Gao Tian-shu, Teng Wei-ping, Shan Zhong-yan, Jin Ying, Guan Hai-xia, Teng Xiao-chun, Yang Fan, Wang Wei-bo, Shi Xiao-guang, Tong Ya-jie, Li Dan, Chen Wei
Department of Endocrinology, First Hospital of China Medical University, Shenyang, China.
Chin Med J (Engl). 2004 Oct;117(10):1518-22.
Reports are increasingly appearing on the side effects caused by excessive iodine intake. Our objective was to find out whether iodine excess would impair the thyroid function and intelligence of schoolchildren in rural areas of China.
A comparative epidemiological study was made on thyroid function and intelligence of the schoolchildren in the areas of low, moderate or excessive intake of iodine. In the area of low intake of iodine (Panshan, Liaoning province, median urinary iodine (MUI) was 99 microg/L), of moderate intake of iodine (Zhangwu, Liaoning Province, MUI was 338 microg/L) and of excessive intake of iodine (Huanghua, Hebei Province, MUI was 631 microg/L). The numbers of schoolchildren from each area selected to take part in a Chinese version of Raven's Test were 190, 236 and 313, respectively, and then 116, 110 and 112 of them were tested for thyroid function, thyroid autoantibody (TAA) and urinary iodine (UI).
There were no significant differences in the incidences of overt hyperthyroidism, subclinical hyperthyroidism and overt hypothyroidism in Panshan, Zhangwu and Huanghua. But significant differences were found in the incidences of subclinical hypothyroidism (P = 0.001) in these three areas. The incidences of subclinical hypothyroidism in Huanghua and Zhangwu were 4.76 and 3.37 times higher than that in Panshan. TAA were negative in all the schoolchildren with subclinical hypothyroidism except for one. No significant difference was found among the rates of thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TGAb) in these three areas. Mean serum thyroglobulin (TG) value of Huanghua was markedly higher than those of the other two (P = 0.02). Mean serum TG value of Zhangwu was higher than that of Panshan but the difference was not significant. Mean IQ value of the schoolchildren in Huanghua was markedly higher than that for Zhangwu (P = 0.001). Mean IQ value of the schoolchildren in Panshan was lower than that of Huanghua and higher than that of Zhangwu but, again, the differences were not significant.
The increase of iodine intake may increase the risk for schoolchildren of subclinical hypothyroidism. In the area of iodine excess, most of the subclinical hypothyroidism cases are not of autoimmune origin. No obvious effect of excess iodine was found on mental development of schoolchildren.
关于碘摄入过量所导致副作用的报道日益增多。我们的目的是探究碘过量是否会损害中国农村地区学龄儿童的甲状腺功能和智力。
对碘摄入量低、中等或过量地区的学龄儿童的甲状腺功能和智力进行了一项对比性流行病学研究。碘摄入量低的地区(辽宁省盘山,尿碘中位数(MUI)为99微克/升)、碘摄入量中等的地区(辽宁省彰武,MUI为338微克/升)以及碘摄入量过量的地区(河北省黄骅,MUI为631微克/升)。从每个地区选取参加中文版瑞文测验的学龄儿童数量分别为190名、236名和313名,随后对其中116名、110名和112名儿童进行甲状腺功能、甲状腺自身抗体(TAA)和尿碘(UI)检测。
盘山、彰武和黄骅地区显性甲状腺功能亢进、亚临床甲状腺功能亢进和显性甲状腺功能减退的发生率无显著差异。但这三个地区亚临床甲状腺功能减退的发生率存在显著差异(P = 0.001)。黄骅和彰武地区亚临床甲状腺功能减退的发生率分别是盘山地区的4.76倍和3.37倍。除1例之外,所有亚临床甲状腺功能减退的学龄儿童的TAA均为阴性。这三个地区的甲状腺过氧化物酶抗体(TPOAb)和甲状腺球蛋白抗体(TGAb)的比率无显著差异。黄骅地区的血清甲状腺球蛋白(TG)均值明显高于其他两个地区(P = 0.02)。彰武地区的血清TG均值高于盘山地区,但差异不显著。黄骅地区学龄儿童的智商均值明显高于彰武地区(P = 0.001)。盘山地区学龄儿童的智商均值低于黄骅地区且高于彰武地区,但差异同样不显著。
碘摄入量增加可能会增加学龄儿童患亚临床甲状腺功能减退的风险。在碘过量地区,大多数亚临床甲状腺功能减退病例并非自身免疫性起源。未发现碘过量对学龄儿童智力发育有明显影响。