| Objective 1)To explore the accuracy of Spot UIC and UI/Cr to estimate pregnant women's TII by collecting spot urine samples and 24 hour urine samples from pregnant women.2)The spot urine sample and venous blood samples were collected,and physical examinations were performed on pregnant women to explore UL of iodine for pregnant women in China.3)Food were collected by the double meal method,stool and 24 hour urine samples were collected for seven consecutive days.Observing the iodine intake when the nursing mother and infants reach "zero iodine balance".Method 1)Pregnant women who attended routine antenatal outpatient visits at Zibo Maternal and Child Health Hospital in Gaoqing County were included.Collected spot urine samples and 24 hour urine samples,and Uvol were measured.The iodine concentration and creatinine concentration in spot urine samples and and iodine concentration in 24 hour urine samples were tested in laboratory.The ROC curve was used to determine the accuracy of Spot UIC and UI/Cr to evaluate the iodine intake of pregnant women.2)Pregnant women who attended routine antenatal outpatient visits at Tanggu Maternal and Children's Hospital and Zibo Maternal and Child Health Hospital in Gaoqing County were included.Spot urine samples were collected to determined the UI/Cr,venous blood samples were collected to determine thyroid function indictors include TSH,FT3,FT4,TPOAb and TGAb.Ultrasound was performed to detect Tvol and thyroid nodules.3)The iodine balance experiment were carried out on the lactating women and infants in Gaoqing county.Food intaken were collected and the volume of drinking water and the Uvol of lactating women in 24 hours were recored.BMIE were calculated by “weighing method”.TII and TIE of lactating women and infants were calculated.Results 1)There was a significant correlation between UI/Cr and UIE(r=0.627,P<0.001),and Spot UIC correlated with UIE(r=0.559,P<0.001).The area of UI/Cr and Spot UIC under the ROC curve is 0.83 and 0.78 for the diagnosis of insufficient iodine intake respectively.And the area of UI/Cr and Spot UIC under the ROC curve is 0.91 and 0.85 for the diagnosis of excessive iodine intake respectively.2)The Spot UIC and UI/Cr of pregnant women in Gaoqing County were significantly higher than those of pregnant women in Tianjin.As the results of threshold effect analysis,after adjusted age,pre-BMI and gestational weeks,when UI/Cr>330?g/g,the growth trend of Tvol becomes larger,and the risk of thyroid nodules increases.Query our team's corresponding table of UI/Cr and TII,the results show that when UI/Cr = 330?g/g,TII= 463?g/d.3)In the iodine balance test,the iodine intake of lactating women from food was 112.2(59.6,211.3)?g/d,the intake of iodine from drinking water was 24.8(9.0,47.5)?g/d,and the TII was 154.5(94.1,296.5)?g/d.The amount of iodine excreted by all lactating mothers through the stools,breast milk,breath and urine were14.6(0,43.5)?g/d,66.6(39.4,107.2)?g/d,112.2(71.3,167.0)?g/d,18.0(17.3,19.6)?g/d,respectively.And the TIE is 245.1(166.9,335.1)?g/d.When pregnant women reach "zero iodine balance",the TII was 282?g/d.The TII of was 131.2(74.7,202.8)?g/d,The TIE of was 76.9(49.5,121.5)?g/d.When infants reach "zero iodine balance",the TII was 75?g/d.Conclusion 1)Compared with Spot UIC,UI/Cr can be used as an index for evaluating the insufficient iodine intake and excessive iodine intake of pregnant women.2)When UI/Cr in pregnant women exceeds 330?g/g,the Tvol growth trend becomes larger and the risk of thyroid nodules increased The TII corresponding to the UI/Cr established by our research team suggest that the TII of pregnant women should not exceed 463?g/d.3)When the lactating mother reaches the "zero iodine balance",the TII is 282 ?g/d.When the infants reached "zero iodine balance",the TII was 75 ?g/d. |
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