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[儿童智力与碘缺乏、补碘及碘过量因素关系的Meta分析]

[Meta-analysis on the relationship between children's intelligence and factors as iodine deficiency, supplement iodine and excessive iodine].

作者信息

Qian Ming, Yan Yuqin, Chen Zupei, Wang Dong

机构信息

Department of Medical Psychology, Tianjin Medical University, Tianjin 300070, China.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2002 Aug;23(4):246-9.

Abstract

OBJECTIVE

To estimate the role and extent of iodine deficiency, iodine supplement and iodine excess on mental development of children.

METHODS

Meta-analysis was applied to study 128 independent items from 63 published and non-published papers and reports. The standards of references collected included: age of sample declared by references was 5 - 15; belong to comparison study; children lived in iodine deficiency disorders (IDD) and iodine excess areas; no difference of social economic and culture development level between the study group and the control group.

RESULTS

Sixty-seven percent and 79% of the reports mainly involved severe IDD areas respectively. Hunter test of each studies, i.e. iodine deficiency, iodine supplement and excessive iodine group had not discovered statistic difference at the level of alpha = 0.05. The weighted average ES of damage affecting on children's intelligence by iodine deficiency achieved 0.69, which was equivalent to a marked drop in 10.4 IQ points [95% confidence interval (CI): 9.9 - 10.9] when comparing with the children living under non-IDD. The weighted average ES of protective effect on children's intelligence by iodine supplement reached 0.81, which meant that the IQ of children born after correction of iodine deficiency increased 12.2 points (95% CI: 11.5 - 12.9) in comparison with those born at least one year before the correction of iodine deficiency. Most of the references about the relationship between iodine excess and intelligence were gathered from proceedings, while the others were from journals. They location were in some areas of Shandong, Hebei, Shanxi and Inner Mongolia. The mean ES of the role of iodine excess on intelligence was 0.21, which was corresponding to 3.2 IQ points (95% CI: 2.5 - 4.0).

CONCLUSION

  1. Iodine deficiency played a role of intermediate strength compared with other causes in delaying brain development making children to be at least 10 IQ points loss in IDD areas. 2) Effective iodine supplement plays a remarkable strengthening role in promoting brain development and can cause 12 IQ points increase for children who were born after the correction of iodine status. 3) Iodine excess has not shown significant important role in children's intelligence.
摘要

目的

评估碘缺乏、碘补充及碘过量对儿童智力发育的作用及程度。

方法

采用Meta分析方法,研究63篇已发表和未发表的论文及报告中的128个独立项目。收集的参考文献标准包括:参考文献声明的样本年龄为5 - 15岁;属于对照研究;儿童生活在碘缺乏病(IDD)地区和碘过量地区;研究组和对照组社会经济和文化发展水平无差异。

结果

67%和79%的报告主要分别涉及重度IDD地区。各研究的Hunter检验,即碘缺乏、碘补充和碘过量组在α = 0.05水平未发现统计学差异。碘缺乏对儿童智力影响的加权平均效应量(ES)达到0.69,与生活在非IDD地区的儿童相比,相当于智商显著下降10.4分[95%置信区间(CI):9.9 - 10.9]。碘补充对儿童智力的保护作用加权平均ES达到0.81,这意味着碘缺乏纠正后出生的儿童智商比碘缺乏纠正前至少一年出生的儿童增加12.2分(95% CI:11.5 - 12.9)。关于碘过量与智力关系的参考文献大多来自会议论文集,其他来自期刊。它们来自山东、河北、山西和内蒙古的一些地区。碘过量对智力作用的平均ES为0.21,相当于3.2个智商点(95% CI:2.5 - 4.0)。

结论

1)与其他原因相比,碘缺乏在延缓脑发育方面起中等强度作用,使IDD地区儿童智商至少损失10分。2)有效的碘补充在促进脑发育方面起显著增强作用,可使碘状态纠正后出生的儿童智商增加12分。3)碘过量在儿童智力方面未显示出显著重要作用。

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