The effect of iodine deficiency on the course of recurrent respiratory infection in children living in the iodine deficient region

Background. The consequence of iodine deficiency is a decrease in the secretion of thyroid hormones, which adversely affects the immune system with the development of somatic and predisposition to frequent respiratory diseases. The purpose was to investigate the iodine supply of the body of children with recurrent respiratory infections (RRI) by studying the organification and inorganic fractions of iodine in the serum and excretion of iodine in the urine. Materials and methods. The study was conducted by simple sampling, taking into account the characteristics of the clinic course of respiratory disease. Clinical and laboratory and instrumental examination was performed in 60 children aged 3 to 11 years with a diagnosis of RRI. The concentration of iodine in urine, the level of inorganic and organification iodine in the blood were studied. Results. The clinical picture presented with the symptoms of intoxication, fever, and catarrhal symptoms typical of RRI. In children with severe RRI experienced a clear decrease in the iodine level to 57.34 μg/l (p < 0.05) and a decline in the blood content of total iodine and iodine organification by 31.12 and 39.11 % (p < 0.001), respectively. The concentration of inorganic iodine was significantly higher (p < 0.001). Such results indicate a “wrong” subcellular distribution of iodine into fractions in the inflammatory process caused by RRI. The children with detected iodine deficiency demonstrated a more severe course of RRI. There was a moderately negative relationship between the levels of organification and inorganic iodine (r = –0.515; p < 0.05) and a direct relationship between the blood concentrations of total and organification iodine (r = 0.899; p < 0.05). Conclusions. The course of RRI in patients with iodine deficiency is characterized by an increase in the level of inorganic iodine, a decrease in organification iodine and total iodine, the deepening of these changes correlates with the severity of the respiratory disease.

Iodine Deficiency Disorders: Current State of the Problem in the Republic of Crimea

Background: The article presents the results of a control and epidemiological study conducted in September 2020 by specialists of the Federal State Budgetary Institution «NMIC of Endocrinology» of the Ministry of Health of Russia, aimed at assessing the current state of iodine provision in the population of the Republic of Crimea. The study in Crimea is part of a number of activities and work carried out on behalf of the Ministry of Health of the Russian Federation within the framework of state assignments «Scientific assessment of the need for additional regulatory legal and other measures to eliminate iodine deficiency in pilot regions with severe iodine deficiency» and «Epidemiological and molecular-cellular characteristics of tumor, autoimmune and iodine deficiency thyropathies as a basis for prevention of complications and personalization of treatment.The data obtained reflect the state of the problem of iodine consumption on the territory of the Crimean Peninsula and indicate the relevance of the adoption of a regional preventive program aimed at eliminating iodine deficiency in the diet of the population and related diseases.Aim: Assessment of iodine supply of the population of the Republic of CrimeaMaterials and methods: The research was carried out in secondary schools of four districts of the Republic of Crimea — in the years. Simferopol, Belogorsk, Bakhchisarai and Saki.The volume of the study — 356 schoolchildren of 8-10 years old, all were completed: taking anamnesis and anthropometric parameters (height, weight), examination by an endocrinologist with palpation of the thyroid gland (thyroid gland), ultrasound examination of the thyroid gland (thyroid ultrasound), obtaining single portions of urine and samples of table salt (5-10 grams), which is used daily in the diet in their families. The measurements of the height and weight of the children by the standard method were carried out during the examination by a specialist. Thyroid ultrasound was performed in the supine position using a portable LOGIQe ultrasound machine (China) with a 10-15 MHz multifrequency linear transducer. All urine samples (n = 356) in disposable Eppendorf microtubes were immediately frozen at a temperature of minus 20-25°! for further determination of the concentration of iodine in urine using the cerium-arsenite method (based on the clinical diagnostic laboratory of the Federal State Budgetary Institution NMITs endocrinology «of the Ministry of Health of Russia). A qualitative study for the presence of potassium iodate in food table salt samples (n = 203) was carried out on site by the express method.Informed consent was obtained from all parents / guardians of children for the examination and processing of personal data. The permission of the local ethical committee of the Federal State Budgetary Institution «NMIC of Endocrinology» of the Ministry of Health of Russia was received on March 25, 2020, No. 5.Results: According to the results of a survey of 356 children of primary school age, the median concentration of iodine in urine (mCIM) is 97 pg / l and varies from 78 to 98 pg / l in the surveyed areas, the proportion of urine samples with a reduced iodine concentration was 51.2%. The share of iodized salt use in the families of schoolchildren was 12.3% (values range from 10% to 15%). The average incidence of goiter in children according to ultrasound data is 9.5% (range of values from 1.7% to 16.3%).Conclusion.The indicator of the median concentration of iodine in urine indicates an insufficient iodine supply of the population of the Republic of Crimea.The prevalence of goiter in children of primary school age according to the ultrasound examination of the thyroid gland corresponds to the mild severity of iodine deficiency in the mild degree of goiter endemic in the region.The share of households using iodized salt is extremely low and amounts to 12.3%, which does not meet the WHO recommendations for regions with natural iodine deficiency (from 90% or more).

Frequency of iodine deficiency disorders among children living in the iodine deficiency region

Introduction. Currently, only a small number of countries have a stable iodine adequacy, about a third of the world’s population lives in areas with some iodine deficiency. Because children have an increased risk of adverse effects in response to iodine deficiency, it is important to assess the health of these children. Aim. To investigate the frequency of iodine deficiency in children from the iodine deficiency region. Methods. The research was conducted during expeditions to various geographical areas of Northern Bukovyna (Chernivtsi region, Ukraine). 1,973 school-age children were examined (measurement of anthropometric indicators, assessment of cognitive, physical and sexual development, ultrasonography of the thyroid gland (TG), ovaries and testicles, determination of hormonal status and iodine in urine). Results. Of 1,973 children, 53.7% (1060) had thyroid abnormalities. The frequency of goiter in the mountain zone – 59.8%. In 12.3% of children there was a tendency to increase of TSH. The median ioduria in children from mountainous areas corresponds to moderate iodine deficiency. Children from mountainous areas have various disorders: 38.5% disharmonious physical development, a third low intellectual development, disorders of the order of appearance and development of secondary sexual characteristics in the examined children. Conclusion. The results of the study show the negative impact of iodine deficiency on the body of children. It is necessary to continue monitoring of ioduria and children’s health and implement preventive measures.

Iodine, Thyroglobulin and Thyroid Gland

Iodine is essential in the biosynthesis of thyroid hormones that affect metabolic processes in the organism from the prenatal state to the elderly. The immediate indicator of iodine intake is the concentration of iodine in urine, but the indicator of iodine intake in the longer term of several months is thyroglobulin (Tg). Tg negatively correlated with increasing intake of iodine in population that do not suffer from thyroid disease, while a more than adequate to excessive iodine intake leads to an increase in Tg. The dependence of Tg on iodine can be described by a U-shaped curve. Thyroglobulin in serum is elevated in thyroid disease mainly in hyperthyroidism (diagnosis E05 of WHO ICD-10 codes) and in goiter (diagnosis E04 of WHO ICD-10 codes). Tg values decrease below 20 µg/l after effective treatment of patients with thyroid disease. Thyroglobulin may thus be an indicator of thyroid stabilization and the success of the thyroid gland treatment.

The prevalence of endemic goiter and iodine deficiency in the population of boys aged 11–13 years in different ecogeographical regions of the Republic Of Dagestan

Purpose. Conducting a comparative analysis and assessment of the dynamics of endemic goiter and iodine deficiency in the population of boys of the Republic of Dagestan at the age of 11–13 years for the period 2002–2013, living in different ecological and geographical zones.Patients and methods. 3457 adolescent boys 11–13 years old, living in different ecological and geographical zones, were surveyed. Methods of investigation were: determination of daily excretion of iodine in urine, palpation and ultrasound examination of the thyroid gland.Results. It was revealed that during the period of preventive measures there was an improvement in iodine supply regardless of the area of residence. However, against the background of preventive measures in the lowland zone, iodine deficiency decreased not evenly, and in some cases the aggravation occured.Conclusion. The incidence of endemic goiter and the severity of iodine deficiency in boys aged 11–13 years in the mountain and foothill ecology and geographical zones of the Republic of Dagestan are generally comparable to those of iodine deficiency and endemic goiter in the general population of the Republic of Dagestan. On a flat ecogeographical zone, endemic goiter in boys 11-13 years is less common than in the general population in this region. Preventive measures to combat iodine deficiency have led to a decrease in the frequency of endemic goiter, but constant monitoring is required. As a result, there was no correlation between the incidence of endemic goiter and the severity of iodine deficiency.