Iodine status in children with intestinal failure

Objectives Children on long‐term parenteral nutrition (PN) are at high risk of iodine deficiency (ID). However, most available information comes from cross‐sectional studies. We investigated the iodine status, associated factors, and prevalence of hypothyroidism in children with intestinal failure (...

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Veröffentlicht in:Journal of pediatric gastroenterology and nutrition 2024-03, Vol.78 (3), p.691-698
Hauptverfasser: Leite, Heitor Pons, Hatanaka, Eduardo Freitas, Sabio, Giovana Sertori Galati, Evangelista, Nara Michelle de Araújo, Camargo, Maria Fernanda Carvalho
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container_title Journal of pediatric gastroenterology and nutrition
container_volume 78
creator Leite, Heitor Pons
Hatanaka, Eduardo Freitas
Sabio, Giovana Sertori Galati
Evangelista, Nara Michelle de Araújo
Camargo, Maria Fernanda Carvalho
description Objectives Children on long‐term parenteral nutrition (PN) are at high risk of iodine deficiency (ID). However, most available information comes from cross‐sectional studies. We investigated the iodine status, associated factors, and prevalence of hypothyroidism in children with intestinal failure (IF) who were followed up longitudinally. Methods This was a cohort study of children with IF monitored for urine iodine concentration (UIC), iodine intake, serum selenium concentration, and thyroid function in an intestinal rehabilitation program. The outcome variable ID was defined as a UIC value 
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However, most available information comes from cross‐sectional studies. We investigated the iodine status, associated factors, and prevalence of hypothyroidism in children with intestinal failure (IF) who were followed up longitudinally. Methods This was a cohort study of children with IF monitored for urine iodine concentration (UIC), iodine intake, serum selenium concentration, and thyroid function in an intestinal rehabilitation program. The outcome variable ID was defined as a UIC value &lt; 100 μg/L. Adjusted generalized estimating equations were used to assess the effects of the exposure variables on the UIC. Results Twenty‐four patients aged 62.7 (39.1; 79.7) months who received PN for 46.5 (21.5) months were included. The average energy supply was 81.2 kcal/kg/day, 77.6% of which was provided by PN. An average of 5.2 UIC measurements per patient were performed. ID prevalence decreased from baseline (83.3%) to the last assessment (45.8%). Three patients had hypothyroidism secondary to iodine and selenium combined severe deficiency. Iodine intake from enteral or oral nutritional formulas was positively associated with UIC (β = 0.71 [0.35, 1.07]; p &lt; 0.001). Meeting approximately 80% of the estimated average requirement for iodine from nutritional formulas resulted in a greater probability of normal UIC values. Conclusion ID is highly prevalent in children with IF who receive long‐term PN and its frequency decreases with iodine intake from nutritional formulas. Severe combined iodine and selenium deficiencies are associated with the development of hypothyroidism in these patients. What is Known Cross‐sectional evidence has shown that children receiving long‐term parenteral nutrition are at increased risk of developing iodine deficiency and hypothyroidism. Insufficient iodine status may occur even in children receiving the recommended iodine dose in parenteral nutrition. What is New Iodine deficiency is common in children with intestinal failure and its frequency decreases inversely with iodine intake from oral or enteral nutritional formulas. Severe combined iodine and selenium deficiency is associated with hypothyroidism in these patients. Regular monitoring of iodine and selenium status, dietary iodine intake, and thyroid function can help in timely prevention and management of complications.</description><identifier>ISSN: 0277-2116</identifier><identifier>EISSN: 1536-4801</identifier><identifier>DOI: 10.1002/jpn3.12117</identifier><identifier>PMID: 38323710</identifier><language>eng</language><publisher>United States</publisher><subject>enteral nutrition ; home parenteral nutrition ; hypothyroidism ; selenium ; short bowel syndrome</subject><ispartof>Journal of pediatric gastroenterology and nutrition, 2024-03, Vol.78 (3), p.691-698</ispartof><rights>2024 European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3297-7e6925bc347e23a633519a5555c0416480b910c0077db0bb9bff28da5daa68933</citedby><cites>FETCH-LOGICAL-c3297-7e6925bc347e23a633519a5555c0416480b910c0077db0bb9bff28da5daa68933</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fjpn3.12117$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fjpn3.12117$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38323710$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Leite, Heitor Pons</creatorcontrib><creatorcontrib>Hatanaka, Eduardo Freitas</creatorcontrib><creatorcontrib>Sabio, Giovana Sertori Galati</creatorcontrib><creatorcontrib>Evangelista, Nara Michelle de Araújo</creatorcontrib><creatorcontrib>Camargo, Maria Fernanda Carvalho</creatorcontrib><title>Iodine status in children with intestinal failure</title><title>Journal of pediatric gastroenterology and nutrition</title><addtitle>J Pediatr Gastroenterol Nutr</addtitle><description>Objectives Children on long‐term parenteral nutrition (PN) are at high risk of iodine deficiency (ID). However, most available information comes from cross‐sectional studies. We investigated the iodine status, associated factors, and prevalence of hypothyroidism in children with intestinal failure (IF) who were followed up longitudinally. Methods This was a cohort study of children with IF monitored for urine iodine concentration (UIC), iodine intake, serum selenium concentration, and thyroid function in an intestinal rehabilitation program. The outcome variable ID was defined as a UIC value &lt; 100 μg/L. Adjusted generalized estimating equations were used to assess the effects of the exposure variables on the UIC. Results Twenty‐four patients aged 62.7 (39.1; 79.7) months who received PN for 46.5 (21.5) months were included. The average energy supply was 81.2 kcal/kg/day, 77.6% of which was provided by PN. An average of 5.2 UIC measurements per patient were performed. ID prevalence decreased from baseline (83.3%) to the last assessment (45.8%). Three patients had hypothyroidism secondary to iodine and selenium combined severe deficiency. Iodine intake from enteral or oral nutritional formulas was positively associated with UIC (β = 0.71 [0.35, 1.07]; p &lt; 0.001). Meeting approximately 80% of the estimated average requirement for iodine from nutritional formulas resulted in a greater probability of normal UIC values. Conclusion ID is highly prevalent in children with IF who receive long‐term PN and its frequency decreases with iodine intake from nutritional formulas. Severe combined iodine and selenium deficiencies are associated with the development of hypothyroidism in these patients. What is Known Cross‐sectional evidence has shown that children receiving long‐term parenteral nutrition are at increased risk of developing iodine deficiency and hypothyroidism. Insufficient iodine status may occur even in children receiving the recommended iodine dose in parenteral nutrition. What is New Iodine deficiency is common in children with intestinal failure and its frequency decreases inversely with iodine intake from oral or enteral nutritional formulas. Severe combined iodine and selenium deficiency is associated with hypothyroidism in these patients. Regular monitoring of iodine and selenium status, dietary iodine intake, and thyroid function can help in timely prevention and management of complications.</description><subject>enteral nutrition</subject><subject>home parenteral nutrition</subject><subject>hypothyroidism</subject><subject>selenium</subject><subject>short bowel syndrome</subject><issn>0277-2116</issn><issn>1536-4801</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kEFLwzAYhoMobk4v_gDpUYTOJF_TNEcZUydDPeg5JGnKMrJ2Ni1j_97MTo9-lw9eHl5eHoSuCZ4SjOn9elvDlFBC-AkaEwZ5mhWYnKIxppynMc9H6CKENcaYZwyfoxEUQIETPEZk0ZSutknoVNeHxNWJWTlftrZOdq5bxaCzoXO18kmlnO9be4nOKuWDvTr-Cfp8nH_MntPl29Ni9rBMDVDBU25zQZk2kHFLQeUAjAjF4hmckTwu1IJgEyfxUmOtha4qWpSKlUrlhQCYoNuhd9s2X30cITcuGOu9qm3TB0kFBaCc0QN6N6CmbUJobSW3rduodi8JlgdF8qBI_iiK8M2xt9cbW_6hv04iQAZg57zd_1MlX95fYSj9BqiCbqM</recordid><startdate>202403</startdate><enddate>202403</enddate><creator>Leite, Heitor Pons</creator><creator>Hatanaka, Eduardo Freitas</creator><creator>Sabio, Giovana Sertori Galati</creator><creator>Evangelista, Nara Michelle de Araújo</creator><creator>Camargo, Maria Fernanda Carvalho</creator><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202403</creationdate><title>Iodine status in children with intestinal failure</title><author>Leite, Heitor Pons ; Hatanaka, Eduardo Freitas ; Sabio, Giovana Sertori Galati ; Evangelista, Nara Michelle de Araújo ; Camargo, Maria Fernanda Carvalho</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3297-7e6925bc347e23a633519a5555c0416480b910c0077db0bb9bff28da5daa68933</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>enteral nutrition</topic><topic>home parenteral nutrition</topic><topic>hypothyroidism</topic><topic>selenium</topic><topic>short bowel syndrome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Leite, Heitor Pons</creatorcontrib><creatorcontrib>Hatanaka, Eduardo Freitas</creatorcontrib><creatorcontrib>Sabio, Giovana Sertori Galati</creatorcontrib><creatorcontrib>Evangelista, Nara Michelle de Araújo</creatorcontrib><creatorcontrib>Camargo, Maria Fernanda Carvalho</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of pediatric gastroenterology and nutrition</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Leite, Heitor Pons</au><au>Hatanaka, Eduardo Freitas</au><au>Sabio, Giovana Sertori Galati</au><au>Evangelista, Nara Michelle de Araújo</au><au>Camargo, Maria Fernanda Carvalho</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Iodine status in children with intestinal failure</atitle><jtitle>Journal of pediatric gastroenterology and nutrition</jtitle><addtitle>J Pediatr Gastroenterol Nutr</addtitle><date>2024-03</date><risdate>2024</risdate><volume>78</volume><issue>3</issue><spage>691</spage><epage>698</epage><pages>691-698</pages><issn>0277-2116</issn><eissn>1536-4801</eissn><abstract>Objectives Children on long‐term parenteral nutrition (PN) are at high risk of iodine deficiency (ID). However, most available information comes from cross‐sectional studies. We investigated the iodine status, associated factors, and prevalence of hypothyroidism in children with intestinal failure (IF) who were followed up longitudinally. Methods This was a cohort study of children with IF monitored for urine iodine concentration (UIC), iodine intake, serum selenium concentration, and thyroid function in an intestinal rehabilitation program. The outcome variable ID was defined as a UIC value &lt; 100 μg/L. Adjusted generalized estimating equations were used to assess the effects of the exposure variables on the UIC. Results Twenty‐four patients aged 62.7 (39.1; 79.7) months who received PN for 46.5 (21.5) months were included. The average energy supply was 81.2 kcal/kg/day, 77.6% of which was provided by PN. An average of 5.2 UIC measurements per patient were performed. ID prevalence decreased from baseline (83.3%) to the last assessment (45.8%). Three patients had hypothyroidism secondary to iodine and selenium combined severe deficiency. Iodine intake from enteral or oral nutritional formulas was positively associated with UIC (β = 0.71 [0.35, 1.07]; p &lt; 0.001). Meeting approximately 80% of the estimated average requirement for iodine from nutritional formulas resulted in a greater probability of normal UIC values. Conclusion ID is highly prevalent in children with IF who receive long‐term PN and its frequency decreases with iodine intake from nutritional formulas. Severe combined iodine and selenium deficiencies are associated with the development of hypothyroidism in these patients. What is Known Cross‐sectional evidence has shown that children receiving long‐term parenteral nutrition are at increased risk of developing iodine deficiency and hypothyroidism. Insufficient iodine status may occur even in children receiving the recommended iodine dose in parenteral nutrition. What is New Iodine deficiency is common in children with intestinal failure and its frequency decreases inversely with iodine intake from oral or enteral nutritional formulas. Severe combined iodine and selenium deficiency is associated with hypothyroidism in these patients. Regular monitoring of iodine and selenium status, dietary iodine intake, and thyroid function can help in timely prevention and management of complications.</abstract><cop>United States</cop><pmid>38323710</pmid><doi>10.1002/jpn3.12117</doi><tpages>8</tpages></addata></record>
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subjects enteral nutrition
home parenteral nutrition
hypothyroidism
selenium
short bowel syndrome
title Iodine status in children with intestinal failure
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