24 h urinary creatinine excretion during pregnancy and its application in appropriate estimation of 24 h urinary iodine excretion

Bu, Yue; Lin, Yuan; Tian, Chunyuan; Zhao, Chongjun; Ji, Chunlei; Gao, Xueke; Cai, Yan; Sun, Dianjun; Liu, Ying

doi:10.1016/j.jtemb.2021.126751

Cited by 11 publications

(4 citation statements)

References 39 publications

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“…Both this study and our pilot study show that the use of a 24 h UIC underestimates the iodine status, because the encountered median urine volumes (1.9–2.0 L) were higher than the 1.5 L used by the WHO [ 35 ]. We therefore conclude that during pregnancy, 24 h urine iodine excretion is the most reliable parameter of iodine status, as recently demonstrated [ 34 ].…”

Section: Discussionsupporting

confidence: 84%

“…The samples were stored in a cool place and transported to the UMCG within 48 h. The participants noted the starting and final time of collection. The 24 h urine collections that were incomplete (as noted by the participant), had a volume <300 mL [ 34 ] or were not collected within a 22–26 h time frame were considered to be collected incorrectly and therefore excluded. The volume of 24 h urine was estimated by the investigators and subsequently, it was homogenized and divided into portions.…”

Section: Methodsmentioning

confidence: 99%

“…However, in our pilot study, we found a mean urine volume of 1.9 L/day, indicating that the 24 h UIC is likely to underestimate iodine status. We therefore chose to calculate the 24 h urine iodine excretion (24H-UIE), which was recently described as the gold standard to evaluate iodine nutrition during pregnancy [ 34 ], and it was reasoned that an adequate status of the population can be expected when the median 24H-UIE is at least 225 µg (1.5 L* ×150 µg/L). In addition, we used the UICR cut-off value of 150 µg/g to evaluate the iodine status [ 36 , 37 , 38 ].…”

Section: Methodsmentioning

confidence: 99%

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Pregnant Dutch Women Have Inadequate Iodine Status and Selenium Intake

et al. 2022

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Iodine and selenium are essential for thyroid hormone synthesis. Iodine and selenium interact. Pregnancy increases the maternal iodine requirement. We previously reported inadequate iodine status in pregnant Dutch women. Since little is known about their selenium intake, we investigated the iodine status and selenium intake in relation to iodine and selenium supplement use during pregnancy. Iodine status was established in 201 apparently healthy pregnant women as 24 h iodine excretion (24H-UIE; sufficient if median ≥225 µg), iodine concentration (24H-UIC; ≥150 µg/L) and iodine/creatinine ratio (24H-UICR; ≥150 µg/g). Selenium intake was calculated from 24 h selenium excretion. Iodine status in pregnancy proved insufficient (medians: 24H-UIE 185 µg; 24H-UIC 95 µg/L; 24H-UICR 141 µg/g). Only women taking 150 µg iodine/day were sufficient (median 24H-UIE 244 µg). Selenium intake was below the Estimated Average Requirement (EAR; 49 µg/day) in 53.8%, below the Recommended Dietary Allowance (RDA; 60 µg/day) in 77.4% and below the Adequate Intake (AI; 70 µg/day) in 88.7%. Combined inadequate iodine status and selenium intake <RDA was found in 61%. Women who want to become pregnant should, consistently with WHO and ETA recommendations, be advised to use a 150 µg iodine-containing supplement. Concomitant selenium supplementation should be added to this advice, at least in The Netherlands.

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Section: Discussionsupporting

confidence: 84%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Pregnant Dutch Women Have Inadequate Iodine Status and Selenium Intake

et al. 2022

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“…1a , 1b ), assuming a constant urinary creatinine excretion over 24 h [ 38 ]. In pregnant women, UCE reference values are lacking and the use of age- and sex-specific creatinine values based on non-pregnant Swiss women [ 40 ] is possibly a limitation as the UCE may be altered in pregnancy [ 71 ]. UCC improves the interpretation of the iodine intake compared to UIC alone, as discussed above.…”

Section: Discussionmentioning

confidence: 99%

Iodine intake in the Swiss population 100 years after the introduction of iodised salt: a cross-sectional national study in children and pregnant women

Fischer,

Andersson,

Braegger

et al. 2023

Eur J Nutr

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Purpose The Swiss voluntary salt iodisation programme has successfully prevented iodine deficiency for 100 years, but dietary habits are changing and today only one-third of processed foods contain iodised salt. We aimed to monitor the current iodine status in children and pregnant women. Methods We conducted a nationwide cross-sectional study in children (6–12 years) and pregnant women and measured the urinary iodine concentration (UIC) in spot urine samples. We estimated the iodine intake using UIC and urinary creatinine concentration (UCC) and determined the prevalence of intakes below the average requirement (AR) using the SPADE method. We measured dried blood spot (DBS) thyroglobulin (Tg), TSH and total T4 in pregnant women. Results The median UIC was 127 μg/L (bootstrapped 95% CI 119, 140, n = 362) in children and 97 μg/L (bootstrapped 95% CI 90, 106, n = 473) in pregnant women. The estimated prevalence of inadequate iodine intake (< 65 μg/day) was 5.4% (bootstrapped 95% CI 0.0, 14.6) in children. Half (47%) of the women consumed iodine-containing multivitamin and mineral supplements (≥ 150 μg/day). Compared to non-users, users had higher median UIC (129 vs. 81 μg/L, P < 0.001), lower prevalence of inadequacy (< 160 μg/day; 0.2 vs. 31%) and lower DBS-Tg (23 vs. 29 μg/L, P < 0.001). All women were euthyroid. Conclusions The Swiss diet and current salt fortification provides adequate iodine intake in children, but not in all pregnant women. Iodine supplements cover the dietary gap in pregnancy but are not universally consumed. Therefore, improved use of iodised salt in processed foods is desired to ensure adequate iodine intake in all population groups. This trial was registered at clinicaltrials.gov as NCT04524013.

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Study on the Relationship Between Serum Iodine and Thyroid Dysfunctions: a Cross-Sectional Study

Guo

Ren

et al. 2022

Biol Trace Elem Res

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24 h urinary creatinine excretion during pregnancy and its application in appropriate estimation of 24 h urinary iodine excretion

Cited by 11 publications

References 39 publications

Pregnant Dutch Women Have Inadequate Iodine Status and Selenium Intake

Pregnant Dutch Women Have Inadequate Iodine Status and Selenium Intake

Iodine intake in the Swiss population 100 years after the introduction of iodised salt: a cross-sectional national study in children and pregnant women

Study on the Relationship Between Serum Iodine and Thyroid Dysfunctions: a Cross-Sectional Study

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