The Urine Iodine to Creatinine as an Optimal Index of Iodine During Pregnancy in an Iodine Adequate Area in China
The Urine Iodine to Creatinine as an Optimal Index of Iodine During Pregnancy in an Iodine Adequate Area in China
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DOI：
10.1210/jc.2015-3519
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发表时间：
2016-03-01
影响因子：
5.8
通讯作者：
Teng, Weiping
中科院分区：
文献类型：
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作者：
Li, Chenyan;Peng, Shiqiao;Teng, Weiping
背景：碘营养是一项全球性事件，特别是对孕妇而言。目的：制定适合人群怀孕期间的碘摄入量指数。设计、背景和参与者：2012年至2014年，妊娠8周以下孕妇（n = 222）和育龄妇女（n = 827）参与了本研究。在妊娠8、12、16、20、28和36周以及产后3和6个月的随访中对孕妇进行评估。主要结果指标：在妊娠第8周收集24小时尿液样本。所有受试者均测量了尿碘 (UI) 和肌酐 (Cr) 以及血清甲状腺球蛋白。使用电感耦合等离子体质谱法在妊娠第 8、20、36 周和产后 6 个月测量循环碘。结果：妊娠期间中位 UI 浓度从 183.6 微克/升下降至 104.2 微克/升。血清碘 (SI) 变化与 UI 与肌酐比值 (UI/Cr) 相似。 SI水平在妊娠第8周最低（60.5μg/L），直到20周（106.5μg/L）显着上升，然后开始下降（36周，84.7μg/L）。 24小时UI排泄测量被视为金标准。碘缺乏诊断的 UI/Cr 接受者操作特征曲线下面积为 0.92，SI 的接受者操作特征曲线下面积为 0.78。碘过量诊断的 SI 面积为 0.82，UI/Cr 诊断的 SI 面积为 0.75。这些曲线下的面积显着不同 (P < .001)。对于碘缺乏和碘过量诊断，UI 受试者工作特征曲线下面积分别为 0.61 (P = .11) 和 0.65 (P = .08)。此外，对于甲状腺球蛋白，这些值分别为 0.54 (P = .53) 和 0.53 (P = .74)。结论：通过孕妇现场 UI 浓度评估的碘摄入量是不准确的，并且会增加碘缺乏的患病率。 UI/Cr更好地反映孕期和产后24小时碘排泄和循环碘水平。
Context: Iodine nutrition is a global event, especially for pregnant women.Objective: To develop applicable index of iodine intake for population during pregnancy.Design, Setting, and Participants: From 2012 to 2014, pregnant women at less than 8 weeks of gestation (n = 222) and reproductive-age women(n = 827) participated in this study. The pregnant women were evaluated at follow-up visits at 8, 12, 16, 20, 28, and 36 weeks of gestation and 3 and 6 months postpartum.Main Outcome Measures: Twenty-four-hour urine samples were collected at weeks 8 of gestation. Urine iodine (UI) and creatinine (Cr) and serum thyroglobulin were measured in all of the subjects. Circulatory iodine was measured using inductively coupled plasma-mass spectrometry at 8, 20, and 36 weeks of gestation and 6 months postpartum.Results: The median UI concentration decreased from 183.6 to 104.2 mu g/L during pregnancy. The serum iodine (SI) changes were similar to the UI to creatinine ratio (UI/Cr). The SI level was lowest at the eighth week of gestation (60.5 mu g/L), which rose significantly until 20 weeks (106.5 mu g/L) and then began to decline (36 wk, 84.7 mu g/L). The 24-hour UI excretion measurement was regarded as the gold standard. The area under the receiver-operating characteristic curve for UI/Cr was 0.92 for iodine deficiency diagnoses and 0.78 for SI. The area for SI was 0.82 for excessive iodine diagnoses and 0.75 for UI/Cr. The areas under these curves were significantly different (P < .001). The areas under the receiver-operating characteristic curve for UI were 0.61 (P = .11) and 0.65 (P = .08) for iodine deficiency and excessive iodine diagnoses, respectively. Additionally, for thyroglobulin, these values were 0.54 (P = .53) and 0.53 (P = .74), respectively.Conclusions: Iodine intake, as assessed by spot UI concentration in pregnant women, is inaccurate and increases the prevalence of iodine deficiency. The UI/Cr better reflects the 24-hour iodine excretion and circulating iodine levels during pregnancy and the postpartum period.