| Part I: Correlation Analysis on Adult iodine nutrition and thyroid nodulesObjective Combining repeated urinary iodine results with daily iodine intakes to reflectiodine nutritional status.To investigate the relationship with the daily iodine intakes,urinary iodine capacity and thyroid nodules.Method Totally 30 participants were enrolled.The 3-day survey of weighing dietary records was made to evaluate the daily nutrient intakes by using a nutrition assessment software.In the second and third day of dietary records,all participants collected repeated urine samples in fasting and 2 hours after meals(n = 240)and thyroid ultrasonography were performed.The levels of urine iodine were measured in iodine laboratory at Center for Disease Control and Prevention.Results The MUI of general participants was 137.56?g/L.The portions of iodine insufficiency,iodine adequate and iodine above requirements or excessive were 20.2%,56.7%and 23.3%,respectively.Inter-individual median urinary iodine varied from 36.3 to 359.2 ?g/L.There was no statistically different of the two-day MUI,(69.8?g / L vs 73.4?g / L,P = 0.055),(137.9?g / L vs 133.3?g / L,P = 0.396)and(212.0?g / L vs 229.0?g / L,P = 0.726),respectively.Analyzed MUI in two days of the same time point,found significant differences in iodine deficiency group(52.1?g / L vs 126.8?g / L,P = 0.025),in the rest of the groups were not statistically different(P> 0.05).Compared MUI within two days of each group of four time points,we found iodine adequate group was significantly different(P = 0.02)four time points,the other two groups had no difference(P> 0.05).The average value of daily iodine intake was 197.2±57.5?g/d,and that derived from iodine salt and drinking water were 70.2% and 5.4%,respectively.There was a significant correlation between dietary iodine intake and urinary iodine value of the day(R=0.426,P <0.05).Participants with thyroid nodules had higher UICs than normal participants(194.0±101.5?g/L vs.135.7±72.9?g/L,P<0.01).Conclusion Inter-individualiodine nutritional status were significantly different.The excessurineiodine may be related to thyroid nodules.24-hour urine iodine test combines with weighing dietary records dietary assessment may evaluate of individual iodine nutritional status,and provide reference to individual iodine nutrition-related dietary guidance.Part II: Iodine Nutrition During Pregnancy and Related Neonatal Physical Development in ShanghaiObjective This part was aimed to assesss the iodine nutrition in the population of women during late pregnancy by combining multiple urinary iodine tests and estimating of dietary iodine intakes in Shanghai.And we wanted to provide some data about the relationship between iodine nutritional status during late pregnancy and fetal physical development.Method We used the prospective cohort study data from the women during late pregnancy(28-34 week)who accepted the follow-up intervention in the Department of Clinical Nutrition in Shanghai Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine in 2014.11~2015.8.On their first visits and admissionto be produced,all subjects recored twice dietary surveies(including iodine-related food frequency method and 24-hour food diary).And we used software to calculate dietary iodine intake.All subjects collected a spoturine sample very two weeks(3/person).We recorded their physical development and neonatal heel blood thyroid stimulating hormone(thyrotropic stimulating hormone,TSH)results during hospitalization of childbirth.Results This study included 201 cases of pregnant women,151 in normal group and 50 in gestational diabetes(gestational diabetes mellitus,GDM)group.Data from the study showed all pregnant women(sample size 201)had a median UI concentration of 101.6 ?g/L(63.9~157.0)?g/L.In sequence urinary iodine levels of 150 ?g/L,249 ?g/L were defined as the cut-off points of iodine insufficient,adequate,more than adequate,the incidence of which was 74.6%,21.4%,4.0%,respectively.The survey found that the normal pregnant women(n=151)and pregnant womenwith gestational diabetes mellitus(n=50)had a median UIC of 100.0 ?g/L and 105.3 ?g/L,respectively.And no significant difference was found in the urinary iodine of them(P=0.976).The normal group of pregnant women(n=151)divided into three subgroups of iodine insufficient,adequate and more than adequate,the incidence of which was 76.8%,19.2%,4.0%,respectively.Subgroup analysis showed that iodine insufficient group(n=116)compared with adequate iodine group(n =29),their birth weight and length was no significant difference.In addition,analysis of the head circumference of newborns,placental weight and heel blood TSH results,no significant difference between the two subgroups.Iodine insufficient group(n=150)compared with adequate and more than adequate iodine group(n=51),the composition ratio of education level was statistical difference(?2=6.205,P=0.043).Conclusion According to WHO standards,the rate of iodine deficiency in pregnant women in late pregnancy is 74.6% in Shanghai.The results of the study suggest that there was no significant difference between the status of iodine nutrition during pregnancy and fetal development.Therefore,the standard is applicable to Chinese pregnant women,need to be further multi-center study of a large sample confirmed. |
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