Analiza koncentracije joda u mokraći trudnica koje uzimaju dodatak prehrani koji sadrži jod [An analysis of ionide concentration in urine in pregnant women who are taking ionide supplementation]

Borić, Marta (2016) Analiza koncentracije joda u mokraći trudnica koje uzimaju dodatak prehrani koji sadrži jod [An analysis of ionide concentration in urine in pregnant women who are taking ionide supplementation]. PhD thesis, Sveučilište u Zagrebu.

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Abstract

Iodine, as a part of thyroid hormones, is one of the most significant microelements in our organism and it plays important role in neurological development of children. Insufficient iodine intake can result in wide specter of disorders for which prevention Nacional programs of salt iodization have been developed. According to WHO/UNICEF/ICCIDD recommendations, urinary iodine concentration median is the method of choice in evaluation of iodine intake in general population. Recommended values for general population are 100-200 μg/L, while for pregnant women the range is 150-250 μg/L. According to the latest data from 2009, Croatia is a country with sufficient iodine intake in general population thanks to legislative of salt iodization with 25 mg KI/kg. Median of iodine urinary concentration in schoolchildren was 200 – 300 μg/L. In the research that involved pregnant women there have been 150 participants included. Urinary iodine concentration median was 165 μg/L, which represents sufficient iodine intake. But, 44% had values of iodine concentration < 150 μg/L, and that represents significant number of those with insufficient iodine intake. Median of the control group, those without additional iodine intake, was 96 μg/L, while the median of the group that took additional iodine through nutritional supplements, was 181 μg/L. In Croatia, country with established sufficient iodine intake in general population, urinary iodine values are in significant number of pregnant women under recommended, while those that have taken iodine supplementation have sufficient iodine intake according to the WHO/UNICEF/ICCIDD recommendation. Taking into consideration jet unproven harmful consequences in women having iodine values in urine < 150 μg/L, when general population has adequate iodine intake, there should be revision of WHO/UNICEF/ICCIDD recommendations of 150 μg/L as the lowest value for pregnant women. Also, studies referring to reasons for low values of urinary iodine concentration median in pregnant women who don’t take iodine supplementation should be conducted taking into consideration trend of salt restriction. Overall, it should be considered, in National program that follows status of iodine intake in general population, implementation of recommendations for additional iodine intake for pregnant women through nutritional supplements with prior established recommendations of amount of iodine that each supplement should contain.

Abstract in Croatian

Jod je jedan od značajnijih mikroelemenata u našem organizmu, sastavni dio hormona štitnjače koji imaju važnu ulogu u neurološkom razvoju djeteta. Nedostatan unos joda u organizam može rezultirati čitavim spektrom poremećaja te su u prevenciju istog razvijeni Nacionalni programi koji se temelje na jodiranju soli. Prema WHO/ICCIDD/UNICEF preporukama, medijan koncentracije joda u urinu je metoda procjene nutricijskog unosa joda unutar određene populacije. Preporučene vrijednosti za opću populaciju su 100-200 μg/L, dok su za trudnice 150-250 μg/L. Prema zadnjim podatcima iz 2009. godine Hrvatska pripada grupi zemalja sa dostatnim unosom joda u općoj populaciji zahvaljujući zakonski reguliranom propisu obvezatnog jodiranja soli sa 25 mg KI/kg soli. Medijan koncetracije joda u urinu u djece školske dobi je iznosio 200 – 300 μg/L. U istraživanju na populaciji trudnica ukupno je bilo uključeno 150 ispitanica. Medijan koncentracije joda u urinu je iznosio165 μg/L što odgovara adekvatnom unosu joda. Međutim, njih 44% je imalo vrijednosti koncentracije joda ispod 150 μg/L što čini značajan udio onih sa nedostatnim unosom joda. Medijan kontrolne skupine, one bez dodatnog unosa joda, je iznosio 96 μg/L, dok je medijan ispitivane skupine trudnica koje su uzimale dodatke prehrani koji sadrže jod, iznosio 181 μg/L. U Hrvatskoj, zemlji s dokazanim dostatnim unosom joda u općoj populaciji, vrijednost joda u urinu je u značajnog broja trudnica ispod preporučenih, dok trudnice koje su uzimale dodatke prehrani koji sadrže jod imaju dostatan unos joda prema WHO/UNICEF/ICCIDD preporukama. Uzimajući u obzir još uvijek nedokazane štetne posljedice u žena koje su imale vrijednosti joda u urinu < 150 μg/L unutar opće populacije sa dokazanim adekvatnim unosom joda potrebno je razmotriti WHO/UNICEF/ICCIDD preporuke o 150 μg/L kao najniže prihvatljivoj granici za trudnice. Također, potrebno je provesti istraživanja kojima bi se razlučili razlozi niske vrijednosti medijana koncentracije joda u urinu trudnica koje ne uzimaju dodatni jod, prvenstveno uzimajući u obzir trend restrikcije unosa soli. U konačnici, u obzir dolazi, u sklopu Nacionalnog programa praćenja statusa unosa joda u općoj populaciji, razmatranje uvođenje preporuka za uzimanjem dodatnog joda tijekom trudnoće putem dodataka prehrani uz prethodno usuglašene preporuke o količini joda koju bi svaki pripravak trebao sadržavati.

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