Hypertension and Salt-Restrictive Diet Promotes Low Urinary Iodine Concentration in High-Risk Pregnant Women: Results from a Cross-Sectional Study Conducted After Salt Iodination Reduction in Brazil.

During pregnancy, the demand for daily iodine increases by 50-70% which occurs to reach around 250 µg/day. Limited information is available on the association of high-risk pregnancy (HRP) with urinary iodine concentration (UIC) and variables such as socioeconomic factors. To analyze iodine nutritional status and socioeconomic, demographic and anthropometric characteristics among women with HRP screened at the main referral public health center at Bahia, Brazil, a cross-sectional study was conducted in 241 women with HRP (15-46 years old) in Salvador, Bahia, Brazil. The median UIC (MUIC) was 119 µg/L (25-75th, 58.7-200.4 µg/L), indicating mild iodine deficiency. Low UIC (< 150 µg/L) was detected in 61.8% (n = 149) - 18.3% between 100 and 150 µg/L, 24.5% between 50 and 100 µg/L, and 19.1% with UIC < 50 µg/L. Overall, 53% (n = 128) of our population adhered to a low-salt diet, and 32.5% (n = 77) had hypertension. Among the 73% of hypertensive women adhering to a salt-restricted diet, there was a 112% increased risk of iodine deficiency observed (OR = 2.127; 95% confidence interval [1.178-3.829]; p = 0.011). Adhering to a salt-restricted diet was associated with iodine deficiency (OR = 1.82; 95% confidence interval [1.073-3.088], p = 0,026). Hypertension and salt restriction diet significantly increased susceptibility for iodine deficiency in HRP. Therefore, low-salt diet when prescribed to pregnant women (PW) might be carefully followed by iodine nutritional status assessment or universal preconception iodine supplementation.

Effects of type 1 diabetes mellitus on efferent auditory system in children and adolescents.

AIM: To investigate whether type 1 diabetes mellitus (T1DM) could affect the efferent auditory system by analyzing the relationship between the activation of the medial olivocochlear reflex with disease duration, metabolic control and age at time of diagnosis. METHOD: A total of 101 children and adolescents were evaluated. They were divided into two groups: 50 with T1DM and 51 without the disease. The participants answered a structured questionnaire containing questions about auditory complaints and were evaluated for tonal audiometry, tympanometry, acoustic reflex, otoacoustic emission by distortion product to evaluate the inhibitory effect of medial olivocochlear reflex (MOC). RESULTS: The participants with T1DM presented changed AR (increased or absent) at all the frequencies in both ears (p < 0.05) when compared with the group without the disease. No differences were found between the DPOAE amplitudes of the individuals with and without T1DM, in both ears at all the frequencies. There were significant differences in the activation of the MOC reflex between the groups with and without T1DM, the participants with T1DM presented the absence of the inhibitory effect of the DPOAE in the right and left ears, in the frequencies of 4000 Hz (p = 0.035/0.002respectively) and 6000 Hz (p = 0.033/0.031 respectively) and 8000 Hz (p = 0.007/0.001 respectively) when compared to the healthy group. Significant differences were also observed between the groups with and without T1DM (p < 0.05) for self-reported complaints of tinitus, difficulties with the perception of speech when there was noise and distraction with noise. No association was found between the hearing complaints and the audiological measurements obtained and disease time, metabolic control and age at the time of diagnosis. CONCLUSION: The findings suggest the presence of early auditory dysfunction of the efferent pathway in patients with T1DM.

Study of cochlear function in neonates and infants with congenital hypothyroidism.

OBJECTIVE: To investigate the signal amplitudes of transient evoked otoacoustic emissions (TEOAE) in neonates and infants diagnosed with congenital hypothyroidism (HC) and verify their association with clinical and laboratory aspects. METHODS: A cross-sectional study with a convenience sample of 22 individuals with congenital hypothyroidism and a group of 22 individuals without the disease, neonates and infants, aged 0-12 months. The TEOAE amplitudes were evaluated in both groups and compared using the Mann-Whitney test. The existence of association between TEOAE amplitudes and clinical-laboratory variables was verified through the Spearman correlation coefficient. RESULTS: There were no statistically significant differences between TEOAE amplitudes between the two groups. There was an association between the amplitudes of TEOAE and serum levels of thyroid stimulating hormone (TSH) and free thyroxine (T4) in the diagnostic test. CONCLUSIONS: The existence of an association between serum levels of TSH and free T4 in the diagnostic test and the amplitudes of TEOAE suggests the influence of these hormones on the auditory function.

Self-reported participation restrictions in normal hearing individuals in thyroid ontogeny: Evidence of subclinical changes.

PURPOSE: To verify evidence of subclinical alterations through self-reported participation restrictions in normal hearing individuals and congenital hypothyroidism patients. METHODS: An analytical, quantitative, cross-sectional exploratory study with a 1:1 ratio, consisting of a convenience sample of 86 normal hearing individuals with (n = 42) and without (n = 44) congenital hypothyroidism diagnosis. All participants underwent tonal and speech audiometry, immitance and distortion product otoacoustic emissions. The researchers excluded people with hearing loss, genetic syndromes and metabolic diseases. The instrument used for evaluate of self-reported participation restrictions was the HHIE-adapted questionnaire, composed of 25 questions, 12 of which were social domain and 13 emotional domain. Student's t-test and chi-square test were used for statistical analysis at a significance level of 5%. RESULTS: There was a significant (p < 0.001) self-reported participation restrictions in CH (61.9%), with a greater relevance for the social domain (p = 0.002). There was a greater frequency of mild/moderate (40.5%) and higher prevalence of association with clinical factors and adherence to treatment. CONCLUSION: The findings indicate that self-reported participation restrictions in normal hearing individuals with congenital hypothyroidism was more significant than in the non-exposed group, suggesting evidence of subclinical auditory abnormalities in this population.