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La Rivista Italiana della Medicina di Laboratorio 2021 Settembre;17(3):139-42

DOI: 10.23736/S1825-859X.21.00108-0


lingua: Italiano

La determinazione della concentrazione urinaria di iodio nell’attività di monitoraggio della iodoprofilassi

Antonella OLIVIERI 1, Marcello BAGNASCO 2

1 Dipartimento di Malattie Cardiovascolari, Endocrino-Metaboliche e Invecchiamento, Istituto Superiore di Sanità, Roma, Italia; 2 Dipartimento di Medicina Interna e Specialità Mediche, Università degli Studi di Genova, Genova, Italia

An adequate iodine supply is required for normal thyroid function, and a normal thyroid function is required for normal development, with special reference to central nervous system, and metabolic homeostasis. Iodine deficiency has significantly conditioned human biological and cultural evolution. Although the cretinism as a manifestation of severe iodine deficiency has disappeared, at least in developed countries, iodine deficiency is still a determinant of the incidence of goiter, congenital hypothyroidism and cognitive impairment. Iodine requirement depends upon age, and increases in pregnancy and lactation. The main strategy to eradicate iodine deficiency is the use of salt fortified with iodine. The use of iodine salt on a voluntary basis has been implemented in Italy in 2005 by the Law 55. The control strategy for iodoprophylaxis strategies is based on the measure of urinary iodine excretion. To date, the gold standard for urinary iodine evaluation is plasma mass spectrometry (ICP/MS). For epidemiological surveys, the evaluation of urinary iodine concentration (UIC) on morning spot samples is most widely used. Due to the fact that UIC is a short-term indicator of iodine supply, being conditioned by its high day-by-day variability, relatively large samples are required, and the median UIC value should be taken into account. Typically, samples of schoolchildren (about 1000) are evaluated: among the variables to be considered, attention should be paid to Body Mass Index, which may affect UIC evaluation. Special attention, and specific monitoring programs, should be deserved to pregnant women, in whom a higher iodine supply is required, due to increased thyroid hormone synthesis and increased renal clearance, to ensure optimal condition for fetal development. On the other hand, UIC monitoring at population level is important to avoid iodine excess, which may contribute to the development of thyroid autoimmunity and to abnormal thyroid function. In conclusion, UIC as a laboratory parameter is clinically useful in single case only in a few specific clinical situations, such as iodine-induced thyroiditis: on the other hand, it plays a primary role as a tool for epidemiological studies, which are relevant for public health.

KEY WORDS: Iodine; Urine specimen collection; Prevention and control

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