Status of iodine in rural pregnant women of different trimesters in Lucknow-A cross-sectional study
CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH
Authors: Jauhari, Sugandha; Agarwal, Monica; Ali, Wahid; Singh, V. K.; Tasleem, M.
Abstract
Background and objectives: Iodine plays a critical role in fetal brain development and hence has immense importance during pregnancy. Even mild to moderate iodine deficiency in pregnancy has adverse effects on obstetric and neonatal outcome. So, the aim of this study was to assess the trimester-wise urinary iodine status of pregnant women in rural areas and determine their iodine intake. Methods: A cross-sectional study was conducted in Sarojini nagar, which is a rural block of Lucknow, Uttar Pradesh from August 2016 to July 2017. All married pregnant women (15-45 years) of different trimesters attending the primary health centre (PHC) for antenatal check-up were enrolled in the study after written consent. Total 300 pregnant women were interviewed for Knowledge, Attitude and Practice (KAP) survey. Urine and salt sample was taken from 200 of them for biochemical analysis of iodine. Estimation of iodine in urine was done by wet digestion method and in salt by iodometric titration. Results: The median urinary iodine concentration of the rural pregnant women was 246.5 mu g/L with IQR of 194.9-383.4 mu g/L. On comparing the urine iodine levels in the three trimesters, maximum deficiency was observed in first trimester (39.5%) followed by third trimester (31.6%) and a dip was seen in the second trimester (28.9%). The median urinary iodine levels did not show a significant difference across the three trimesters. Conclusion: Iodine insufficiency was observed among pregnant women. Maximum deficiency was observed in first trimester which is the most vulnerable period of gestation responsible for organogenesis and fetal brain development.
Sodium Intake Is Associated With Renal Resistive Index in an Adult Population-Based Study
HYPERTENSION
Authors: Jaques, David A.; Pruijm, Menno; Ackermann, Daniel; Vogt, Bruno; Guessous, Idris; Burnier, Michel; Pechere-Bertschi, Antoinette; Bochud, Murielle; Ponte, Belen
Abstract
Renal resistive index (RRI) has been associated with adverse renal and cardiovascular outcomes. Although traditionally considered a marker of intrinsic renal damage, RRI could also reflect systemic vascular dysfunction. As sodium intake was linked to alterations in vascular properties, we wished to characterize the association of salt consumption with RRI in the general adult population. Participants were recruited in a population-based study in Switzerland. RRI was measured by ultrasound in 3 segmental arteries. Sodium intake (UNa; mmol/24 h) was estimated on 24-hour urine samples. Carotido-femoral pulse wave velocity was obtained by applanation tonometry. Mixed multivariate regression models were used with RRI or pulse wave velocity as independent variables and UNa as dependent variable, adjusting for possible confounders. We included 1002 patients in the analyses with 528 (52.7%) women and mean age of 47.2 +/- 17.4. Mean values of UNa and RRI were 141.8 +/- 61.1 mmol/24 h and 63.8 +/- 5.5%, respectively. In multivariate analysis, UNa was positively associated with RRI (P=0.002) but not with pulse wave velocity (P=0.344). Plasma renin activity and aldosterone did not modify the relationship between UNa and RRI (P=0.087 for interaction). UNa/urinary potassium ratio was positively associated with pulse wave velocity >= 12 m/s (P=0.033). Our results suggest that dietary salt consumption has a direct impact on renal hemodynamic in the adult general population. Alterations in vascular properties likely explain those findings, but inadequate renal vaso-motor response is also possible. Sodium intake could thus potentially be linked to underlying structural systemic damages affecting this population.