ACTA ENDOCRINOLOGICA (BUC)

Objective. To monitor the iodine status in Romanian schoolchildren and neonates after 20 years of mandatory salt iodization. Subjects and methods. In a national representative sample of 1352 children (7-12 years) we measured median urinary iodine concentration (mUIC) and creatinine (UCC) in spot urine samples and investigated household use of iodized salt. From 18349 neonates registered in the MEDILOG program for TSH screening we calculated the percentage of neonatal TSH >5 mIU/L (<3% indicating adequate iodine intake). Results. mUIC in schoolchildren was 141 μg/L (bootstrapped 95% CI 134, 146), showing adequate iodine intake in all but 1 county; mUIC was similar in historical endemic and non-endemic counties (140 μg/L and 143 ug/L, respectively) and in urban and rural areas (140 μg/L and 142 μg/L, respectively); mUIC/UCC = 118 ug/g. Iodized salt was used in 62% of households. In children using iodized salt (61.7%), mUIC was higher than in those using coarse (non-iodized) salt (24.6%): 150 vs. 121 μg/L (p<0.001). The percentage of nTSH >5 mIU/L was 14.7% (3.2%-27.3%), higher in non-endemic counties and urban areas. Conclusion. The current salt iodization program for households and bakery industry ensures an adequate iodine intake in schoolchildren. Discordantly, nTSH levels indicate a mild-moderate ID in neonates, suggesting ID in pregnant women. The percentage of households using iodized salt is below the recommended >90% needed for an efficient ID prevention program. More efforts should be directed to increase the public awareness on the health risks of ID and the benefits of ID prevention, notably for the neurointellectual development in children.

Objective. Congenital hypothyroidism (CH) is one of the common preventable causes of intellectual disability in neonates, by early detection through neonatal screening. We present the 8-year experience of the National Institute for Mother and Child Health (INSMC) in using MEDILOG national registry for the neonatal screening of CH. Methods. Neonatal screening for CH, done by TSH measurement in dried blood spot, is organized in 5 regional centers, each with a reference laboratory. Results. In 2018 80% of all the newborns, from 80% of the maternity hospitals, were registered in MEDILOG. After re-testing of TSH and T4/FT4 from venous blood in positive cases, the incidence of confirmed CH in 2018 was 1/3576 - 1/ 4746. In INSMC center (which includes 26 counties and Bucharest, out of 41 counties), in 2018 the incidence of positive CH cases at screening was 1/2094 (TSH cut-off ≥17 mIU/L) and of confirmed CH cases 1/3576 newborns. For positive screening cases, the median duration from birth to the INSMC laboratory result was 19 days: median of 9 days between screening and laboratory registration and 6 days between registration and test result. Conclusion. MEDILOG registry is a practical instrument for monitoring the steps of neonatal CH screening, the incidence of CH, the evolution of the diagnosed cases, for evaluation of iodine deficiency (by neonatal TSH), and also for research, with the aim of improving early disease detection and treatment.

Background. A rising trend in obesity among children has been observed in recent years\r\nin most countries. The majority of obese children will become obese adults having an increased\r\nrisk for chronic diseases associated with obesity, with a negative impact on their lifespan.\r\nObjective. Assesing the obesity prevalence among school children in Cluj-Napoca.\r\nMethods. The study included 7904 school children of all grades (grade 1 to grade 12) from\r\n20 schools in Cluj-Napoca. The weight, height and body mass index (BMI) were recorded for\r\neach child. Using the BMI percentile, they were classified as: normal (BMI < 85th percentile),\r\noverweight (BMI between 85th and 95th percentile) or obese (BMI > 95th percentile). BMI average\r\nand standard deviation have been calculated per age groups and sex.\r\nResults. 8.29% of school children in Cluj-Napoca are obese, while 12.84% of them are\r\noverweight. The difference between sex groups is statistically significant with boys more likely to\r\nbe obese or overweight than girls (p<0.0001). The highest prevalence has been observed among\r\nthe 6-10 years age group, while teenagers have recorded the lowest prevalence figures.\r\nConclusion. Data derived from this study would place Romania among the countries\r\nwith an average prevalence of obesity. However, extending such studies at national level\r\nwould provide more accurate data about obesity prevalence in Romania.

Background. Metabolic syndrome is an important risk factor for cardiovascular diseases. \r\nObjective. Evaluating the prevalence of metabolic syndrome and serum profile of adipokines in children with overweight or obesity. \r\nMethods. Sixty two children were included in the study, with a body mass index (BMI) that exceeded 85th percentile. Waist circumference and blood pressure (BP) were recorded, followed by the determination of: glucose, cholesterol, triglycerides, HDL cholesterol, insulin, adiponectin and leptin. The insulin resistance was then calculated. \r\nResults. Of the 52 children included, 28,8% have met the criteria for diagnosis of metabolic syndrome. BMI and BP values were higher in children with metabolic syndrome as well as the values of leptin (69.59 ? 50;89 vs. 58.44 ? 42.28 ng / ml) and insulin resistance (1.65 ? 0 ,74 vs. 1.41? 0.78). We could found a positive correlation, statistically significant between BMI and serum leptin (r = 0.32, p =0.02), BMI and insulin (r = 0.33, p = 0.01) and BMI and insulin resistance (r = 0.33, p = 0.01). \r\nConclusion. Metabolic syndrome has a high prevalence in childhood obesity. The adipokines seem to have a very good correlation with the clinical and bioumoral features of the metabolic syndrome.