The state of U.S. Iodine nutrition: how can we ensure adequate iodine for all?
The state of U.S. Iodine nutrition: how can we ensure adequate iodine for all?
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美国碘营养状况：如何确保所有人都有足够的碘？
DOI：
10.1089/thy.2013.0295
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发表时间：
2013
期刊：
影响因子：
--
通讯作者：
Leung,AngelaM
中科院分区：
文献类型：
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作者：
Pearce,ElizabethN;Leung,AngelaM
考德威尔等人的报告。(1)出现在这期《甲状腺》杂志上对公众健康有着重要的意义。它包括来自最近的国家健康和营养检查调查（NHANES）的数据和来自国家儿童研究（NCS）的试点数据。总之，这些提供了美国最大的孕妇尿碘浓度（UIC）样本，这是人群碘状况的标志。这也是美国第一个报告特定三个月和特定地区UIC措施的研究。2009-2010年美国整体UIC中位数为144 lg/L;虽然仍在最佳范围内，但已从2007-2008年的164 lg/L下降，是自20世纪70年代初NHANES开始以来观察到的最低值。与最近的其他NHANES分析一样，育龄妇女的UIC低于其他群体。在2005-2010年NHANES中，美国孕妇的UIC中位数为129 lg/L，远低于国际碘缺乏病控制理事会（ICCIDD）全球网络和世界卫生组织（WHO）倡导的150 lg/L妊娠阈值（2）。有趣的是，孕妇的UIC中位数值在前三个月和后三个月较低，并在后三个月正常化。需要更多的研究来确定这是否与饮食变化有关，在怀孕后期添加含碘补充剂，或其他因素。充足的膳食碘摄入量在怀孕期间特别重要，因为它是正常胎儿神经发育所必需的。建议孕妇每天摄入220 lg碘，高于非怀孕成人的建议摄入量150 lg/d（3）。Bougma及其同事最近的一项系统综述（4）得出结论，子宫内或婴儿早期碘缺乏导致智商下降6.9至10.2分。塔斯马尼亚州最近的一项研究检查了9岁儿童的教育成果与母亲怀孕时的UIC值（5），发现UIC< 150 lg/L的妇女的孩子与UIC≥ 150 lg/L的妇女相比，拼写，语法和英语读写成绩较差。类似地，英国的雅芳父母和儿童纵向研究（ALSPAC）最近发现，怀孕期间UIC值< 150 lg/g肌酐的妇女的孩子在9岁时的语言智商，阅读准确性和阅读理解分数较低的风险增加。
The report by Caldwell et al.(1) appearing in this issue of Thyroid has important implications for public health. It includes data from the most recent National Health and Nutrition Examination Surveys (NHANES) and pilot data from the National Children’s Study (NCS). Together, these provide the largest US sample of urinary iodine concentrations (UIC), a marker for population iodine status, in pregnant women. It is also the first US study to report trimester-specific and region-specific UIC measures. The overall US median UIC in 2009–2010 was 144 lg/L; while still in the optimal range, it has fallen from 164 lg/L in 2007–2008 and is the lowest value observed since NHANES began in the early 1970s. As in other recent NHANES analyses, UIC was lower in women of childbearing age than in other groups. The median UIC for US pregnant women in NHANES 2005–2010 was 129 lg/L, well below the 150 lg/L threshold advocated by the International Council for the Control of Iodine Deficiency Disorders (ICCIDD) Global Network and the World Health Organization for pregnancy (2). Interestingly, median UIC values in pregnant women were low in the first and second trimesters, and normalized by the third trimester. More studies are needed to determine whether this is related to dietary changes, the addition of iodine-containing supplements relatively late in pregnancy, or other factors.Adequate dietary iodine intake is particularly important in pregnancy, since it is required for normal fetal neurodevelopment. It has been recommended that pregnant women should ingest 220lg iodine daily, higher than the 150 lg/d recommended for nonpregnant adults (3). A recent systematic review by Bougma and colleagues (4) concluded that iodine deficiency in utero or in early infancy results in a 6.9 to 10.2 point IQ decrement. A recent study in Tasmania examined educational outcomes in 9-year-old children in relation to their mothers’ pregnancy UIC values (5) and found that children of women with UIC< 150 lg/L had poorer spelling, grammar, and English literacy scores compared with those of women with UIC≥ 150 lg/L. Similarly, the Avon Longitudinal Study of Parents and Children (ALSPAC) in the United Kingdom recently found that children of women with UIC values< 150 lg/g creatinine in pregnancy were at increased risk for low verbal IQ, reading accuracy, and reading comprehension scores at age 9 (6).