title: Iodine nutrition in adults on long-term home parenteral nutrition.
abstract: OBJECTIVE
  The aim of this study was to evaluate iodine nutrition in adults on long-term home parenteral nutrition (HPN) and to compare it with iodine supplemented with PN, categorized as below or according to the European Society for Clinical Nutrition and Metabolism guidelines (ESPEN-GL) recommendation.
  
  
  METHODS
  Iodine nutrition was evaluated retrospectively in 31 stable adults on long-term HPN. We analyzed urinary iodine concentration (UIC) and serum thyroid-stimulating hormone (TSH). A median UIC value ≥100 μg/L was considered indicative of adequate iodine intake, a value between 50 and 100 was indicative of moderate iodine deficiency, and a value <50 μg/L was indicative of overt iodine deficiency.
  
  
  RESULTS
  PN iodine amount was according to ESPEN-GL in 26% of patients and lower in 19%; 55% did not receive iodine with PN. The median UIC was 63 μg/L (95% confidence interval [CI], 26-99 μg/L) in the whole group of patients, 56 μg/L (95% CI, 24-100) in the group including patients who did not receive any PN iodine supplementation and those who received PN iodine supply lower than the ESPEN-GL recommendation, and slightly higher (77 μg/L) in eight patients with PN iodine supply according to the ESPEN-GL (P = 0.42). TSH was normal in 74% of patients, increased in 23%, and reduced in 3%. Results did not change when patients with reduced glomerular filtration rate were excluded from the analysis.
  
  
  CONCLUSIONS
  The analyzed patients on long-term HPN had a low iodine intake as shown by low median UIC level, as did the group of patients who received PN iodine supplementation according to ESPEN-GL. A condition of subclinical hypothyroidism was observed in a small percentage of patients.
authors.affiliation: Chronic Intestinal Failure Centre of S. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy. Electronic address: Mariacristina.guidetti@aosp.bo.it.
authors.forename: Mariacristina
authors.initials: M
authors.lastname: Guidetti
authors.affiliation: Chronic Intestinal Failure Centre of S. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Agostini
authors.affiliation: Chronic Intestinal Failure Centre of S. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy.
authors.forename: Giada
authors.initials: G
authors.lastname: Lapenna
authors.affiliation: Chronic Intestinal Failure Centre of S. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Pazzeschi
authors.affiliation: Chronic Intestinal Failure Centre of S. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Soverini
authors.affiliation: Chronic Intestinal Failure Centre of S. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy.
authors.forename: Rossella
authors.initials: R
authors.lastname: Petitto
authors.affiliation: Chronic Intestinal Failure Centre of S. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy.
authors.forename: Loris
authors.initials: L
authors.lastname: Pironi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019587:Dietary Supplements; D017408:Guidelines as Topic; D006801:Humans; D007037:Hypothyroidism / Q000097:blood / Q000453:epidemiology; D007455:Iodine / Q000008:administration & dosage / Q000172:deficiency* / Q000652:urine; D008875:Middle Aged; D009752:Nutritional Status; D016331:Parenteral Nutrition, Home; D012016:Reference Values; D012189:Retrospective Studies; D013972:Thyrotropin / Q000097:blood; D013997:Time Factors
chemical_list: D013972:Thyrotropin; D007455:Iodine
keywords: Intestinal failure; Iodine excretion; Iodine requirement; Long-term HPN; Thyroid function; Trace elements