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Kapoor A, Baig F, Channa NA, Othman SS, Abualhamael SA, Baig M. Estimation of calories intake, iron, zinc, and selenium among children of the underprivileged area in Sindh, Pakistan. PLoS One 2024; 19:e0304277. [PMID: 38917170 PMCID: PMC11198758 DOI: 10.1371/journal.pone.0304277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 05/09/2024] [Indexed: 06/27/2024] Open
Abstract
INTRODUCTION Malnutrition is one of the most serious community health issues in developing countries. This study estimated total energy intake, Iron (Fe), Zinc (Zn), Selenium (Se), Calcium (Ca), and Phosphate (PO4) levels among school-going children (aged 13-17 years) of the underprivileged area in Sindh, Pakistan. METHODS Children from Mithi City, District Tharparkar, were selected for this cross-sectional investigation. Students from various schools from both genders who fulfilled the selection criteria were selected. A questionnaire was filled, and five ml blood samples were taken to analyze blood parameters. Each participant's estimated nutrient intake (ENI) per day was assessed and matched to the recommended daily allowance (RDA) to determine their micro and macronutrient intake. RESULTS A total of 300 school-going children [150(50%) boys (mean age 15± 0.8 years) and 150(50%) girls (mean age 14±1.3years)] were included in this study. Total calories (1449±949 Kcal vs. 1245±215 Kcal; p < .001), carbohydrates (138±27 gm vs. 126 ±25 gm; p < .001) protein (47±9.1 gm vs. 44±6 gm; p < .001) was significantly higher among boys compared to girls. In contrast, calcium (1094±105 mg vs. 1144±100; 0.004), phosphate 1050±125 vs. 1148±147; p<0.001), iron (9.2±1.7 mg vs. 10±1.3 mg; p<0.001), and Zinc (7.4±1.8 mg vs. 9.9±1.7 mg; p<0.001) intake was significantly higher among girls than boys. Gender-wise comparison of serum metals in school-going children showed that serum iron was significantly lower among girls than boys (100.86±25.65 μg/dl vs. 78.48±28.66 μg/dl; p<0.001), and no difference was found in serum Zn, Se, and Ca levels. Total proteins were also significantly lower among girls than boys (6.48±1.01g/dl vs. 4.87±1.4301g/dl; p<0.001). Serum iron, Ca, and total proteins were significantly lower among girls with normal ranges compared to boys with normal ranges. Total protein was significantly lower among girls below normal ranges than boys with normal ranges (p < .001). The correlation of carbohydrates, protein, and fat with some serum biochemical parameters in school-going children showed that serum Fe was significantly linked with proteins (r = 0.255; p < .0.05). CONCLUSION Our findings showed a concurrent shortage of macro and micronutrients. The current study also revealed that total energy intake was lower than the RDA and significant Fe, Zn, and Se deficiencies. The findings highlight the importance of measures aimed at improving children's nutritional status.
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Affiliation(s)
- Aneel Kapoor
- Department of Biochemistry, Peoples University of Medical and Health Sciences for Women, Benazirabad, Sindh, Pakistan
| | - Fizzah Baig
- Ziauddin Medical College, Ziauddin University, Karachi, Pakistan
| | | | - Sahar Shafik Othman
- Department of Family Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Mukhtiar Baig
- Department of Clinical Biochemistry, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
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Li J, Liu JX, Wang YQ, Lu AX, Wang YH, Lin Y, Yan CH. Iodine status and associated dietary factors among preschool children in Shanghai. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:121823-121833. [PMID: 37962761 DOI: 10.1007/s11356-023-30942-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 11/03/2023] [Indexed: 11/15/2023]
Abstract
Children aged 3-6 years undergo a critical stage of growth and development and are irreversibly affected by their iodine status. In order to reveal iodine status in preschool children, we detected iodine concentrations in urine samples from 1382 children aged 3-6 years based on a cross-sectional study. The median urinary iodine concentration (UIC) of children was 193.36 μg/L and was 336.96 μg/g·Cr corrected for creatinine. The study developed a link between dietary habits and iodine status, revealing that regular calcium supplement (OR: 1.79, (95% CI: 1.03, 3.12)) increased deficiency risk, while moderate seafood consumption (OR: 0.60, (95% CI: 0.38, 0.95)) decreased it. Additionally, modest intake of shellfish (OR: 0.58, (95% CI: 0.33, 1.00)), vegetables (OR: 0.61, (95% CI: 0.38, 0.97)), and eggs (OR: 0.53, (95% CI: 0.30, 0.95)) was found to protect against excess iodine. The findings underline the importance of balanced diets and various nutrients' roles in preschoolers' iodine status.
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Affiliation(s)
- Jing Li
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Jun-Xia Liu
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 1665, Kongjiang Road, Shanghai, 200092, China
| | - Yu-Qing Wang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - An-Xin Lu
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 1665, Kongjiang Road, Shanghai, 200092, China
| | - Yi-Hong Wang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 1665, Kongjiang Road, Shanghai, 200092, China
| | - Yin Lin
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 1665, Kongjiang Road, Shanghai, 200092, China
| | - Chong-Huai Yan
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 1665, Kongjiang Road, Shanghai, 200092, China.
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Baliki G, Weiffen D, Schreinemachers P, Shrestha A, Shrestha RM, Schreiner M, Brück T. Effect of an Integrated School Garden and Home Garden Intervention on Anemia Among School-Aged Children in Nepal: Evidence From a Cluster Randomised Controlled Trial. Food Nutr Bull 2023; 44:195-206. [PMID: 37728126 DOI: 10.1177/03795721231194124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
BACKGROUND Integrated school and home garden interventions can improve health outcomes in low-income countries, but rigorous evidence remains scarce, particularly for school-aged children and to reduce anemia. OBJECTIVE We test if an integrated school and home garden intervention, implemented at pilot stage, improves hemoglobin levels among school children (aged 9-13 years) in a rural district in the mid-hills of Nepal. METHODS We use a cluster randomized controlled trial with 15 schools each in the control and treatment groups (n = 680 school children). To test if nutritional improvements translate into a reduction of anemia prevalence, hemoglobin data were collected 6 months after intervention support had ended. Using structural equation modeling, we estimate the direct and indirect effects of the treatment through several pathways, including nutritional knowledge, good food and hygiene practices, and dietary diversity. RESULTS The integrated school and home garden intervention did not lead to a direct significant reduction in anemia. Causal positive changes of the treatment on nutritional outcomes, although significant, are not strong enough to impact hemoglobin levels. The program improved hemoglobin levels indirectly for children below 12 by increasing the use of good food and hygiene practices at home. These practices are associated with higher hemoglobin levels, particularly for girls, young children, and in households where caregivers are literate. CONCLUSIONS Even integrated school and home garden interventions are not sufficient to reduce anemia among school children. Incorporating behavioral change components around food and hygiene practices into integrated garden interventions is important to unlocking their health impacts.
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Affiliation(s)
- Ghassan Baliki
- ISDC-International Security and Development Center, Berlin, Germany
- Leibniz Institute of Vegetable and Ornamental Crops, Großbeeren, Germany
| | - Dorothee Weiffen
- ISDC-International Security and Development Center, Berlin, Germany
| | | | - Akina Shrestha
- Dhulikhel Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
| | | | - Monika Schreiner
- Leibniz Institute of Vegetable and Ornamental Crops, Großbeeren, Germany
| | - Tilman Brück
- ISDC-International Security and Development Center, Berlin, Germany
- Leibniz Institute of Vegetable and Ornamental Crops, Großbeeren, Germany
- Thaer-Institute, Humboldt University of Berlin, Germany
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Lopes SO, Abrantes LCS, Azevedo FM, de Morais NDS, Morais DDC, Gonçalves VSS, Fontes EAF, Franceschini SDCC, Priore SE. Food Insecurity and Micronutrient Deficiency in Adults: A Systematic Review and Meta-Analysis. Nutrients 2023; 15:nu15051074. [PMID: 36904074 PMCID: PMC10005365 DOI: 10.3390/nu15051074] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 02/10/2023] [Accepted: 02/15/2023] [Indexed: 02/24/2023] Open
Abstract
Food insecurity is a public health problem as it affects a wide array of individuals in the population. It can be characterized by food deprivation, lack of essential nutrition, lack of dietary education, lack of adequate storage conditions, poor absorption, and poor overall nutrition. The relationship between food insecurity and micronutrient deficiency requires more effort to deepen and discuss the relationship. This systematic review aimed to evaluate the association between food insecurity and micronutrient deficiency in adults. The research was conducted according to PRISMA using the Medline/Pubmed, Lilacs/BVS, Embase, Web of Science, and Cinahl databases. Studies carried out with male and female adults were included, which investigated the correlation or association between food insecurity and the nutritional status of micronutrients. There were no publication year, country, or language restrictions. A total of 1148 articles were found, and 18 of these were included, carried out mainly on the American continent and with women. The most evaluated micronutrients were iron and vitamin A. Food insecurity was associated with nutrient deficiency in 89% (n = 16) of the studies. As a result of the meta-analysis, it was observed that there is a greater chance of anemia and low levels of ferritin among food insecure individuals. It is concluded that food insecurity is associated with micronutrient deficiency. Understanding these problems allows the creation of public policies capable of contributing to changes. Protocol registration: This review was registered on the PROSPERO-International Prospective Register of Systematic Reviews database-CRD42021257443.
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The Joint Role of Thyroid Function and Iodine Status on Risk of Preterm Birth and Small for Gestational Age: A Population-Based Nested Case-Control Study of Finnish Women. Nutrients 2019; 11:nu11112573. [PMID: 31731400 PMCID: PMC6893669 DOI: 10.3390/nu11112573] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 10/21/2019] [Accepted: 10/22/2019] [Indexed: 11/17/2022] Open
Abstract
Normal maternal thyroid function during pregnancy is essential for fetal development and depends upon an adequate supply of iodine. Little is known about how iodine status is associated with preterm birth and small for gestational age (SGA) in mildly iodine insufficient populations. Our objective was to evaluate associations of early pregnancy serum iodine, thyroglobulin (Tg), and thyroid-stimulating hormone (TSH) with odds of preterm birth and SGA in a prospective, population-based, nested case-control study from all births in Finland (2012–2013). Cases of preterm birth (n = 208) and SGA (n = 209) were randomly chosen from among all singleton births. Controls were randomly chosen from among singleton births that were not preterm (n = 242) or SGA (n = 241) infants during the same time period. Women provided blood samples at 10–14 weeks’ gestation for serum iodide, Tg and TSH measurement. We used logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for preterm birth and SGA. Each log-unit increase in serum iodide was associated with higher odds of preterm birth (adjusted OR = 1.19, 95% CI = 1.02–1.40), but was not associated with SGA (adjusted OR = 1.01, 95% CI = 0.86–1.18). Tg was not associated with preterm birth (OR per 1 log-unit increase = 0.87, 95% CI = 0.73–1.05), but was inversely associated with SGA (OR per log-unit increase = 0.78, 95% CI = 0.65–0.94). Neither high nor low TSH (versus normal) were associated with either outcome. These findings suggest that among Finnish women, iodine status is not related to SGA, but higher serum iodide may be positively associated with preterm birth.
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O'Kane SM, Mulhern MS, Pourshahidi LK, Strain JJ, Yeates AJ. Micronutrients, iodine status and concentrations of thyroid hormones: a systematic review. Nutr Rev 2019; 76:418-431. [PMID: 29596650 DOI: 10.1093/nutrit/nuy008] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Context The metabolism of thyroid hormones, which are essential for normal development, involves many proteins and enzymes. It requires iodine as a key component but is also influenced by several other micronutrients, including selenium, zinc, iron, and vitamin A. Objective This systematic review was designed to investigate the effect of micronutrient status and supplementation on iodine status and thyroid hormone concentrations. Data Sources Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines, electronic databases were searched from their inception to April 2016. Study Selection Human studies published in English and reporting data on micronutrient status and iodine status and/or thyroid hormone concentrations were included. Studies that examined the effect of micronutrient supplementation on iodine status and/or thyroid hormone concentrations were also included. Data Extraction A predesigned and piloted data extraction form was used to compile data from individual studies. Results A total of 57 studies were included: 20 intervention studies and 37 observational studies. Although observational evidence suggests that concentrations of selenium, zinc, and iron are positively associated with iodine status, data from randomized controlled trials fail to confirm this relationship. Conclusions Further studies are needed to provide greater understanding of the role of micronutrient status in iodine nutrition and thyroid function to ascertain the public health implications for populations worldwide.
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Affiliation(s)
- S Maria O'Kane
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, County Londonderry, United Kingdom
| | - Maria S Mulhern
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, County Londonderry, United Kingdom
| | - L Kirsty Pourshahidi
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, County Londonderry, United Kingdom
| | - J J Strain
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, County Londonderry, United Kingdom
| | - Alison J Yeates
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, County Londonderry, United Kingdom
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Tamang B, Khatiwada S, Gelal B, Shrestha S, Mehta KD, Baral N, Shah GS, Lamsal M. Association of antithyroglobulin antibody with iodine nutrition and thyroid dysfunction in Nepalese children. Thyroid Res 2019; 12:6. [PMID: 31320934 PMCID: PMC6615089 DOI: 10.1186/s13044-019-0067-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 07/01/2019] [Indexed: 11/10/2022] Open
Abstract
Background Aberrant iodine intake and thyroid autoimmunity affect thyroid function. Deficiencies of iodine including thyroid disorders have serious impact on child physical and mental development. This study was conducted to investigate iodine nutrition, thyroid function and thyroid autoimmunity in the Nepalese children, and explore the association of thyroidal autoimmunity with iodine nutrition and thyroid dysfunction. Methods Five schools from Udayapur district of eastern Nepal were selected for the study. A total of 213 school children aged 6–12 years were enrolled, and anthropometric data, urine samples and blood samples were collected. Urinary iodine concentration (UIC), free triiodothyronine (fT3), free thyroxine (fT4), thyroid stimulating hormone (TSH), and antithyroglobulin antibody (TgAb) was measured. Independent T test, Man-Whitney test, Chi-square test and Fisher’s Exact test were used for testing statistical significance. Spearman’s correlation analysis was done to find association between variables. Results The median UIC with IQR, mean ± SD fT3, mean ± SD fT4, median TSH and TgAb with IQR was 150.0 μg/L (102.8; 204.0), 2.49 ± 0.83 pg/ml, 1.33 ± 0.42 ng/dl, 2.49 mIU/L (1.58; 4.29), and 21.40 IU/ml (15.54; 31.20) respectively. Elvated TgAb (≥30 IU/ml, thyroid autoimmune condition) was seen in 25.8% (n = 55) children. UIC was less than 100 μg/L in 17.4% (n = 37) of the children. Subclinical hypothyroidism, overt hypothyroidism and sublinical hyperthyroidism was seen in 1.4% (n = 3), 3.3% (n = 7) and 3.8% (n = 8) children respectively. A strong association of TgAb with UIC (r = − 0.210, p = 0.002) and thyroid hormones; fT3 (r = − 0.160, p = 0.019), fT4 (r = − 0.275, p < 0.001), and TSH (r = 0.296, p < 0.001) was seen. The relative risk for thyroid autoimmunity in children with UIC less than 100 μg/L was 1.784 (95% CI: 1.108–2.871, p = 0.024). Similarly, children with thyroid autoimmunity had higher relative risk [7.469 (95% CI: 2.790–19.995, p < 0.001)] for thyroid dysfunction. Conclusions School children of eastern Nepal have adequate iodine nutrition. Thyroid autoimmunity is very common, while thyroid dysfunction is sparse in children. An association of thyroid autoimmunity with iodine nutrition and thyroid dysfunction was seen in children.
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Affiliation(s)
- Binaya Tamang
- 1Department of Biochemistry, Universal College of Medical Sciences, Bhairahawa, Nepal
| | | | - Basanta Gelal
- 3Department of Biochemistry, B P Koirala Institute of Health Sciences, Ghopa, Dharan, Nepal
| | - Shrijana Shrestha
- 3Department of Biochemistry, B P Koirala Institute of Health Sciences, Ghopa, Dharan, Nepal
| | - Kishun Deo Mehta
- 3Department of Biochemistry, B P Koirala Institute of Health Sciences, Ghopa, Dharan, Nepal
| | - Nirmal Baral
- 3Department of Biochemistry, B P Koirala Institute of Health Sciences, Ghopa, Dharan, Nepal
| | - Gauri Shankar Shah
- 4Department of Paediatrics and Adolescent medicine, B P Koirala Institute of Health Sciences, Dharan, Nepal
| | - Madhab Lamsal
- 3Department of Biochemistry, B P Koirala Institute of Health Sciences, Ghopa, Dharan, Nepal
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Soliman AT, De Sanctis V, Yassin M, Wagdy M, Soliman N. Chronic anemia and thyroid function. ACTA BIO-MEDICA : ATENEI PARMENSIS 2017; 88:119-127. [PMID: 28467346 PMCID: PMC6166193 DOI: 10.23750/abm.v88i1.6048] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 12/19/2016] [Indexed: 12/20/2022]
Abstract
Anaemia is a global public health problem affecting both developing and developed countries with major consequences for human health as well as social and economic development. It occurs at all stages of the life cycle, but is more prevalent in pregnant women and young children. Iron deficiency anaemia (IDA) impairs thyroid metabolism in animals and human and may negatively affect growth and develpment of children. On the other hand both overt and subclinical hypothyroidism are associated with anemia and adding iron to thyroxine therapy improves both conditions compared to thyroxine therapy alone. In addition patients with chronic hemolytic anemia requiring repeated blood transfusion have high prevalence of hypothalamic-pituitary thyroid axis. Both primary hypothyroidism and central hypothyroidism occur in these patients with increasing prevalence with age, severity of the anemia and higher ferritin concentration denoting poor chelation. Proper blood transfusion and intensive chelation appears to prevent deterioration of thyroid function and in many cases can reverse thyroid pathology. Physicians treating these forms of anemia should be aware of thyroid disorders in these patients for early screening, prevention and proper management of any thyroid dysfunction.
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Affiliation(s)
- Deepak Bansal
- Hematology/Oncology Unit, Department of Pediatrics, Advanced Pediatrics Center, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
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Henjum S, Kjellevold M, Ulak M, Chandyo RK, Shrestha PS, Frøyland L, Strydom EE, Dhansay MA, Strand TA. Iodine Concentration in Breastmilk and Urine among Lactating Women of Bhaktapur, Nepal. Nutrients 2016; 8:E255. [PMID: 27136582 PMCID: PMC4882668 DOI: 10.3390/nu8050255] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 04/15/2016] [Accepted: 04/21/2016] [Indexed: 11/24/2022] Open
Abstract
Adequate iodine concentration in breastmilk (BMIC) is essential for optimal neonatal thyroid hormone synthesis and neurological development in breastfed infants. For many decades, iodine deficiency has been a public health problem in Nepal. However, recently, excessive iodine intakes among Nepali infants have been reported. This study aimed to measure BMIC and urinary iodine concentration (UIC) among lactating women in a peri-urban area of Nepal. Iodine concentration was measured in spot urine (n = 485) and breastmilk samples (n = 291) of 500 randomly selected lactating women. The median (p25, p75) BMIC and median UIC were 250 (130, 370) µg/L and 230 (135-377) µg/L, respectively. Around 82% had BMIC > 100 µg/L, 61% had BMIC > 200 µg/L and 81% had UIC > 100 µg/L, 37% had >300 µg/L and 20% had >500 µg/L. In multiple linear regression models, time since birth (β 3.0, 95% CI (0.2, 5.0)) and UIC (β 1.0, 95% CI (0.1, 2.0)) were associated with BMIC, explaining 26% of the variance. A large proportion of the women had adequate BMIC and UIC; however, a subset had high iodine concentrations. These findings emphasize the importance of carefully monitoring iodine intake to minimize the risk of iodine excess and subsequently preventing transient iodine-induced hypothyroidism in breastfed infants.
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Affiliation(s)
- Sigrun Henjum
- Oslo and Akershus University College of Applied Sciences, P.O. Box 4, St. Olavs plass, Oslo 0130, Norway.
| | - Marian Kjellevold
- National Institute of Nutrition and Seafood Research (NIFES), Bergen 5817, Norway.
| | - Manjeswori Ulak
- Department of Child Health, Institute of Medicine, Tribhuvan University ,Maharajgunj, P.O. Box 1524, Kathmandu 44600, Nepal.
| | - Ram K Chandyo
- Centre for International Health, University of Bergen, P.O. Box 7800, Bergen 5020, Norway.
| | - Prakash S Shrestha
- Department of Child Health, Institute of Medicine, Tribhuvan University ,Maharajgunj, P.O. Box 1524, Kathmandu 44600, Nepal.
| | - Livar Frøyland
- National Institute of Nutrition and Seafood Research (NIFES), Bergen 5817, Norway.
| | - Emmerentia E Strydom
- Burden of Disease Research Unit, South African Medical Research Council, P.O. Box 19070, Tygerberg 7505, South Africa.
| | - Muhammad A Dhansay
- Burden of Disease Research Unit, South African Medical Research Council, P.O. Box 19070, Tygerberg 7505, South Africa.
- Division of Human Nutrition and Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg Hospital, Tygerberg 7505, South Africa.
| | - Tor A Strand
- Department of Research, Innlandet Hospital Trust, Lillehammer 2629, Norway.
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Khatiwada S, Gelal B, Baral N, Lamsal M. Association between iron status and thyroid function in Nepalese children. Thyroid Res 2016; 9:2. [PMID: 26819633 PMCID: PMC4729155 DOI: 10.1186/s13044-016-0031-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 01/11/2016] [Indexed: 11/10/2022] Open
Abstract
Background Deficiencies of iodine and iron may have adverse effect on thyroid function. This study was undertaken to investigate the association between iron status and thyroid function in Nepalese children living in hilly regions. Methods A cross-sectional study was conducted among 227 school children aged 6–12 years living in hilly regions of eastern Nepal. Urine and blood samples were analyzed for urinary iodine concentration, free thyroxine, free triiodothyronine, thyroid stimulating hormone, hemoglobin, serum iron and total iron binding capacity, and percentage transferrin saturation was calculated. Results The cohort comprised euthyroid (80.6 %, n = 183), overt hypothyroid (1.3 %, n = 3), subclinical hypothyroid (16.3 %, n = 37) and subclinical hyperthyroid (1.8 %, n = 4) children respectively. About 35.2 % (n = 80) children were anemic, 43.6 % (n = 99) were iron deficient and 19.8 % (n = 45) had urinary iodine excretion < 100 μg/L. Hypothyroidism (overt and subclinical) was common in anemic and iron deficient children. The relative risk of having hypothyroidism (overt and subclinical) in anemic and iron deficient children was 5.513 (95 % CI: 2.844−10.685, p < 0.001) and 1.939 (95 % CI: 1.091-3.449, p = 0.023) respectively as compared to non-anemic and iron sufficient children. Thyroid stimulating hormone had significant negative correlation with hemoglobin (r = −0.337, p < 0.001) and transferrin saturation (r = −0.204, p = 0.002). Conclusions Thyroid dysfunction, iron deficiency and anemia are common among Nepalese children. In this cohort, anemic and iron deficient children had poor thyroid function.
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Affiliation(s)
- Saroj Khatiwada
- Department of Biochemistry, Modern Technical College, Lalitpur, Nepal
| | - Basanta Gelal
- Department of Biochemistry, B P Koirala Institute of Health Sciences, Ghopa, Dharan, Nepal
| | - Nirmal Baral
- Department of Biochemistry, B P Koirala Institute of Health Sciences, Ghopa, Dharan, Nepal
| | - Madhab Lamsal
- Department of Biochemistry, B P Koirala Institute of Health Sciences, Ghopa, Dharan, Nepal
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