Maberly G F, Eastman C J
Southeast Asian J Trop Med Public Health. 1976 Sep;7(3):434-42.
A comparative epidemiological and anthropometric survey was conducted among Ibans, the largest indigenous ethnic group in Sarawak, in three regions where the endemicity of goitre exhibited marked differences , to assess the effect of endemic goitre on somatic growth. In the Ai river region the prevalence of goitre was 99.5%; 35% having grade 3 goitres, 55% grade 2 goitres and 9.5% grade 1 goitres. At Rubu the prevalence of endemic goitre was 74%; 3% having grade 3 goitre, 16% grade 2 goitre and 55% grade 1 goitre. In the Bajong region relatively few people were detected with goitre and most of these had migrated from other regions. Neurological cretinism was estimated at 3.6% in the severely goitrous Ai river population but was not detected in the other regions. Anthropometric data obtained from the three adult populations did not reveal any statistically significant differences in the following parameters: weight, height, weight/height ratio, height/sitting height ratios, head circumference, scapular skinfold thickness and left mid arm muscle circumference. The haemoglobin, serum total protein and serum albumin concentrations were similar in the three populations. It is concluded that endemic goitre occurs with a frequency of close to 100% in certain Iban populations which represents one of the highest incidences of endemic goitre in the world. Neurological cretinism is common in this population. Our observations suggest that body proportions and somatic growth do not vary among similar ethnic populations exhibiting greatly different endemicity of goitre. Although no iodine balance studies were performed, assessment of diets suggested that iodine deficiency is a significant contributory factor in the development of endemic goitre in Sarawak. Urgent attention to iodine supplementation is indicated to prevent the development of endemic goitre and neurological cretinism.
在砂拉越最大的原住民族群伊班族居住的三个地区，甲状腺肿流行程度差异显著，开展了一项对比性的流行病学和人体测量学调查，以评估地方性甲状腺肿对身体生长的影响。在艾河地区，甲状腺肿患病率为99.5%；35%为3级甲状腺肿，55%为2级甲状腺肿，9.5%为1级甲状腺肿。在鲁布，地方性甲状腺肿患病率为74%；3%为3级甲状腺肿，16%为2级甲状腺肿，55%为1级甲状腺肿。在巴琼地区，检测到甲状腺肿的人数相对较少，且大多数是从其他地区迁移过来的。在甲状腺肿严重的艾河人群中，神经型克汀病估计为3.6%，但在其他地区未检测到。从这三个成年人群获得的人体测量数据在以下参数方面未显示出任何统计学上的显著差异：体重、身高、体重/身高比、身高/坐高比、头围、肩胛皮褶厚度和左上臂中部肌肉周长。这三个人群的血红蛋白、血清总蛋白和血清白蛋白浓度相似。得出的结论是，地方性甲状腺肿在某些伊班人群中的发生率接近100%，这是世界上地方性甲状腺肿发病率最高的情况之一。神经型克汀病在该人群中很常见。我们的观察结果表明，在甲状腺肿流行程度差异极大的相似族群中，身体比例和身体生长并无差异。尽管未进行碘平衡研究，但对饮食的评估表明，碘缺乏是砂拉越地方性甲状腺肿发生的一个重要促成因素。为预防地方性甲状腺肿和神经型克汀病的发生，迫切需要关注碘补充问题。
