ketendoКлиническая и экспериментальная тиреоидологияClinical and experimental thyroidology1995-54722310-3787Endocrinology Research Centre10.14341/ket20117233-42ketendo-4360Research ArticleСтатьиArticlesИспользование йодированной соли в домашнем хозяйстве улучшает обеспечение питания йодом у беременных и детей школьного возраста: двойное слепое рандомизированное контролируемое исследование в ДонецкеUse of iodized salt in the households improves the iodine status of pregnant women and school-age children in Donetsk, Ukraine: A double-blind randomized controlled trialFirsovaN A

канд. мед. наук, врач Донецкого регионального центра охраны материнства и детства

-VanDer F.

профессор Школы общественного здоровья Университета Эмори, Атланта, США

fvander@sph.emory.eduDeminaT N

доктор мед. наук, профессор кафедры акушерства, гинекологии и перинатологии ФИПО Донецкий медицинский университет

-ChaikaV C

член.-корр. АМНУ, доктор мед. наук, профессор кафедры акушерства, гинекологии и перинатологии ФИПО Донецкий медицинский университет

-IvanovaL

руководитель проекта, Представительство Детского фонда ООН (ЮНИСЕФ) в Украине

-TrushO A

руководитель проектов по вопросам питания Представительства Детского фонда ООН (ЮНИСЕФ) в Украине

-20111506201172ТОМ 7, №2 (2011)3342Copyright © Firsova N.A., Van d.F., Demina T.N., Chaika V.C., Ivanova L., Trush O.A., 20112011Firsova N.A., Van d.F., Demina T.N., Chaika V.C., Ivanova L., Trush O.A.Firsova N.A., Van d.F., Demina T.N., Chaika V.C., Ivanova L., Trush O.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.cet-endojournals.ru/jour/article/view/4360

Было исследовано влияние потребления йодированной соли на обеспечение питания йодом беременных женщин и детей школьного возраста, проживающих в Донецке. 160 домохозяйств, в которых жили беременная и ребенок в возрасте от 6 до 12 лет, двойным слепым рандомизированным методом были разделены на 2 группы: 50% обследованных использовали в питании обычную соль, а вторая половина – йодированную соль. Немаркированную соль домохозяйства получали от исследовательской группы. Образцы мочи для определения йода собирались до и в среднем спустя 15,1 дня после начала исследования. С помощью вопросников собиралась информация о том, какие продукты питания испытуемые употребляли в течение предшествующих 24 ч до визита. В начале исследования содержание йода в соли составляло 10,2 мг/кг (SD – 3,1), а медиана концентрации йода в моче у беременных (89 мкг/л) значительно не отличалась от этого показателя у детей (101 мкг/л). Содержание йода в соли в период проведения испытания в исследуемых домохозяйствах составляло 43,3 мг/кг (SD – 4,6), и этот показатель был значительно выше (p < 0,001) содержания йода в соли в домохозяйствах, включенных в контрольную группу, – 11,4 мг/кг (SD – 5,1). Медиана концентрации йода в моче беременных (141 мкг/л; 95% ДИ – 123–163) в исследуемых домохозяйствах была ниже (p < 0,05), чем у детей (169 мкг/л; 95% ДИ – 147–194), но суммарное воздействие потребления ЙС на концентрацию йода в моче у беременных (73 мкг/л; 95% ДИ – 66–81) было значительно выше (p < 0,01), чем у детей (59 мкг/л; 95% ДИ – 53–67). Установлено, что потребление морской рыбы (в обеих группах) и молочных продуктов, кроме сыра, детьми оказало значительное влияние на уровень йода в моче. Таким образом, использование ЙС в домохозяйствах за 2 нед нормализовало уровень потребления йода с питанием у детей, но не у беременных женщин, несмотря на большее суммарное воздействие ЙС на концентрацию йода в моче у беременных женщин.

This study analyzed the effect of iodized salt consumption on the iodine status of pregnant women and school children living in the households of Donetsk, Ukraine. 160 households with a healthy pregnant woman and a child aged 6–12 years were assigned in concealed sequence 1 : 1 to the use of either common or iodized salt. Casual urine samples were collected and the consumption of specific foods was obtained verbally from the women and the children during a baseline and a follow-up visit in each household. All the women (age 30 years; pregnancy duration 20 weeks) and the children (age 8.5 years) completed the trial without any adverse event. At the baseline visit, the mean household salt iodine content was 10.2 mg/kg (SD 3.1) and the median urinary iodine (UI) concentration in the women (89 μg/L) and the children (101 μg/L) was not significantly different. The salt iodine content during the trial in the experimental households was 43.3 mg/kg (SD 4.6) and starkly higher (p<0.001) than in comparison house- holds (11.4 mg/kg; SD 5.1). The final UI of the pregnant women (141μg/L; 95% CI: 123–163) in experimental households was lower (p < 0.05) than of the children (169μg/L; 95% CI: 147–194), but the net effect of iodized salt consumption on the UI levels of the women (73μg/L; 95% CI: 66–81) was significantly higher (p<0.01) than that of the children (59μg/L; 95% CI: 53–67). The baseline UI (in both groups), and the consumption of marine fish (both groups) and of dairy products other than cheese (in children) were significant effect modifiers. Introduction of iodized salt in the households of Donetsk was associated with adequate iodine intake in school-age children but it did not realize sufficient iodine intake in pregnant women, despite the greater net effect on the UI concentration in the latter group.

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