Please enter verification code
Confirm
Role of Supplementations of Combined Vitamins with Minerals on Iodine Status in Pregnant Women in Bulgaria
International Journal of Diabetes and Endocrinology
Volume 5, Issue 3, September 2020, Pages: 47-53
Received: Sep. 10, 2020; Accepted: Oct. 6, 2020; Published: Oct. 13, 2020
Views 65      Downloads 14
Authors
Anna-Maria Borissovа, Clinic of Endocrinology, University Hospital Sofiamed, Sofia, Bulgaria; Faculty of Medicine, Sofia University Saint. Kliment Ohridski, Sofia, Bulgaria
Ludmila Ivanova, Faculty of Medicine, Sofia University Saint. Kliment Ohridski, Sofia, Bulgaria
Boyana Trifonova, Clinic of Endocrinology, University Hospital Sofiamed, Sofia, Bulgaria; Faculty of Medicine, Sofia University Saint. Kliment Ohridski, Sofia, Bulgaria
Lilia Dakovska, Clinic of Endocrinology, University Hospital Sofiamed, Sofia, Bulgaria
Eugenia Mihailova, Clinic of Endocrinology, University Hospital Sofiamed, Sofia, Bulgaria
Mircho Vukov, Clinic of Endocrinology, University Hospital Sofiamed, Sofia, Bulgaria
Article Tools
Follow on us
Abstract
Underestimating the risk of iodine deficiency among the population and its impact on high risk groups such as pregnant women and children creates a serious problem for the health care system. The aim of the present study is to establish the current iodine status in pregnant women in Bulgaria and to clarify the importance of additional supplementation with combined vitamins and minerals (including iodine). Material: We included 537 non selected in advance pregnant women, avarage age 30.49±5 years (95% CI: 30.06 - 30.91), median – 30 (18-47) (95% CI: 30 - 31). More than 50% (271/537) of pregnant women took only vitamins with minerals or combined with other medications. Methods: After completing a personal Questionnaire, each pregnant woman followed the study protocol: sample for TSH and TPOAb (ECLIA method) morning urine to determine the iodine concentration by inductively coupled plasma mass spectrometry (ICP-MS); ultrasound examination to determine the volume of the thyroid gland. Results: The mean concentration of iodine in urine for the whole group of pregnant women (n-537) was 181.60±93.97 µg / L, median 170 µg / L (20th percentile – 102 µg / L, 80th percentile – 248 µg / L). According to the criterion “additional supplementation” three groups of pregnant women were formed – A (79, 14.71%) – not taking anything, B (271, 50.47%) – taking combined vitamins with minerals (including iodine), C (187, 34.82%) – taking medicines other than vitamins. The highest is the average level of iodine in urine in Group B – 191.08±95.42 µg / L and the lowest in Group A – 162.91±93.23 µg / L, P < 0.01. If combined vitamins with minerals (including iodine) are taken, it will be significantly less common to have low iodine in urine – Group B – 31.1% against Group A – 53.2%, P < 0.033 i.e. there is a greater chance to normalize the level of iodine in the body. The supplementation with combined vitamins with minerals (including iodine) increased the percentage of pregnant women with over-optimal iodine in urine (> 250 µg / L) – 23.3% against 15.6% of these not taking combined vitamins with minerals (P < 0.04). No association was found between iodine in urine and thyroid volume, nor with abnormalities in TSH or TPOAb levels. Conclusion: The additional intake of combined vitamins with minerals (including iodine) contributes to the normal level of iodine in urine in pregnant Bulgarian women.
Keywords
Supplementation, Iodine in Urine, TSH, TPOAb, Thyroid Volume
To cite this article
Anna-Maria Borissovа, Ludmila Ivanova, Boyana Trifonova, Lilia Dakovska, Eugenia Mihailova, Mircho Vukov, Role of Supplementations of Combined Vitamins with Minerals on Iodine Status in Pregnant Women in Bulgaria, International Journal of Diabetes and Endocrinology. Vol. 5, No. 3, 2020, pp. 47-53. doi: 10.11648/j.ijde.20200503.13
Copyright
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
[1]
World Health Organization. (2004). Iodine status worldwide: WHO global database on iodine deficiency. Geneva.
[2]
WHO, UNICEF, ICCIDD. (2001). Assessment of iodine deficiency disorders and monitoring their elimination. A guide for programme managers, 2nd ed. World Health Organization, Geneva.
[3]
World Health Organization. (2007). Assessment of iodine deficiency disorders and monitoring their elimination: a guide for programme managers, 3rd ed. WHO.
[4]
World Health Organization, UNICEF, ICCIDD. (2008). Assessment of iodine deficiency disorders and monitoring their elimination. A guide for programme managers, Third edition, updated 1st September 2008.
[5]
Delange F. (2000). The role of iodine in brain development. Proc Nutr Soc 59: 75-79.
[6]
de Escobar G. M, Obregon MJ, Escobar del Rey F. (2000). Is neuropsychological development related to maternal hypothyroidism or to maternal hypothyroxinemia? J Clin Endocrinol Metab 85: 3975-3987.
[7]
Bernal J. (2005). Thyroid hormones and brain development. Vitam Horm 71: 95-122.
[8]
World Medical Association (2013). "Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects". JAMA. 310 (20): 2191–2194. doi: 10.1001/jama.2013.28105.
[9]
Lazarus J, Brown RS, Daumerie C, Hubalewska-Dydejxzyk A, Negro R, Vaidya B. (2014). 2014 European Thyroid Association guidelines for the management of subclinical hypothyroidism in pregnancy and in children. Eur Thyroid J 3 (2): 76–94. https://doi.org/10.1159/00036 2597.
[10]
Alexander EK, Pearce EN, Brent GA, Brown RS, Chen H, Dosiou C, Grobman WA, Laurberg P, Lazarus JH, Mandel SJ, Peeters RP. and Sullivan S. (2017). 2017 Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and the postpartum. Thyroid 27 (3): 315–389. https://doi.org/10.1089/thy.2016.0457.
[11]
Soldin OP. (2002). Controversies in urinary iodine determinations. Clin Biochem 35: 575–579.
[12]
Brunn J, Block U, Ruf G, Bos I, Kunze WP, Scriba PC. (1981). Volumetric analysis of thyroid lobes by real-time ultrasound. Dtsch Med Wochenschr. 106: 1338–1340.
[13]
Zimmermann MB, Hess S. Y, Molinari L, de Benoist B, Delange F, Braverman L. E, Fujieda K, Ito Y, Jooste P. L, Moos K, Jooste P. L, Pearce E. N Pretell E. A, Shishiba Y. (2004). New reference values for thyroid volume by ultrasound in iodine sufficient school children: a World Health Organization / Nutrition for Health and Development Iodine Deficiency Study Group Report. Am J Clin Nutr 79: 231–237.
[14]
Bath S. C. and Rayman M. P. (2015). A review of the iodine status of UK pregnant women and its implications for the offspring. Environ Geochem Health. 37 (4): 619–629.
[15]
Huang C-J, Tseng C-L, Chen H-S, Hwu C-M, Tang K-T, Won J. G-S, Shih C-S, Yeh C-C, Yang C-C, Wang F-F. (2020). Iodine nutritional status of pregnant women in an urban area of northern Taiwan in 2018. PLOS ONE, May 15, 1-12. https://doi.org/10.1371/journal.pone.0233162.
[16]
Mortimer RH, Galligan JP, Cannell GR, Addison RS, Roberts MS. (1996). Maternal to fetal thyroxine transmission in the human term placenta is limited by inner ring deiodination. J Clin Endocrinol Metab 81: 2247-2249.
[17]
Burrow GN, Fisher DA, Larsen PR. (1994). Maternal and fetal thyroid function. N Engl J Med 331: 1072-1078.
[18]
Biban B. G, Lichiardopol C. (2017). Iodine Deficiency, Still a Global Problem? Current Health Sciences Journal Vol. 43, No. 2, April-June.
[19]
Manousou S, Andersson M, Eggertsen R, Hunziker S, Hulthen L, Nystrom H. F. (2019). Iodine deficiency in pregnant women in Sweden: a national cross-sectional study. European Journal of Nutrition, Published online: 15 October; https://doi.org/10.1007/s00394-019-02102-5.
[20]
Boyanov M, Vidinov K. (2011). Ultrasound of the cervical region in the practice of the endocrinologist. Pages 25-32. Central Medical Library, Medical University – Sofia, Bulgaria.
[21]
Halenka M, Frysak Z. (2017). Atlas of Thyroid Ultrasonography. 2.2. US Features of Diffuse goiter. Sringer Int. Publishing AG, Cham, Switzerland.
[22]
World Health Organization. (1994). Indicators for assessing iodine deficiency disorders and their control through salt iodization. Geneva, Switzerland. WHO [Document No WHO/NUT 94.6].
[23]
Azizi F, Smyth P. (2009). Breastfeeding and maternal and infant iodine nutrition. Clin. Endocrinol. 70, 803-809.
[24]
WHO. Assessment of iodine deficiency disorders and monitoring their elimination. A guide for programme managers. 2nd ed. World Health Organisation, International Council for Control of Iodine Deficiency Disorders, United Nations Children’s Fund; 2007.
[25]
Rhee SS, Braverman LE, Pino S, He X, Pearce EN. (2011). High iodine content of Korean seaweed soup: a health risk for lactating women and their infants. Thyroid 21: 927-928.
[26]
Chung HR, Shin CH, Yang SW, Choi CW, Kim BI. (2009). Subclinical hypothyroidism in Korean preterm infants associated with high levels of iodine in breast milk. J Clin Endocrinol Metab 94: 4444-4447.
[27]
de Escobar G. M, Obregon MJ, del Rey F E. (2004). Role of thyroid hormone during early brain development. Eur J Endocrinol 151: U25-U37.
[28]
Andersen S. L, Laurberg P. (2016). Iodine Supplementation in Pregnancy and the Dilemma of Ambiguous Recommendations. Eur Thyroid J. 5: 35-43.
[29]
Lombardi F. A, Fiore E, Tonacchera M. (2013). The effect of voluntary iodine prophylaxis in a small rural community: the pescopagano survey 15 years later. The Journal of Clinical Endocrinology & Metabolism. 98 (3): 1031-1039.
[30]
Gorstein J. L, Bagriansky J, Pearce E. N, Kupka R, Zimmermann M. B. (2019). Estimating the Health and Economic Benefits of Universal Salt Iodization Programs to correct Iodine Deficiency Disorders. Thyroid DOI: 10.1089/thy.2019.0719, page 1-26.
[31]
UNICEF, State of the World’s Children. (2017). Global Experience of with salt iodization: percentage of households currently cosuming iodized salt.
ADDRESS
Science Publishing Group
1 Rockefeller Plaza,
10th and 11th Floors,
New York, NY 10020
U.S.A.
Tel: (001)347-983-5186