Husein Mohammed, Grace S Marquis, Frances Aboud, Karim Bougma, Aregash Samuel
{"title":"一项随机临床试验:TSH介导加碘盐对儿童认知的影响。","authors":"Husein Mohammed, Grace S Marquis, Frances Aboud, Karim Bougma, Aregash Samuel","doi":"10.1177/11786388211025352","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>This study examines the hormonal mediators of the effect of iodized salt in pregnancy on child cognition.</p><p><strong>Methods: </strong>Sixty districts across 6 zones in the Amhara region of Ethiopia were randomly allocated to a control or intervention arm of early market access to iodized salt. Twenty-two villages per arm were randomly selected for this sub-study. A total of 1220 pregnant women who conceived after the intervention began were enrolled and assessed for their iodine and iron status. Data were collected once on the household socio-demographic status and iodized salt use, and maternal urinary iodine during pregnancy. Then, infants' diet, urinary iodine level, cognitive development (Bayley III), serum hormonal levels, iron status, and inflammation markers were measured between 2 and 13 months of age.</p><p><strong>Results: </strong>The median maternal urinary iodine concentration was adequate and significantly higher in the intervention mothers than that of the controls (163 vs 121 µg/L, <i>P</i> < .0001). Intervention children compared to the control children had lower thyroid-stimulating hormone (TSH) (mean: 2.4 ± 1.0 µIU/mL vs 2.7 ± 1.0 µIU/mL, effect size = 0.18, <i>P</i> < .01) and thyroglobulin (Tg) (41.6 ± 1.0 ng/mL vs 45.1 ± 1.0 ng/mL, effect size = 0.14, <i>P</i> < .05). There was an interaction between the intervention and iron stores such that cognition was higher with iron (effect size = 0.28, 100 vs 94 IQ points). TSH was a partial mediator (12%) of the effect of the intervention on child cognition (Sobel z-score = 2.1 ± 0.06, <i>P</i> < .05).</p><p><strong>Conclusion: </strong>TSH partially mediated the effect of the iodized salt intervention on child cognition.</p>","PeriodicalId":19396,"journal":{"name":"Nutrition and Metabolic Insights","volume":null,"pages":null},"PeriodicalIF":2.3000,"publicationDate":"2021-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/11786388211025352","citationCount":"2","resultStr":"{\"title\":\"TSH Mediated the Effect of Iodized Salt on Child Cognition in a Randomized Clinical Trial.\",\"authors\":\"Husein Mohammed, Grace S Marquis, Frances Aboud, Karim Bougma, Aregash Samuel\",\"doi\":\"10.1177/11786388211025352\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>This study examines the hormonal mediators of the effect of iodized salt in pregnancy on child cognition.</p><p><strong>Methods: </strong>Sixty districts across 6 zones in the Amhara region of Ethiopia were randomly allocated to a control or intervention arm of early market access to iodized salt. Twenty-two villages per arm were randomly selected for this sub-study. A total of 1220 pregnant women who conceived after the intervention began were enrolled and assessed for their iodine and iron status. Data were collected once on the household socio-demographic status and iodized salt use, and maternal urinary iodine during pregnancy. Then, infants' diet, urinary iodine level, cognitive development (Bayley III), serum hormonal levels, iron status, and inflammation markers were measured between 2 and 13 months of age.</p><p><strong>Results: </strong>The median maternal urinary iodine concentration was adequate and significantly higher in the intervention mothers than that of the controls (163 vs 121 µg/L, <i>P</i> < .0001). Intervention children compared to the control children had lower thyroid-stimulating hormone (TSH) (mean: 2.4 ± 1.0 µIU/mL vs 2.7 ± 1.0 µIU/mL, effect size = 0.18, <i>P</i> < .01) and thyroglobulin (Tg) (41.6 ± 1.0 ng/mL vs 45.1 ± 1.0 ng/mL, effect size = 0.14, <i>P</i> < .05). There was an interaction between the intervention and iron stores such that cognition was higher with iron (effect size = 0.28, 100 vs 94 IQ points). TSH was a partial mediator (12%) of the effect of the intervention on child cognition (Sobel z-score = 2.1 ± 0.06, <i>P</i> < .05).</p><p><strong>Conclusion: </strong>TSH partially mediated the effect of the iodized salt intervention on child cognition.</p>\",\"PeriodicalId\":19396,\"journal\":{\"name\":\"Nutrition and Metabolic Insights\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2021-06-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1177/11786388211025352\",\"citationCount\":\"2\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Nutrition and Metabolic Insights\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/11786388211025352\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2021/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"NUTRITION & DIETETICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nutrition and Metabolic Insights","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/11786388211025352","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2021/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}
引用次数: 2
摘要
目的:探讨孕期加碘盐对儿童认知影响的激素介质。方法:将埃塞俄比亚阿姆哈拉地区6个地区的60个地区随机分配到加碘盐早期市场准入的对照或干预组。每组随机选取22个村庄作为亚研究。共有1220名在干预开始后怀孕的孕妇被纳入研究,并评估了她们的碘和铁状况。收集了一次家庭社会人口状况、碘盐使用情况和孕妇孕期尿碘的数据。然后,在2至13个月大期间测量婴儿的饮食、尿碘水平、认知发展(Bayley III)、血清激素水平、铁状态和炎症标志物。结果:干预组产妇尿碘浓度中位数正常,显著高于对照组(163µg/L vs 121µg/L, P P P P P)。结论:TSH部分介导了加碘盐干预对儿童认知的影响。
TSH Mediated the Effect of Iodized Salt on Child Cognition in a Randomized Clinical Trial.
Objectives: This study examines the hormonal mediators of the effect of iodized salt in pregnancy on child cognition.
Methods: Sixty districts across 6 zones in the Amhara region of Ethiopia were randomly allocated to a control or intervention arm of early market access to iodized salt. Twenty-two villages per arm were randomly selected for this sub-study. A total of 1220 pregnant women who conceived after the intervention began were enrolled and assessed for their iodine and iron status. Data were collected once on the household socio-demographic status and iodized salt use, and maternal urinary iodine during pregnancy. Then, infants' diet, urinary iodine level, cognitive development (Bayley III), serum hormonal levels, iron status, and inflammation markers were measured between 2 and 13 months of age.
Results: The median maternal urinary iodine concentration was adequate and significantly higher in the intervention mothers than that of the controls (163 vs 121 µg/L, P < .0001). Intervention children compared to the control children had lower thyroid-stimulating hormone (TSH) (mean: 2.4 ± 1.0 µIU/mL vs 2.7 ± 1.0 µIU/mL, effect size = 0.18, P < .01) and thyroglobulin (Tg) (41.6 ± 1.0 ng/mL vs 45.1 ± 1.0 ng/mL, effect size = 0.14, P < .05). There was an interaction between the intervention and iron stores such that cognition was higher with iron (effect size = 0.28, 100 vs 94 IQ points). TSH was a partial mediator (12%) of the effect of the intervention on child cognition (Sobel z-score = 2.1 ± 0.06, P < .05).
Conclusion: TSH partially mediated the effect of the iodized salt intervention on child cognition.
期刊介绍:
Nutrition and Metabolic Insights is a peer-reviewed, open-access online journal focusing on all aspects of nutrition and metabolism. This encompasses nutrition, including the biochemistry of metabolism, exercise and associated physical processes and also includes clinical articles that relate to metabolism, such as obesity, lipidemias and diabetes. It includes research at the molecular, cellular and organismal levels. This journal welcomes new manuscripts for peer review on the following topics: Nutrition, including the biochemistry of metabolism, Exercise and associated physical processes, Clinical articles that relate to metabolism, such as obesity, lipidemias and diabetes, Research at the molecular, cellular and organismal levels, Other areas of interest include gene-nutrient interactions, the effects of hormones, models of metabolic function, macronutrient interactions, outcomes of changes in diet, and pathophysiology.