加拿大蒙特利尔母婴碘营养状况：一项母乳喂养婴儿维生素D补充试验的二次分析

Iodine Status of Mother-Infant Dyads from Montréal, Canada: Secondary Analyses of a Vitamin D Supplementation Trial in Breastfed Infants.

作者信息

Bertinato Jesse, Gaudet Jeremiah, De Silva Nimal, Mohanty Smitarani, Qiao Cunye, Herod Matthew, Gharibeh Nathalie, Weiler Hope

机构信息

Nutrition Research Division, Bureau of Nutritional Sciences, HPFB (Health Products and Food Branch), Health Canada, Ottawa, Canada.

Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, Canada.

出版信息

J Nutr. 2022 Jun 9;152(6):1459-1466. doi: 10.1093/jn/nxac047.

DOI:10.1093/jn/nxac047

PMID:35218192

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9178965/

Abstract

BACKGROUND

Most pregnant or lactating women in Canada will not meet iodine requirements without iodine supplementation.

OBJECTIVES

To assess the iodine status of 132 mother-infant pairs based on secondary analyses of a vitamin D supplementation trial in breastfed infants from Montréal, Canada.

METHODS

Maternal iodine status was assessed using the breastmilk iodine concentration (BMIC). Singleton, term-born infants were studied from 1-36 months of age. Usual (adjusted for within-person variation) iodine intakes were estimated from urinary iodine and creatinine concentrations. Iodine status was assessed using median urinary iodine concentrations (UICs) and by estimating inadequate intakes by the cut-point method using a proposed Estimated Average Requirement for infants 0-6 months of age (72 μg/d).

RESULTS

At 1, 3, and 6 months of age, 70%, 63%, and 3% of infants, respectively, were exclusively breastfed. From 1-36 months of age (n = 82-129), the median UICs were ≥100 μg/L (range, 246-403 μg/L), which is the cutoff for adequate intakes set by the WHO for children <2 years. Almost all (98%-99%) infants at 1 and 2 months, 2 and 3 months, and 3 and 6 months of age had usual creatinine-adjusted iodine intakes ≥ 72 μg/d. The median BMIC was higher (P < 0.001) at 1 month compared to 6 months of lactation [1 month, 198 μg/kg (IQR, 124-274; n = 105) and 6 months, 109 μg/kg (IQR, 67-168; n = 78)]. At 1 and 6 months, 96% and 79% of mothers, respectively, had a BMIC ≥ 60 μg/kg, the lower limit of a normal reference range. The percentages of mothers that used a multivitamin-mineral (MVM) supplement containing iodine were 90% in pregnancy and 79% and 59% at 1 and 6 months of lactation, respectively.

CONCLUSIONS

The iodine status of infants was adequate throughout infancy. These results support a recommendation that all women who could become pregnant, who are pregnant, or who are breastfeeding take a daily MVM supplement containing iodine.

摘要

背景

在加拿大，大多数怀孕或哺乳期妇女若不补充碘，将无法满足碘的需求。

目的

基于对加拿大蒙特利尔市母乳喂养婴儿维生素D补充试验的二次分析，评估132对母婴的碘状况。

方法

采用母乳碘浓度（BMIC）评估母亲的碘状况。对单胎足月出生的婴儿进行1至36个月的研究。根据尿碘和肌酐浓度估算通常（校正个体内差异）碘摄入量。使用尿碘中位数浓度（UICs）并通过采用提议的0至6个月婴儿估计平均需求量（72μg/d）的切点法估算摄入不足情况来评估碘状况。

结果

在1、3和6个月龄时，分别有70%、63%和3%的婴儿纯母乳喂养。在1至36个月龄（n = 82 - 129）期间，UICs中位数≥100μg/L（范围为246 - 403μg/L），这是世界卫生组织为2岁以下儿童设定的充足摄入量下限。几乎所有1和2个月、2和3个月以及3和6个月龄的婴儿通常经肌酐校正的碘摄入量≥72μg/d。与哺乳6个月相比，哺乳1个月时BMIC中位数更高（P < 0.001）[1个月时为198μg/kg（IQR，124 - 274；n = 105），6个月时为109μg/kg（IQR，67 - 168；n = 78）]。在1和6个月时，分别有96%和79%的母亲BMIC≥60μg/kg，这是正常参考范围的下限。孕期使用含碘多种维生素 - 矿物质（MVM）补充剂的母亲比例为90%，哺乳1个月和6个月时分别为79%和59%。