Delange F
Postgrad Med J. 2001 Apr;77(906):217-20. doi: 10.1136/pmj.77.906.217.
This editorial reviews the impact of iodine deficiency (1) on thyroid function in pregnant women and neonates and (2) on the neurointellectual development of infants and children. All degrees of iodine deficiency (mild: iodine intake of 50-99 microg/day, moderate: 20-49 microg/day, and severe: <20 microg/day) affect thyroid function of the mother and the neonate as well as the mental development of the child. The damage increases with the degree of the deficiency, with overt endemic cretinism as the severest consequence. Maternal hypothyroxinaemia during early pregnancy is a key factor in the development of the neurological damage in the cretin. Selenium deficiency combined with iodine deficiency partly prevents the neurological damage but precipitates severe hypothyroidism in cretins. Iodine deficiency results in a global loss of 10-15 IQ points at a population level and constitutes the world's greatest single cause of preventable brain damage and mental retardation.
本社论综述了碘缺乏(1)对孕妇和新生儿甲状腺功能的影响,以及(2)对婴幼儿神经智力发育的影响。所有程度的碘缺乏(轻度:碘摄入量为50 - 99微克/天,中度:20 - 49微克/天,重度:<20微克/天)都会影响母亲和新生儿的甲状腺功能以及儿童的智力发育。损害程度随缺乏程度的加重而增加,最严重的后果是显性地方性克汀病。孕早期母亲甲状腺素水平低下是克汀病神经损伤发生发展的关键因素。硒缺乏与碘缺乏共同作用,部分可预防神经损伤,但会促使克汀病患者发生严重甲状腺功能减退。在人群层面,碘缺乏导致智商整体下降10 - 15分,是世界上可预防脑损伤和智力发育迟缓的最大单一原因。