| Abstract | Jod je jedan od značajnijih mikroelemenata u našem organizmu, sastavni dio hormona
štitnjače koji imaju važnu ulogu u neurološkom razvoju djeteta. Nedostatan unos joda
u organizam može rezultirati čitavim spektrom poremećaja te su u prevenciju istog
razvijeni Nacionalni programi koji se temelje na jodiranju soli. Prema
WHO/ICCIDD/UNICEF preporukama, medijan koncentracije joda u urinu je metoda
procjene nutricijskog unosa joda unutar određene populacije. Preporučene vrijednosti
za opću populaciju su 100-200 μg/L, dok su za trudnice 150-250 μg/L.
Prema zadnjim podatcima iz 2009. godine Hrvatska pripada grupi zemalja sa
dostatnim unosom joda u općoj populaciji zahvaljujući zakonski reguliranom propisu
obvezatnog jodiranja soli sa 25 mg KI/kg soli.
Medijan koncetracije joda u urinu u
djece školske dobi je iznosio 200 – 300 μg/L.
U istraživanju na populaciji trudnica ukupno je bilo uključeno 150 ispitanica. Medijan
koncentracije joda u urinu je iznosio165 μg/L što odgovara adekvatnom unosu joda.
Međutim, njih 44% je imalo vrijednosti koncentracije joda ispod 150 μg/L što čini
značajan udio onih sa nedostatnim unosom joda. Medijan kontrolne skupine, one bez
dodatnog unosa joda, je iznosio 96 μg/L, dok je medijan ispitivane skupine trudnica
koje su uzimale dodatke prehrani koji sadrže jod, iznosio 181 μg/L. U Hrvatskoj,
zemlji s dokazanim dostatnim unosom joda u općoj populaciji, vrijednost joda u urinu
je u značajnog broja trudnica ispod preporučenih, dok trudnice koje su uzimale
dodatke prehrani koji sadrže jod imaju dostatan unos joda prema
WHO/UNICEF/ICCIDD preporukama. Uzimajući u obzir još uvijek nedokazane
štetne posljedice u žena koje su imale vrijednosti joda u urinu < 150 μg/L unutar opće
populacije sa dokazanim adekvatnim unosom joda potrebno je razmotriti
WHO/UNICEF/ICCIDD preporuke o 150 μg/L kao najniže prihvatljivoj granici za
trudnice. Također, potrebno je provesti istraživanja kojima bi se razlučili razlozi niske
vrijednosti medijana koncentracije joda u urinu trudnica koje ne uzimaju dodatni jod,
prvenstveno uzimajući u obzir trend restrikcije unosa soli. U konačnici, u obzir dolazi,
u sklopu Nacionalnog programa praćenja statusa unosa joda u općoj populaciji,
razmatranje uvođenje preporuka za uzimanjem dodatnog joda tijekom trudnoće putem
dodataka prehrani uz prethodno usuglašene preporuke o količini joda koju bi svaki
pripravak trebao sadržavati. |
| Abstract (english) | Iodine, as a part of thyroid hormones, is one of the most significant microelements in
our organism and it plays important role in neurological development of children.
Insufficient iodine intake can result in wide specter of disorders for which prevention
Nacional programs of salt iodization have been developed. According to
WHO/UNICEF/ICCIDD recommendations, urinary iodine concentration median is
the method of choice in evaluation of iodine intake in general population.
Recommended values for general population are 100-200 μg/L, while for pregnant
women the range is 150-250 μg/L.
According to the latest data from 2009, Croatia is a country with sufficient iodine
intake in general population thanks to legislative of salt iodization with 25 mg KI/kg.
Median of iodine urinary concentration in schoolchildren was 200 – 300 μg/L.
In the research that involved pregnant women there have been 150 participants
included. Urinary iodine concentration median was 165 μg/L, which represents
sufficient iodine intake. But, 44% had values of iodine concentration < 150 μg/L, and
that represents significant number of those with insufficient iodine intake. Median of
the control group, those without additional iodine intake, was 96 μg/L, while the
median of the group that took additional iodine through nutritional supplements, was
181 μg/L. In Croatia, country with established sufficient iodine intake in general
population, urinary iodine values are in significant number of pregnant women under
recommended, while those that have taken iodine supplementation have sufficient
iodine intake according to the WHO/UNICEF/ICCIDD recommendation. Taking into
consideration jet unproven harmful consequences in women having iodine values in
urine < 150 μg/L, when general population has adequate iodine intake, there should
be revision of WHO/UNICEF/ICCIDD recommendations of 150 μg/L as the lowest
value for pregnant women. Also, studies referring to reasons for low values of urinary
iodine concentration median in pregnant women who don’t take iodine
supplementation should be conducted taking into consideration trend of salt
restriction.
Overall, it should be considered, in National program that follows status of iodine
intake in general population, implementation of recommendations for additional
iodine intake for pregnant women through nutritional supplements with prior
established recommendations of amount of iodine that each supplement should
contain. |
