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Clinical and experimental thyroidology

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Armenia's experience in achieving an adequate iodine status of the population

https://doi.org/10.14341/ket12525

Abstract

Armenia was one of the first post-Soviet countries, that after a relatively short break has restored the production of iodized salt at the beginning of the 2000s, and in 2004 adopted a decree that made the production and import of iodized salt mandatory, as well as its use in the food industry. A 2016 national survey showed high sustainability of the iodine prophylaxis program in Armenia – median urinary iodine concentration (UIC) in schoolchildren and pregnant women (PW) was in the optimal range (242 and 226 μg/l, respectively), and coverage of households with quality iodized salt was 95%. In addition to iodized salt used in households, more than 50% of iodine was consumed with processed foods, primarily bakery products. An essential advantage of the iodine prophylaxis program in Armenia is that it provides adequate iodine status not only for the general population, but also for PW. At the same time about 37% of PW used iodine supplements, which were not necessary. The experience of Armenia shows that the analysis of screening datasets for neonatal hypothyroidism screening makes it possible to efficiently and at minimal cost annually evaluate the iodine status of the population. And if the frequency of TSH levels > 5 mIU/L exceeds 3%, the health authorities should consider this as an alarm and conduct a more detailed assessment to find out the cause of the iodine status insufficiency and take appropriate measures

About the Authors

Gregory A. Gerasimov
https://www.researchgate.net/profile/Gregory_Gerasimov2
Iodine Global Network (IGN)
United States

Gregory A. Gerasimov, MD, PhD, Professor

Myrtle Beach

eLibrary Author ID: 296623

 



Nicholas Hutchings
School of Medicine of the University of California
United States

Nicholas Hutchings, MD MS, School of Medicine

Irvine


Competing Interests:

No



Hrayr Aslanyan
National Institute of Health
Armenia

Hrayr Aslanyan, MD, PhD

Yerevan


Competing Interests:

No



Irina Tovmasyan
Arabkir Medical Center
Armenia

Irina Tovmasyan, MD

Neonatal Screening Program

Yerevan


Competing Interests:

нет



References

1. van der Haar F, Gerasimov G, Tyler VQ, Timmer A. Universal salt iodization in the Central and Eastern Europe, Commonwealth of Independent States (CEE/CIS) Region during the decade 2000–09: experiences, achievements, and lessons learned. Food Nutr Bull. 2011;32(4 Suppl):S175–294. doi: 10.1177/15648265110324S401.

2. Andersen S, Karmisholt J, Pedersen KM, Laurberg P. Reliability of studies of iodine intake and recommendations for number of samples in groups and in individuals. Br J Nutr. 2008;99(4):813–818. doi: 10.1017/S0007114507842292.

3. Institute of Medicine; Subcommittee on Interpretation and Uses of Dietary Reference Intakes; Standing Committee on the Scientific Evaluation of Dietary Reference Intakes. Dietary reference intakes. Applications in dietary planning. Washington DC: National Academies Press; 2003. 255 p.

4. Hutchings N, Aghajanova E, Baghdasaryan SA, et al. Stratified cross-sectional clusters model survey of iodine nutrition in Armenia after a decade of universal salt iodization. Endocr Pract. 2019;25(10):987–993. doi: 10.4158/EP-2018-0634.

5. who.int [Internet]. Armenia STEPS Survey, 2016-2017. Fact Sheet [cited 2020 Apr 14]. Available at: https://www.who.int/ncds/surveillance/steps/Armenia_2016_STEPS_FS.pdf.

6. Aslanyan H, Bazarchyan A, Gerasimov G. Iodized salt in processed food in Armenia. IDD Newsletter. 2020;48(2):13–14.

7. Hutchings N, Aghajanova E, Baghdasaryan S, et al. Constituent analysis of iodine intake in Armenia. Public Health Nutr. 2018;21(16):2982–2988. doi: 10.1017/S1368980018002197.

8. Hutchings N, Tovmasyan I, Hovsepyan M, et al. Neonatal thyrotropin (TSH) screening as a tool for monitoring iodine nutrition in Armenia. Eur J Clin Nutr. 2019;73(6):905–909. doi: 10.1038/s41430-018-0298-4.

9. Suplotova LA, Makarova OB, Koval’zhina LS. Neonatal gipertireotropinemiya - an indicator of the severity of iodine deficiency in the population? Clinical and experimental thyroidology. 2015;11(3):47–53. (In Russ.).doi: 10.14341/ket2015347-53.

10. Barnabishvilli N, Gerasimov GА, Azikuri T. The results of neonatal TSH screening do not agree with indicators of the optimal iodine status of pregnant women in the Republic of Georgia. Clinical and experimental thyroidology. 2018;14(2):81–85. (In Russ.). doi: 10.14341/ket9777.

11. Zimmermann MB, Gizak M, Abbott K, et al. Iodine deficiency in pregnant women in Europe. Lancet Diabetes Endocrinol. 2015;3(9):672–674. doi: 10.1016/S2213-8587(15)00263-6.


Supplementary files

1. Figure 1. Histogram of iodine level distribution in salt samples in Armenia [4].
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Type Исследовательские инструменты
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2. Figure 2. Consumption of iodine (in% recommended intake) by adults in Armenia with iodized kitchen salt and selected processed food products produced with iodized salt [6].
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Type Исследовательские инструменты
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3. Figure 3. The frequency of an increase in the level of thyroid-stimulating hormone more than 5 mIU/L in newborns in Armenia from 2012 to 2016 [8].
Subject
Type Исследовательские инструменты
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Review

For citations:


Gerasimov G.A., Hutchings N., Aslanyan H., Tovmasyan I. Armenia's experience in achieving an adequate iodine status of the population. Clinical and experimental thyroidology. 2020;16(2):25-30. (In Russ.) https://doi.org/10.14341/ket12525

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ISSN 1995-5472 (Print)
ISSN 2310-3787 (Online)