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Gebe Kadınlarda Trimesterlere Göre İdrarda İyot Düzeyleri ve Beslenme Durumlarının Değerlendirilmesi

Year 2024, Volume: 7 Issue: 1, 1 - 10, 29.02.2024
https://doi.org/10.53446/actamednicomedia.1176324

Abstract

Amaç: İyot eksikliği, tüm dünyada gebe kadınları ve çocukları ciddi şekilde etkileyen önemli bir sağlık sorunudur. Araştırmada, Konya ilinde yaşayan gebelerde trimesterlere göre idrar iyot düzeylerinin değerlendirilmesi amaçlanmıştır.
Yöntem: Araştırmaya, 1-40 hafta arasında gebeliği olan 15-49 yaş aralığındaki 395 gebe kadın dahil edilmiştir. Araştırmacılar tarafından oluşturulan soru formu, katılımcıların sosyo-demografik, obstetric ve iyotlu tuz kullanma özelliklerini içeren beslenmeye yönelik 54 sorudan oluşmaktadır.
Bulgular: Katılımcıların, medyan idrar iyot düzeyleri 91,90 µg/L idi. Gebelerin birinci, ikinci ve üçüncü trimesterdeki medyan idrar iyot düzeyleri sırasıyla 104,00µg/L, 93,00µg/L ve 71,00µg/L idi. Üçüncü trimesterdeki idrar iyot düzeyi anlamlı olarak düşüktü (p<0,05). 395 gebe kadının %78,70’inde iyot eksikliği (<150µg/L) olduğu belirlenmiştir. Gebelerin birinci trimesterde %9,90’ında, ikinci trimesterde %15,80’inde ve üçüncü trimesterde %34,40’ında ciddi iyot eksikliği (0-49µg/L) saptandı.
Sonuç: Sonuç olarak, bu çalışmaya katılan gebelerin idrar iyot düzeyi yetersizdi ve bu eksiklik trimester ilerledikçe daha belirgin hale gelmektedir.

References

  • Andersson M, Takkouche B, Egli I, Allen HE, de Benoist B. Current global iodine status and progress over the last decade towards the elimination of iodine deficiency. Bull World Health Organ. 2005;83:518-525.
  • Wang Y, Zhang Z, Ge P, Wang Y, Wang S. Iodine deficiency disorders after a decade of universal salt iodization in a severe iodine deficiency region in China. Indian J Med Res. 2009;130:413-417.
  • Glinoer D. Maternal and fetal impact of chronic iodine deficiency. Clin Obstet Gynecol. 1997;40:102-116.
  • Glinoer D. Iodine nutrition requirements during pregnancy. Thyroid. 2006;16:947-948. doi:10.1089/thy.2006.16.947
  • Dafnis E, Sabatini S. The effect of pregnancy on renal function: physiology and pathophysiology. Am J Med Sci. 1992;303:184-205. doi:10.1097/00000441-199203000-00011
  • Glinoer D. The regulation of thyroid function during normal pregnancy: importance of the iodine nutrition status. Best Pract Res Clin Endocrinol Metab. 2004;18:133-152. doi:10.1016/j.beem.2004.03.001
  • Perez-Lopez FR. Iodine and thyroid hormones during pregnancy and postpartum. Gynecol Endocrinol. 2007;23:414-428. doi:10.1080/09513590701464092
  • Dunn JT, Delange F. Damaged reproduction: the most important consequence of iodine deficiency. J Clin Endocrinol Metab. 2001;86:2360-2363. doi:10.1210/jcem.86.6.7611
  • Elnagar B, Eltom A, Wide L, Gebre-Medhin M, Karlsson FA. Iodine status, thyroid function and pregnancy: study of Swedish and Sudanese women. Eur J Clin Nutr. 1998;52:351-355. doi:10.1038/sj.ejcn.1600563
  • Hershman JM. Physiological and pathological aspects of the effect of human chorionic gonadotropin on the thyroid. Best Pract Res Clin Endocrinol Metab. 2004;18:249-265. doi:10.1016/j.beem.2004.03.010
  • Zimmermann MB. Iodine deficiency. Endocr Rev. 2009;30:376-408. doi:10.1210/er.2009-0011
  • Zimmermann MB, Jooste PL, Pandav CS. Iodine-deficiency disorders. Lancet. 2008;372:1251-1262. doi:10.1016/S0140-6736(08)61005-3
  • Pearce EN, Hollowell JG, Jr. Iodine nutrition--more is better. N Engl J Med. 2006; 355:1500; author reply 1501.
  • Zimmermann MB. The effects of iodine deficiency in pregnancy and infancy. Paediatr Perinat Epidemiol. 2012; 26(suppl1):108-117. doi:10.1111/j.1365-3016.2012.01275.x
  • World Health Organization. Iodine Status Worldwide:WHO Global Database on Iodine Deficiency. Geneva: WHO; 2004. http://apps.who.int/iris/bitstream/10665/43010/1/9241592001.pdf. Accessed April 07.
  • Scientific Committee on Food. Opinion of the Scientific Committee on Food on the Tolarable Upper Intake Level of Iodine. Belgium: SCF; 2002. http://ec.europa.eu/food/fs/sc/scf/out146_en.pdf.
  • World Health Organization/UNICEF/International Council for Control of Iodine Deficiency Disorders.Assessment of Iodine Deficiency Disorders and Monitoring Their Elimination, a Guide for Programme Managers (2nd ed). Geneva: WHO; 2001. http://www.who.int/nutrition/publications/en/idd_assessment_monitoring_eliminination.pdf.
  • World Health Organization/UNICEF/International Council for Control of Iodine Deficiency DisordersAssessment of Iodine Deficiency Disorders and Monitoring Their Elimination: A Guide for Programme Managers, 3rd edn. Geneva: WHO; 2007. http://apps.who.int/iris/bitstream/10665/43781/1/9789241595827_eng.pdf.
  • Zimmermann MB, Gizak M, Abbott K, Andersson M, Lazarus JH. Iodine deficiency in pregnant women in Europe. Lancet Diabetes Endocrinol. 2015;3:672-674. doi:10.1016/S2213-8587(15)00263-6
  • Erdogan G, Erdogan MF, Delange F, Sav H, Gullu S, Kamel N. Moderate to severe iodine deficiency in three endemic goitre areas from the Black Sea region and the capital of Turkey. Eur J Epidemiol. 2000;16:1131-1134. doi:10.1023/A:1010959928862
  • Yordam N, Ozon A, Alikasifoglu A, et al. Iodine deficiency in Turkey. Eur J Pediatr. 1999;158:501-505. doi:10.1007/s004310051130
  • Egri M, Ercan C, Karaoglu L. Iodine deficiency in pregnant women in eastern Turkey (Malatya Province): 7 years after the introduction of mandatory table salt iodization. Public Health Nutr. 2009;12:849-852. doi:10.1017/S1368980008003315
  • Glinoer D. Pregnancy and iodine. Thyroid. 2001;11:471-481.
  • Nicola JP, Basquin C, Portulano C, Reyna-Neyra A, Paroder M, Carrasco N. The Na+/I- symporter mediates active iodide uptake in the intestine. Am J Physiol Cell Physiol. 2009;296:C654-662. doi:10.1152/ajpcell.00509.2008
  • Mitka M. Even mild iodine deficiency during gestation may impair brain function in children. JAMA. 2013;309:2428. doi:10.1001/jama.2013.7239
  • Wei Z, Wang W, Zhang J, Zhang X, Jin L, Yu X. Urinary iodine level and its determinants in pregnant women of Shanghai, China. Br J Nutr. 2015;113:1427-1432. doi:10.1017/S0007114515000665
  • Caldwell KL, Pan Y, Mortensen ME, Makhmudov A, Merrill L, Moye J. Iodine status in pregnant women in the National Children's Study and in U.S. women (15-44 years), National Health and Nutrition Examination Survey 2005-2010. Thyroid. 2013;23:927-937. doi:10.1089/thy.2013.0012
  • Gowachirapant S, Winichagoon P, Wyss L, et al. Urinary iodine concentrations indicate iodine deficiency in pregnant Thai women but iodine sufficiency in their school-aged children. J Nutr. 2009;139:1169-1172. doi:10.3945/jn.108.100438
  • HUIPS. Turkey Demographic and Health Survey, THDS 2008. Hacettepe University Institute of Population Studies, Ministry of Health General Directorate of Mother and Child Health and Family Planning, T.R. Prime Ministry Undersecretary of State Planning Organization and TÜBİTAK. Ankara, TURKEY, 2008.
  • Erdogan MF, Agbaht K, Altunsu T, et al. Current iodine status in Turkey. J Endocrinol Invest. 2009;32:617-622. doi:10.1007/BF03346519
  • Anaforoglu I, Algun E, Incecayir O, Topbas M, Erdogan MF. Iodine status among pregnant women after mandatory salt iodisation. Br J Nutr. 2016;115:405-410. doi:10.1017/S0007114515004559
  • Erdogan G, Erdogan MF, Emral R, et al. Iodine status and goiter prevalence in Turkey before mandatory iodization. J Endocrinol Invest. 2002;25:224-228. doi:10.1007/BF03343994
  • Kut A, Gursoy A, Senbayram S, Bayraktar N, Budakoglu, II, Akgun HS. Iodine intake is still inadequate among pregnant women eight years after mandatory iodination of salt in Turkey. J Endocrinol Invest. 2010;33:461-464. doi:10.1007/BF03346625
  • Oguz Kutlu A, Kara C. Iodine deficiency in pregnant women in the apparently iodine-sufficient capital city of Turkey. Clin Endocrinol (Oxf). 2012;77:615-620. doi:10.1111/j.1365-2265.2012.04440.x
  • Koyuncu K, Turgay B, Soylemez F. Iodine deficiency in pregnant women at first trimester in Ankara. J Turk Ger Gynecol Assoc. 2019;20:37-40. doi:10.4274/jtgga.galenos.2018.2017.0150
  • Azizi F, Aminorroya A, Hedayati M, Rezvanian H, Amini M, Mirmiran P. Urinary iodine excretion in pregnant women residing in areas with adequate iodine intake. Public Health Nutr. 2003;6:95-98. doi:10.1079/PHN2002366
  • Ainy E, Ordookhani A, Hedayati M, Azizi F. Assessment of intertrimester and seasonal variations of urinary iodine concentration during pregnancy in an iodine-replete area. Clin Endocrinol (Oxf). 2007;67:577-581. doi:10.1111/j.1365-2265.2007.02928.x
  • Amouzegar A, Khazan M, Hedayati M, Azizi F. An assessment of the iodine status and the correlation between iodine nutrition and thyroid function during pregnancy in an iodine sufficient area. Eur J Clin Nutr. 2014;68:397-400. doi:10.1038/ejcn.2013.273
  • Alvarez-Pedrerol M, Ribas-Fito N, Garcia-Esteban R, et al. Iodine sources and iodine levels in pregnant women from an area without known iodine deficiency. Clin Endocrinol (Oxf). 2010;72:81-86. doi:10.1111/j.1365-2265.2009.03588.x
  • Andersson M, de Benoist B, Rogers L. Epidemiology of iodine deficiency: Salt iodisation and iodine status. Best Pract Res Clin Endocrinol Metab. 2010;24:1-11. doi:10.1016/j.beem.2009.08.005

The Evaluation of Iodine Levels in Urine and Nutrition in Pregnant Women According to Trimesters

Year 2024, Volume: 7 Issue: 1, 1 - 10, 29.02.2024
https://doi.org/10.53446/actamednicomedia.1176324

Abstract

Objective: Iodine deficiency is a major health problem globally that seriously affects pregnant women and children. The aim of this study was to evaluate urinary iodine levels in pregnant women living in the province of Konya according to trimester.
Methods: A total of 395 pregnant women aged between 15-49, with gestational periods of 1 to 40 weeks were included in the study. A questionnaire prepared by the researchers, with a total of 54 questions, was used to determine the socio-demographic, obstetric, and iodized salt nutritional characteristics of the participants.
Results: The overall median urinary iodine levels were 91.90 µg/L. The mean urinary iodine levels of the pregnant women in the first, second, and third trimesters were 104.00 µg/L in the first trimester, 93.00 µg/L in the second trimester, and 71.00 µg/L in the third trimester. The urinary iodine level was lower in the third trimester and this difference was significant (p<0.05). The results revealed that 78.70% of the 395 women had iodine deficiency (<150µg/L). Severe iodine deficiency (0-49µg/L) was detected in 9.90% of pregnant women who were in the first trimester, 15.80% of the women in the second trimester, and in 34.40% of the women in the third trimester.
Conclusion: The pregnant women participating in this study had insufficient iodine levels in their urine, and this deficiency became more prominent as the trimesters continued.

References

  • Andersson M, Takkouche B, Egli I, Allen HE, de Benoist B. Current global iodine status and progress over the last decade towards the elimination of iodine deficiency. Bull World Health Organ. 2005;83:518-525.
  • Wang Y, Zhang Z, Ge P, Wang Y, Wang S. Iodine deficiency disorders after a decade of universal salt iodization in a severe iodine deficiency region in China. Indian J Med Res. 2009;130:413-417.
  • Glinoer D. Maternal and fetal impact of chronic iodine deficiency. Clin Obstet Gynecol. 1997;40:102-116.
  • Glinoer D. Iodine nutrition requirements during pregnancy. Thyroid. 2006;16:947-948. doi:10.1089/thy.2006.16.947
  • Dafnis E, Sabatini S. The effect of pregnancy on renal function: physiology and pathophysiology. Am J Med Sci. 1992;303:184-205. doi:10.1097/00000441-199203000-00011
  • Glinoer D. The regulation of thyroid function during normal pregnancy: importance of the iodine nutrition status. Best Pract Res Clin Endocrinol Metab. 2004;18:133-152. doi:10.1016/j.beem.2004.03.001
  • Perez-Lopez FR. Iodine and thyroid hormones during pregnancy and postpartum. Gynecol Endocrinol. 2007;23:414-428. doi:10.1080/09513590701464092
  • Dunn JT, Delange F. Damaged reproduction: the most important consequence of iodine deficiency. J Clin Endocrinol Metab. 2001;86:2360-2363. doi:10.1210/jcem.86.6.7611
  • Elnagar B, Eltom A, Wide L, Gebre-Medhin M, Karlsson FA. Iodine status, thyroid function and pregnancy: study of Swedish and Sudanese women. Eur J Clin Nutr. 1998;52:351-355. doi:10.1038/sj.ejcn.1600563
  • Hershman JM. Physiological and pathological aspects of the effect of human chorionic gonadotropin on the thyroid. Best Pract Res Clin Endocrinol Metab. 2004;18:249-265. doi:10.1016/j.beem.2004.03.010
  • Zimmermann MB. Iodine deficiency. Endocr Rev. 2009;30:376-408. doi:10.1210/er.2009-0011
  • Zimmermann MB, Jooste PL, Pandav CS. Iodine-deficiency disorders. Lancet. 2008;372:1251-1262. doi:10.1016/S0140-6736(08)61005-3
  • Pearce EN, Hollowell JG, Jr. Iodine nutrition--more is better. N Engl J Med. 2006; 355:1500; author reply 1501.
  • Zimmermann MB. The effects of iodine deficiency in pregnancy and infancy. Paediatr Perinat Epidemiol. 2012; 26(suppl1):108-117. doi:10.1111/j.1365-3016.2012.01275.x
  • World Health Organization. Iodine Status Worldwide:WHO Global Database on Iodine Deficiency. Geneva: WHO; 2004. http://apps.who.int/iris/bitstream/10665/43010/1/9241592001.pdf. Accessed April 07.
  • Scientific Committee on Food. Opinion of the Scientific Committee on Food on the Tolarable Upper Intake Level of Iodine. Belgium: SCF; 2002. http://ec.europa.eu/food/fs/sc/scf/out146_en.pdf.
  • World Health Organization/UNICEF/International Council for Control of Iodine Deficiency Disorders.Assessment of Iodine Deficiency Disorders and Monitoring Their Elimination, a Guide for Programme Managers (2nd ed). Geneva: WHO; 2001. http://www.who.int/nutrition/publications/en/idd_assessment_monitoring_eliminination.pdf.
  • World Health Organization/UNICEF/International Council for Control of Iodine Deficiency DisordersAssessment of Iodine Deficiency Disorders and Monitoring Their Elimination: A Guide for Programme Managers, 3rd edn. Geneva: WHO; 2007. http://apps.who.int/iris/bitstream/10665/43781/1/9789241595827_eng.pdf.
  • Zimmermann MB, Gizak M, Abbott K, Andersson M, Lazarus JH. Iodine deficiency in pregnant women in Europe. Lancet Diabetes Endocrinol. 2015;3:672-674. doi:10.1016/S2213-8587(15)00263-6
  • Erdogan G, Erdogan MF, Delange F, Sav H, Gullu S, Kamel N. Moderate to severe iodine deficiency in three endemic goitre areas from the Black Sea region and the capital of Turkey. Eur J Epidemiol. 2000;16:1131-1134. doi:10.1023/A:1010959928862
  • Yordam N, Ozon A, Alikasifoglu A, et al. Iodine deficiency in Turkey. Eur J Pediatr. 1999;158:501-505. doi:10.1007/s004310051130
  • Egri M, Ercan C, Karaoglu L. Iodine deficiency in pregnant women in eastern Turkey (Malatya Province): 7 years after the introduction of mandatory table salt iodization. Public Health Nutr. 2009;12:849-852. doi:10.1017/S1368980008003315
  • Glinoer D. Pregnancy and iodine. Thyroid. 2001;11:471-481.
  • Nicola JP, Basquin C, Portulano C, Reyna-Neyra A, Paroder M, Carrasco N. The Na+/I- symporter mediates active iodide uptake in the intestine. Am J Physiol Cell Physiol. 2009;296:C654-662. doi:10.1152/ajpcell.00509.2008
  • Mitka M. Even mild iodine deficiency during gestation may impair brain function in children. JAMA. 2013;309:2428. doi:10.1001/jama.2013.7239
  • Wei Z, Wang W, Zhang J, Zhang X, Jin L, Yu X. Urinary iodine level and its determinants in pregnant women of Shanghai, China. Br J Nutr. 2015;113:1427-1432. doi:10.1017/S0007114515000665
  • Caldwell KL, Pan Y, Mortensen ME, Makhmudov A, Merrill L, Moye J. Iodine status in pregnant women in the National Children's Study and in U.S. women (15-44 years), National Health and Nutrition Examination Survey 2005-2010. Thyroid. 2013;23:927-937. doi:10.1089/thy.2013.0012
  • Gowachirapant S, Winichagoon P, Wyss L, et al. Urinary iodine concentrations indicate iodine deficiency in pregnant Thai women but iodine sufficiency in their school-aged children. J Nutr. 2009;139:1169-1172. doi:10.3945/jn.108.100438
  • HUIPS. Turkey Demographic and Health Survey, THDS 2008. Hacettepe University Institute of Population Studies, Ministry of Health General Directorate of Mother and Child Health and Family Planning, T.R. Prime Ministry Undersecretary of State Planning Organization and TÜBİTAK. Ankara, TURKEY, 2008.
  • Erdogan MF, Agbaht K, Altunsu T, et al. Current iodine status in Turkey. J Endocrinol Invest. 2009;32:617-622. doi:10.1007/BF03346519
  • Anaforoglu I, Algun E, Incecayir O, Topbas M, Erdogan MF. Iodine status among pregnant women after mandatory salt iodisation. Br J Nutr. 2016;115:405-410. doi:10.1017/S0007114515004559
  • Erdogan G, Erdogan MF, Emral R, et al. Iodine status and goiter prevalence in Turkey before mandatory iodization. J Endocrinol Invest. 2002;25:224-228. doi:10.1007/BF03343994
  • Kut A, Gursoy A, Senbayram S, Bayraktar N, Budakoglu, II, Akgun HS. Iodine intake is still inadequate among pregnant women eight years after mandatory iodination of salt in Turkey. J Endocrinol Invest. 2010;33:461-464. doi:10.1007/BF03346625
  • Oguz Kutlu A, Kara C. Iodine deficiency in pregnant women in the apparently iodine-sufficient capital city of Turkey. Clin Endocrinol (Oxf). 2012;77:615-620. doi:10.1111/j.1365-2265.2012.04440.x
  • Koyuncu K, Turgay B, Soylemez F. Iodine deficiency in pregnant women at first trimester in Ankara. J Turk Ger Gynecol Assoc. 2019;20:37-40. doi:10.4274/jtgga.galenos.2018.2017.0150
  • Azizi F, Aminorroya A, Hedayati M, Rezvanian H, Amini M, Mirmiran P. Urinary iodine excretion in pregnant women residing in areas with adequate iodine intake. Public Health Nutr. 2003;6:95-98. doi:10.1079/PHN2002366
  • Ainy E, Ordookhani A, Hedayati M, Azizi F. Assessment of intertrimester and seasonal variations of urinary iodine concentration during pregnancy in an iodine-replete area. Clin Endocrinol (Oxf). 2007;67:577-581. doi:10.1111/j.1365-2265.2007.02928.x
  • Amouzegar A, Khazan M, Hedayati M, Azizi F. An assessment of the iodine status and the correlation between iodine nutrition and thyroid function during pregnancy in an iodine sufficient area. Eur J Clin Nutr. 2014;68:397-400. doi:10.1038/ejcn.2013.273
  • Alvarez-Pedrerol M, Ribas-Fito N, Garcia-Esteban R, et al. Iodine sources and iodine levels in pregnant women from an area without known iodine deficiency. Clin Endocrinol (Oxf). 2010;72:81-86. doi:10.1111/j.1365-2265.2009.03588.x
  • Andersson M, de Benoist B, Rogers L. Epidemiology of iodine deficiency: Salt iodisation and iodine status. Best Pract Res Clin Endocrinol Metab. 2010;24:1-11. doi:10.1016/j.beem.2009.08.005
There are 40 citations in total.

Details

Primary Language English
Subjects Obstetrics and Gynaecology
Journal Section Research Articles
Authors

Rabiye Akın 0000-0002-0358-5425

Kamile Marakoğlu 0000-0002-6585-7019

Publication Date February 29, 2024
Submission Date September 16, 2022
Acceptance Date January 17, 2024
Published in Issue Year 2024 Volume: 7 Issue: 1

Cite

AMA Akın R, Marakoğlu K. The Evaluation of Iodine Levels in Urine and Nutrition in Pregnant Women According to Trimesters. Acta Med Nicomedia. February 2024;7(1):1-10. doi:10.53446/actamednicomedia.1176324

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