IODINE NUTRITION IN THE REPUBLIC OF ARTSAKH (NAGORNO KARABAKH) |
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| Affiliation: | 1. College of Physicians & Surgeons, Columbia University, New York, New York;2. Department of Endocrinology, Yerevan State Medical University, Yerevan, Armenia;3. Management Mix, Yerevan, Armenia;4. National Institute of Health, Ministry of Health, Yerevan, Armenia;5. Mount Auburn Hospital, Cambridge, Massachusetts;6. Manoukian Medical Group, Stanford University Healthcare Alliance, Mountain View, California;7. Ministry of Health, Stepanakert, Artsakh;8. Osteoporosis Center of Aremenia, Yerevan, Armenia.;1. Medical Biotechnology Research Center, Ashkezar Branch, Islamic Azad University, Ashkezar, Yazd, Iran;2. Endocrinology and Metabolism Research Center Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran;3. Pathology Department, Medical Faculty, Tehran University of Medical Science, Tehran, Iran;4. Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran;5. 5;6. Global Health Science, University of California, San Francisco, California.;1. From the University of Washington School of Medicine, Seattle, Washington. |
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| Abstract: | Objective: Iodine is a required nutrient for thyroid function. The mountainous terrain in the Republic of Artsakh (Nagorno Karabakh) in the south Caucasus suggests that it is likely to be endogenously deficient in iodine. The region is heavily dependent on neighboring Armenia for food imports including iodized salt. Since 2005, iodine is a government-sanctioned compulsory supplemental ingredient in salt in Armenia. However, there has never been a study of iodine nutrition in Artsakh. We sought to determine the level of iodine nutrition in Artsakh and the iodine content of table salt in the region.Methods: Using a cross-sectional modified cluster model, we measured urine and salt iodine concentrations from a representative sample of children living in Artsakh. From 30 schools throughout the territory, we obtained 772 urine samples from children aged 8 to 10, and 323 samples of table salt. Repeat urine samples from 18.6% of participants were obtained.Results: The median adjusted urinary iodine content was 203 μg/L (mean 206 μg/L, 95% confidence interval 202–210), within the range indicating sufficient iodine nutrition. There were small but statistically significant differences between the 8 administrative regions; however, there were no differences between individual sites. We found that 97.2% of table salt samples tested had iodine concentrations within the standard of 25 to 55 mg/kg.Conclusion: Among school-age children in Artsakh, iodine nutrition is adequate, and the salt is appropriately iodized. These results illustrate the remarkable success of the Armenian salt iodization program in providing sufficient but not excessive iodine to the mountainous territory of Artsakh.Abbreviation: UIC = urinary iodine concentration |
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