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Published on: September 20, 2019

Requesting iodine supplementation in children on parenteral nutrition

M P Cicalese1, E Bruzzese, A Guarino

  • 1Department of Paediatrics, University of Naples Federico II, Via Pansini 5, Naples, Italy. mariapia.cicalese@tiscali.it

Clinical Nutrition (Edinburgh, Scotland)
|March 10, 2009
PubMed

Insights

Parenteral nutrition (PN) iodine supply of 1 microg/kg/day may be insufficient for children, leading to low urinary iodine concentration (UIC). Higher iodine doses should be investigated in clinical trials to ensure adequate nutritional status.

Area of Science:

  • Pediatric Nutrition
  • Endocrinology
  • Clinical Trials

Background:

  • The European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) recommends 1 microg/kg/day of iodine for infants receiving parenteral nutrition (PN).
  • Assessing the nutritional and thyroid status of children on PN is crucial for optimizing care.
  • Urinary iodine concentration (UIC) serves as a key indicator of iodine status.

Purpose of the Study:

  • To evaluate the iodine status of children (1-17 years) receiving PN.
  • To correlate PN duration and iodine intake with urinary iodine concentration (UIC).
  • To assess the impact of PN on thyroid function.

Main Methods:

  • A cohort of 15 children (1-17 years) on PN (TPN or PPN) from 2000-2007 was studied.
  • Iodine intake was administered at approximately 1 microg/kg/day.
  • Urinary iodine concentration (UIC) was measured, along with thyroid function tests (thyroxine, TSH) and thyroid volume.

Main Results:

  • An inverse correlation was observed between PN duration and UIC (P=0.05).
  • Within 4 weeks of PN initiation, low UIC (<100 microg/L) was prevalent in short bowel syndrome (SBS) patients and some non-SBS patients.
  • After 12 weeks, 53% of patients had very low UIC (<50 microg/L), yet thyroid hormones and volume remained stable.

Conclusions:

  • The recommended PN iodine supply of 1 microg/kg/day may be suboptimal for pediatric patients.
  • Higher iodine supplementation levels warrant investigation in controlled trials to ensure adequate iodine status.
  • While short-term thyroid function may appear stable, long-term implications of low UIC require further study.
Abstract

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