罗地亚首次研究表明，BMIC 是哺乳期碘营养状况的可靠生物标志物，可预测母乳喂养婴儿的碘摄入量。研究证实，克罗地亚强制性盐碘化确保了哺乳期妇女充足的膳食碘摄入，以及母乳喂养婴儿母乳中的最佳碘摄入量。
