Iodine nutrition and thyroid function assessment in child bearing age women from Queretaro, Mexico / Estado nutricio en yodo y función tiroidea en mujeres en edad reproductiva de Querétaro, México

Objective: To assess iodine nutrition and thyroid function in Mexican childbearing age women. Methods: 101 childbearing age women (21.7 ± 3.5 years) randomly selected from the university student population participated in this cross-sectional study. TSH, thyroid hormones, anti-thyroid antibodies, thyroid volume, iodine intake, and urinary iodine concentration (UIC) were assessed. The knowledge about the importance of iodine innutrition was also evaluated by using questionnaires. Results: TSH median (interquartile range) value was1.9 (1.4-2.5) mIU/L, while FT4 median value was 9.0 (8.3-9.6) μg/dL. The median FT3 and total rT3 values were 3.3pg/mL and 40.1 ng/dL, respectively. The prevalence of subclinical hypothyroidism (serum TSH >4.5 mIU/L) and of positive anti-thyroid antibodies were 2.9% and <5.9%,respectively. Median thyroid volume was 5.6 mL and none of the subjects were diagnosed with goiter. Median urinary iodine concentration was 146 (104-180) μg/L. As for the knowledge of iodine nutrition, only 37.6% considered that a pregnant woman needs more dietary iodine than a non pregnant woman, while 43.6% recognized that the lack of iodine can cause mental retardation in children. Conclusions: Prevalence of thyroid test function abnormalities was low in this population and the median UIC indicates adequate iodine intake. We also found a poor knowledge about the importance iodine nutrition in the studied population (AU)

Objetivo: Evaluar el estado nutricional en yodo y la función tiroidea en mujeres mexicanas en edad reproductiva. Métodos: 101 mujeres universitarias en edad reproductiva(21,7 ± 3,5 años) fueron seleccionadas al azar para participar en este estudio transversal. Se evaluaron los niveles séricos de tirotropina, hormonas tiroideas, anticuerpos anti-tiroideos, volumen tiroideo, consumo de yodo y yoduria. También se evaluó el conocimiento sobre la importancia del yodo en la nutrición. Resultados: La mediana (rango intercuartilar) de tirotropina fue de 1,9 (1,4-2,5) mIU/L, mientras que para T4libre fue de 9,0 (8,3-9,6) μg/dL. Los valores de la mediana de T3 libre y T3 reversa fueron de 3,3 pg/mL y 40,1 ng/dL, respectivamente. La prevalencia de hipotiroidismo subclínico fue 2,9% (tirotropina sérica >4,5 mUI/L). La prevalencia de anticuerpos antitiroideos positivos fue <5,9%.La mediana del volumen tiroideo fue de 5,6 mL y no se diagnosticaron mujeres con bocio. La mediana (rangointercuartilar) de la yoduria fue de 146 (104-180) μg/L. En cuanto al conocimiento de la importancia del yodo en la nutrición, el 37,6% consideró que las mujeres gestantes requieren más yodo en la dieta que las no gestantes, mientras que el 43,6% reconoció que la deficiencia de yodo puede causar retraso mental en los infantes. Conclusiones: Se encontró una baja prevalencia de alteraciones en las pruebas de función tiroidea, mientras que la mediana de la yoduria indicó un adecuado consumo de yodo. También se encontró un conocimiento bajo acerca de la importancia del yodo en la nutrición (AU)

Iodine nutrition in elementary state schools of Queretaro, Mexico: correlations between urinary iodine concentration with global nutrition status and social gap index / Consumo de iodo em escolas de ensino fundamental de Querétaro, México: correlação entre a concentração urinária de iodo, o estado nutricional geral e o índice de desigualdade social

OBJECTIVE AND METHODS: To estimate median urinary iodine concentration (UIC), and to correlate it with global nutrition indicators and social gap index (SGI) in 50 elementary state schools from 10 municipalities in the State of Queretaro, Mexico. RESULTS: 1,544 students were enrolled and an above of requirements of iodine intake was found (median UIC of 297 µg/L). Iodine status was found as deficient, adequate, more than adequate and excessive in 2, 4, 19 and 25 schools, respectively. Seventy seven percent of table salt samples showed adequate iodine content (20-40 ppm), while 9.6% of the samples had low iodine content (< 15 ppm). Medians of UIC per school were positively correlated with medians of body mass index (BMI) by using the standard deviation score (SDS) (r = 0.47; p < 0.005), height SDS (r = 0.41; p < 0.05), and overweight and obesity prevalence (r = 0.41; p < 0.05). Medians of UIC per school were negatively correlated with stunting prevalence (r = -0.39; p = 005) and social gap index (r = -0.36; p < 0.05). Best multiple regression models showed that BMI SDS and height were significantly related with UIC (p < 0.05). CONCLUSIONS: There is coexistence between the two extremes of iodine intake (insufficient and excessive). To our knowledge, the observed positive correlation between UIC and overweight and obesity has not been described before, and could be explained by the availability and consumption of snack food rich in energy and iodized salt.

OBJETIVO E MÉTODOS: Estimar a concentração de iodo urinário (CIU) mediana e correlacioná-la com os indicadores de nutrição geral e com o índice de desigualdade social (IDS) de 50 escolas estaduais de ensino fundamental de 10 municípios do estado de Querétaro, no México. RESULTADOS: Utilizou-se um total de 1.544 crianças e encontrou-se uma ingestão acima das necessidades de iodo (CIU mediana de 297 µg/L). O nível de iodo determinado foi deficiente, adequado, mais do que adequado e excessivo em 2, 4, 19 e 25 escolas, respectivamente. Setenta e sete por cento de amostras de sal de mesa mostraram uma quantidade de iodo adequada (20-40 ppm), enquanto 9,6% das amostras tinham um teor de iodo baixo (< 15 ppm). As medianas de CIU por escola foram correlacionadas positivamente com as medianas do índice de massa corporal (IMC) usando o desvio-padrão da contagem (DP) (r = 0,47; p < 0.005), o DP da altura (r = 0,41; p < 0.05) e a prevalência de sobrepeso e de obesidade (r = 0,41; p < 0,05). As medianas de CUI por escola foram correlacionadas negativamente com a prevalência de desnutrição (r = -0.39; p = 005) e com o índice de desigualdade social (r = -0.36; p < 0,05). Os melhores modelos de regressão múltipla mostraram que a DP do IMC e a altura foram relacionados significativamente com a CIU (p < 0,05). CONCLUSÃO: Existe uma convivência entre os dois extremos de ingestão de iodo (insuficiente e excessiva). Em nosso conhecimento, a correlação positiva entre a CIU, o excesso de peso e a obesidade não foi descrita anteriormente e poderia ser explicada pela disponibilidade e consumo de alimentos ou refeições ricos(as) em energia e sal iodado.

Importance of iodine in pregnancy

Iodine is an essential constituent of thyroid hormones (TH). TH actively take part in critical periods of brain development during embryonic, fetal and postnatal stages. Therefore the absence of TH or iodine in these critical periods produces an irreversible brain damage. In fact, it is known that iodine deficiency is the leading cause of preventable brain damage worldwide. Because of the physiological adjustments during pregnancy iodine requirements increase significantly from 150 μg per day in non-pregnant adult women to 250 μg per day. Moreover, recent epidemiological studies around the world show that iodine intake during pregnancy is insufficient in many countries, even in developed countries like Australia, Spain and Italy. In the present work an overview of the importance of iodine nutrition during pregnancy is given.

Importancia del yodo en la gestación. El yodo es un nutrimento constituyente indispensable de las hormonas tiroideas (HT). Las HT participan activamente en periodos críticos del desarrollo cerebral durante las etapas embrionaria, fetal y posnatal. Por lo tanto la ausencia o deficiencia de las HT o de yodo en estas etapas del desarrollo produce un daño cerebral irreversible. De hecho, se sabe que la deficiencia de yodo es la principal causa de daño cerebral prevenible en el mundo. Debido a los ajustes fisiológicos propios de la gestación los requerimientos de yodo se incrementan notablemente, pasando de 150 μg al día en la mujer adulta no gestante a 250 μg al día durante el embarazo. Por otra parte, estudios epidemiológicos recientes hechos en todo el mundo muestran que el consumo de yodo durante la gestación es insuficiente en varios países; incluso en países desarrollados como Australia y España e Italia. En la presente revisión se da un panorama general de la importancia del consumo adecuado de yodo durante la gestación.