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Assessment of the iodine status in children aged 2-3 years
Insights
Overnight urine samples accurately assess iodine status in toddlers. Measuring iodine and creatinine in these samples, adjusted for body surface area, can reliably detect iodine deficiency risks.
Area of Science:
- Pediatric Nutrition
- Environmental Health
- Biochemical Monitoring
Background:
- Iodine deficiency remains a global health concern, particularly in infants and toddlers.
- Accurate assessment of iodine nutritional status is crucial for preventing developmental issues like iodine-deficiency goiter.
- Existing methods for monitoring iodine status in young children can be challenging due to collection difficulties.
Purpose of the Study:
- To evaluate the reliability of using spontaneous overnight urine samples for assessing iodine nutritional status in toddlers.
- To compare iodine excretion data from overnight samples with those from timed 24-hour collections.
- To determine if overnight urine iodine-creatinine ratios, adjusted for body surface area (BSA), can effectively identify iodine deficiency.
Main Methods:
- Collected spontaneous urine samples (afternoon U1 and overnight U2) from 22 healthy toddlers.
- Measured iodine and creatinine concentrations in urine samples.
- Calculated iodine-creatinine ratios and adjusted for body surface area (BSA).
- Compared results with WHO criteria for iodine deficiency and data from a separate group (n=23) with timed 24-hour urine collections.
Main Results:
- Median iodine-creatinine ratios were significantly higher in afternoon samples (U1) than overnight samples (U2).
- Overnight urine iodine-creatinine ratios, when corrected for BSA, were comparable to 24-hour urine collection data.
- Approximately half of the toddlers in both study groups (overnight and 24-hour collections) indicated iodine deficiency state II, suggesting an elevated risk for goiter.
Conclusions:
- Spontaneous overnight urine samples provide a reliable method for monitoring iodine nutritional status in infants and toddlers.
- The iodine-creatinine ratio in overnight urine, standardized for body surface area (BSA), is a practical and effective indicator for assessing iodine deficiency.
- This method offers a simpler alternative to timed 24-hour urine collections for public health surveillance in young children.
Abstract:
In 22 healthy toddlers (age: 2.5 +/- 0.06 years; from families living in Dortmund, FRG) measurements of iodine and creatinine concentrations were carried out in spontaneous urine samples collected in the afternoon (U1), as well as during the night (U2). Median iodine-creatinine ratios found in the "afternoon specimens" U1 were significantly elevated (p < 0.05) compared to U2 (181.3 vs. 119.5 micrograms/g). Higher values in U1 than in U2 were also obtained when total daily iodine excretion (under the assumption of an average creatinine excretion of 15 mg/kg/d for infants) was calculated and the corresponding data were related to body surface area (BSA). The results of the specimens collected during the night were (after expressing as iodine-creatinine ratio as well as after correcting for BSA) comparable with the excretion data of accurately timed 24-h urine collections obtained in a separate group of toddlers (n = 23) of nearly the same age. When the iodine-creatinine ratios established by the WHO--after standardizing with BSA--were taken as criteria for iodine deficiency, then in both study groups (spontaneous urine samples at night (U2) and timed 24-h urine collections) about half of the infants would fall in the deficiency state II with an elevated risk for iodine-deficiency goiter. It is suggested that the nutritional status of iodine can be reliably monitored (in infants) by determining iodine and creatinine concentrations in overnight urine samples and relating the data to BSA.