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[碘摄入量对农村地区学龄儿童甲状腺疾病及智力的影响]

[Effect of iodine intake on thyroid diseases and intelligence among schoolchildren in rural areas].

作者信息

Gao T, Teng W, Shan Z

机构信息

Department of Endocrinology, First Hospital Affiliated to China Medical University, Shenyang 110001, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2001 Apr 25;81(8):453-6.

Abstract

OBJECTIVE

To understand the throid function and intelligence among the schoolchildren in three rural areas with different iodine intakes in China to probe the side-effect of excessive iodine intake on intelligence of schoolchildren.

METHODS

Chinese version of Raven's test was made among rural schoolchildren, 190 from Panshan County, Liaoning Province, a low iodine intake area with the median urinary iodine (MUI) of 99 microgram/L among its inhabitants, 236 from Zhangwu County, Liaoning Province, a moderate iodine intake area with the MUI of 338 microgram/L, and 313 from Huanghua County, Hebei Province, an excessive iodine intake area with the MUI of 631 microgram/L. Thyroid function, thyroid autoantibody (TAA), and MUI were determined among 116, 110 and 112 from the above-mentioned schoolchildren from these three areas respectively.

RESULTS

There was no significant difference among the prevalence rates of overt hyperthyroidism, subclinical hyperthyroidism and overt hypothyroidism in the areas of Panshan, Zhangwu and Huanghua. However, a significant difference was found among the prevalence rates of subclinical hypothyroidism in theses three areas (P = 0.001). The prevalence rates of subclinical hypothyroidism in Huanghua and Zhangwu were 4.76 and 3.37 times higher than that in Panshan (P = 0.001). TAA was negative among all of the schoolchildren with subclinical hypothyroidism except for one. No significant difference was found among the positive rates of thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TGAb) in these three areas. Serum thyroglobulin (TG) values in Huanghua were markedly higher than those in the other two areas (P = 0.015 7). Serum TG value in Zhangwu was higher than that in Panshan but with no significant difference. The IQ value of the schoolchildren in Huanghua was markedly higher than that in Zhangwu (P = 0.001 2). The IQ value of the schoolchildren in Panshan was lower than that in Huanghua and higher than that in Zhangwu but with no significant difference.

CONCLUSION

The increase of iodine intake may increase the risk of subclinical hypothyroidism among schoolchildren. In the area with excessive iodine intake, most of the subclicical hypothyroidism cases among schoolchildren are not of autoimmune origin. No obvious effect of excessive iodine intaue is found on mental development of schoolchildren.

摘要

目的

了解我国三个碘摄入量不同的农村地区学龄儿童的甲状腺功能及智力情况,探讨碘摄入过量对学龄儿童智力的不良影响。

方法

对农村学龄儿童进行中文版瑞文测验,其中来自辽宁省盘山县的190名儿童,当地为碘摄入不足地区,居民尿碘中位数(MUI)为99微克/升;来自辽宁省彰武县的236名儿童,当地为碘摄入适宜地区,MUI为338微克/升;来自河北省黄骅县的313名儿童,当地为碘摄入过量地区,MUI为631微克/升。分别对上述三个地区的116名、110名和112名学龄儿童测定甲状腺功能、甲状腺自身抗体(TAA)及MUI。

结果

盘山县、彰武县和黄骅县显性甲状腺功能亢进、亚临床甲状腺功能亢进及显性甲状腺功能减退的患病率差异无统计学意义。然而,这三个地区亚临床甲状腺功能减退的患病率差异有统计学意义(P = 0.001)。黄骅县和彰武县亚临床甲状腺功能减退的患病率分别是盘山县的4.76倍和3.37倍(P = 0.001)。除1例亚临床甲状腺功能减退的学龄儿童外,其余所有患儿TAA均为阴性。这三个地区甲状腺过氧化物酶抗体(TPOAb)和甲状腺球蛋白抗体(TGAb)的阳性率差异无统计学意义。黄骅县血清甲状腺球蛋白(TG)值显著高于其他两个地区(P = 0.015 7)。彰武县血清TG值高于盘山县,但差异无统计学意义。黄骅县学龄儿童的智商值显著高于彰武县(P = 0.001 2)。盘山县学龄儿童的智商值低于黄骅县且高于彰武县,但差异无统计学意义。

结论

碘摄入量增加可能增加学龄儿童亚临床甲状腺功能减退的风险。在碘摄入过量地区,学龄儿童中的大多数亚临床甲状腺功能减退病例并非自身免疫性起源。未发现碘摄入过量对学龄儿童智力发育有明显影响。

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