Olivieri A, Fazzini C, Grandolfo M E, Medda E, Stazi M A, D'Archivio M, De Angelis S, Sorcini M
Laboratorio di Metabolismo e Biochimica Patologica, Istituto Superiore di Sanità, Roma.
Ann Ist Super Sanita. 1998;34(3):331-6.
On the basis of data collected in the National Register of infants with congenital hypothyroidism (CH), a mean incidence of 1 case of CH to 3200 live births has been estimated in Italy. Nevertheless a higher incidence (> 1:2000) than national mean value has been observed in several districts of our country. The aim of this study was to verify a possible occurrence of transient hypothyroidism (TH) in these areas. Results of our study showed that the proportion of infants with thyroid in situ was significantly higher in the areas with very high CH incidence than in the remaining parts of the country. Also serum TSH levels at confirmation showed a less severe hypothyroidism in infants of these areas when compared with the other CH infants. Furthermore, preliminary results of diagnosis reevaluation showed 58% of TH in the areas with CH incidence > 1:2000. Lower percentages of TH have been observed in the other areas in relation to the decreasing of CH incidence. Most of the high CH incidence areas are historically affected by iodine deficiency. This observation supports the hypothesis that iodine deficiency can contribute to the occurrence of transient disorders of thyroid function in our population and stresses the need of promoting diffusion of an adequate iodine prophylaxis.
根据意大利先天性甲状腺功能减退症(CH)婴儿国家登记处收集的数据,估计意大利CH的平均发病率为每3200例活产中有1例。然而,在我国的几个地区观察到发病率高于全国平均值(>1:2000)。本研究的目的是验证这些地区是否可能发生暂时性甲状腺功能减退症(TH)。我们的研究结果表明,CH发病率非常高的地区甲状腺原位婴儿的比例明显高于该国其他地区。与其他CH婴儿相比,这些地区婴儿确诊时的血清促甲状腺激素(TSH)水平显示甲状腺功能减退症较轻。此外,诊断重新评估的初步结果显示,CH发病率>1:2000的地区TH发生率为58%。随着CH发病率的降低,在其他地区观察到的TH百分比也较低。大多数CH发病率高的地区历史上都受到碘缺乏的影响。这一观察结果支持了碘缺乏可能导致我国人群甲状腺功能暂时紊乱的假设,并强调了促进适当碘预防措施普及的必要性。