Nanu M, Delia C E, Toma G M, Ardeleanu I, Nanu I, Stemate M, Nuta D, Gheorghiu M L
"Alessandrescu-Rusescu" National Institute for Mother and Child Health - Research Dept. in Social Pediatry and Obstetrics.
"Alessandrescu-Rusescu" National Institute for Mother and Child Health - Clinical Laboratory.
Acta Endocrinol (Buchar). 2024 Jan-Mar;20(1):80-89. doi: 10.4183/aeb.2024.80. Epub 2024 Oct 3.
To monitor the iodine status in Romanian schoolchildren and neonates after 20 years of mandatory salt iodization.
In a national representative sample of 1352 children (7-12 years) we measured median urinary iodine concentration (mUIC) and creatinine (UCC) in spot urine samples and investigated household use of iodized salt. From 18349 neonates registered in the MEDILOG program for TSH screening we calculated the percentage of neonatal TSH >5 mIU/L (<3% indicating adequate iodine intake).
mUIC in schoolchildren was 141 µg/L (bootstrapped 95% CI 134, 146), showing adequate iodine intake in all but 1 county; mUIC was similar in historical endemic and non-endemic counties (140 µg/L and 143 ug/L, respectively) and in urban and rural areas (140 µg/L and 142 µg/L, respectively); mUIC/UCC = 118 ug/g. Iodized salt was used in 62% of households. In children using iodized salt (61.7%), mUIC was higher than in those using coarse (non-iodized) salt (24.6%): 150 . 121 µg/L (p<0.001). The percentage of nTSH >5 mIU/L was 14.7% (3.2%-27.3%), higher in non-endemic counties and urban areas.
The current salt iodization program for households and bakery industry ensures an adequate iodine intake in schoolchildren. Discordantly, nTSH levels indicate a mild-moderate ID in neonates, suggesting ID in pregnant women. The percentage of households using iodized salt is below the recommended >90% needed for an efficient ID prevention program. More efforts should be directed to increase the public awareness on the health risks of ID and the benefits of ID prevention, notably for the neurointellectual development in children.
监测在强制食盐碘化20年后罗马尼亚学龄儿童和新生儿的碘营养状况。
在1352名7至12岁儿童的全国代表性样本中，我们测量了随机尿样中的尿碘中位数浓度（mUIC）和肌酐（UCC），并调查了家庭碘盐使用情况。从MEDILOG项目登记的18349名接受促甲状腺激素筛查的新生儿中，我们计算了新生儿促甲状腺激素>5 mIU/L的百分比（<3%表明碘摄入充足）。
学龄儿童的mUIC为141μg/L（自抽样95%置信区间134, 146），除1个县外所有地区碘摄入充足；历史上的地方性甲状腺肿流行县和非流行县的mUIC相似（分别为140μg/L和143μg/L），城市和农村地区也相似（分别为140μg/L和142μg/L）；mUIC/UCC = 118μg/g。62%的家庭使用碘盐。在使用碘盐的儿童中（61.7%），mUIC高于使用粗盐（非碘盐）的儿童（24.6%）：150. 121μg/L（p<0.001）。促甲状腺激素>5 mIU/L的百分比为14.7%（3.2%-27.3%），在非流行县和城市地区更高。
当前针对家庭和烘焙行业的食盐碘化计划确保了学龄儿童充足的碘摄入。然而，新生儿促甲状腺激素水平表明存在轻度至中度碘缺乏，提示孕妇存在碘缺乏。使用碘盐的家庭百分比低于有效碘缺乏预防计划建议的>90%。应加大力度提高公众对碘缺乏健康风险以及碘缺乏预防益处的认识，特别是对儿童神经智力发育方面的益处。
