Current status of iodine intake in Croatia--the results of 2009 survey [Stanje unosa joda u Hrvatskoj - rezultati istraživanja provedenog 2009 godine]

Kusić, Zvonko and Jukić, Tomislav and Rogan, Sunčica Andreja and Jureša, Vesna and Dabelić, Nina and Staničić, Josip and Borić, Marta and Lukinac, Ljerka and Mihaljević, Ivan and Punda, Ante and Smokvina, Aleksandar and Topalović, Zlatko and Katalenić, Marijan (2012) Current status of iodine intake in Croatia--the results of 2009 survey [Stanje unosa joda u Hrvatskoj - rezultati istraživanja provedenog 2009 godine]. Collegium Antropologicum, 36 (1). pp. 123-128. ISSN 0350-6134

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Abstract

In 1996, due to persistence of mild to moderate iodine deficiency, new law on obligatory salt iodination with 25 mg of potassium iodide (KI) per kg of salt was implemented in Croatia. Along with a new law, a new program for monitoring of iodine prophylaxis was implemented. Investigations of goiter and iodine intake performed in 2002, demonstrated sufficient iodine intake in Croatia with overall median of urinary iodine concentration (UIC) for schoolchildren in Croatia of 140 microg/L. In 2002, thyroid volumes (TV) measured by ultrasound in schoolchildren from all four geographic regions of Croatia were for the first time within the normal range according to ICCIDD reference values. Nowadays, Croatia is internationally recognized as iodine sufficient country. The aim of the present study was to assess current status of iodine intake in Croatia. The investigation was carried out in 2009. A total of 386 schoolchildren aged 7-10 years from all four major geographic regions of Croatia, 103 euthyroid pregnant women and 36 women of child-bearing age from Zagreb, the capital, were included in the survey. Urinary iodine concentration (UIC) was measured in all participants. Thyroid volumes were measured by ultrasound in schoolchildren from the capital of Zagreb (N = 101) and the village of Rude (N = 56). In the time period 2002-2009, the content of KI was analyzed in 384 salt samples from Croatian salt plants and samples of imported salt. An overall median UIC for schoolchildren in Croatia was 248 microg/L. Median UIC in pregnant women was 159 microg/L, with 50% of samples below and under 150 microg/L. Median UIC in women of child-bearing age was 136 microg/L. Thyroid volumes in schoolchildren were within the normal range according to the new reference values. Mean value of KI/kg of salt in samples from Croatian salt plants was 25.5 mg/kg and 24.9 mg/kg in samples of imported salt. A total of 72/384 (18.8%) of salt samples didn't corresponded to the Croatian law on obligatory salt iodination. Presented data indicate sufficient iodine intake of the Croatian population. Current medians of UIC in schoolchildren in Croatia are significantly higher than medians measured in 2002. This indicates that other potential sources of iodine are present in Croatian diet that may contribute to overall iodine intake. Due to rising medians of UIC in schoolchildren in Croatia, it is important to conduct nutrition studies to identify potential sources of "silent prophylaxis" in order to avoid iodine excess.

Abstract in Croatian

Zbog prisutnosti blagog do umjerenog nedostatka joda, u Hrvatskoj je 1996. godine uveden novi zakon o obveznom jodiranju soli s 25 mg kalij jodida (KI) po kilogramu soli. Uz novi zakon uveden je i novi program za kontrolu provođenja jodne profilakse. Istraživanja stanja gušavosti i unosa joda provedena 2002 godine, pokazala su dostatan unos joda u Hrvatskoj s ukupnim medijanom izlučivanja joda urinom u školske djece od 140 mg/L. Ultrazvučno izmjereni volumeni štitnjače u školske djece iz sve četiri glavne regije Hrvatske bili su po prvi put u granicama normale prema referentnim vrijednostima ICCIDD (Međunarodnog vijeća za kontrolu poremećaja uzrokovanih nedostatkom joda). Hrvatska je danas međunarodno priznata kao zemlja s dostatnim unosom joda. Cilj ovog istraživanja bio je utvrditi sadašnje stanje unosa joda u Hrvatskoj. Istraživanje je provedeno 2009. godine. U istraživanje je uključeno 386 djece u dobi 7–10 godina iz sve četiri regije Hrvatske, 103 trudnice u eutireozi i 36 žena u generativnoj dobi iz Zagreba. Određivanje joda u urinu provedeno je u svih ispitanika. Volumeni štitnjače izmjereni su ultrazvukom u školske djece iz Zagreba (N=101) i sela Rude (N=56). U razdoblju od 2002. do 2009. godine, sadržaj joda u kuhinjskoj soli izmjeren je u ukupno 384 uzorka soli iz hrvatskih solana i uzoraka uvezene soli. Ukupni medijan izlučivanja joda urinom u školske djece u Hrvatskoj iznosio je 248 mg/L. Medijan izlučivanja joda urinom u trudnica iznosio je 159 mg/L, s 50% uzoraka s izlučivanjem joda urinom ispod 150 mg/L, a 50% uzoraka iznad 150 mg/L. Median izlučivanja joda urinom u žena u generativnoj dobi iznosio je 136 mg/L. Volumeni štitnjače u školske djece bili su u granicama normale prema novim referentnim vrijednostima ICCIDD. Srednja vrijednost KI/kg soli u uzorcima soli iz Hrvatskih solana iznosila je 25,5 mg/kg, a u uzorcima uvezene soli 24,9 mg/kg. Ukupno 72/384 uzorka soli (18,8%) odstupala su od novog pravilnika o obveznom jodiranju soli. Prikazani podaci upućuju na dostatan unos joda u Hrvatskoj. Sadašnji medijani izlučivanja joda urinom su značajno viši u odnosu na medijane izmjerene 2002. godine. To upućuje da su drugi potencijalni izvori joda prisutni u Hrvatskim namirnicama koji mogu doprinijeti ukupnom unosu joda. Zbog rastućih medijana izlučivanja joda urinom u školske djece, neophodno je u Hrvatskoj provesti nutricijska istraživanja kako bi se utvrdili potencijalni izvori »tihe profilakse« s ciljem da se izbjegne prekomjeran unos joda.

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