Téllez Téllez Rafael, Michaud Chacón Patricio, Reyes Abarca Carlos, Blount Ben C, Van Landingham Cynthia B, Crump Kenny S, Gibbs John P
Medicine Service, Sótero del Río Hospital, Puente Alto, Chile.
Thyroid. 2005 Sep;15(9):963-75. doi: 10.1089/thy.2005.15.963.
We have conducted a longitudinal epidemiologic study among pregnant women from three cities in northern Chile: Taltal with 114 microg/L, Chañaral with 6 microg/L, and Antofagasta with 0.5 microg/L perchlorate in the public drinking water. We tested the hypothesis that long-term exposure to perchlorate at these levels may cause a situation analogous to iodine deficiency, thus causing increases in thyrotropin (TSH) and thyroglobulin (Tg) levels and decreased levels of free thyroxine (FT4), in either the mother during the early stages of gestation or the neonate at birth, or in the fetus cause growth retardation. We found no increases in Tg or TSH and no decreases in FT4 among either the women during early pregnancy (16.1 +/- 4.1 weeks), late pregnancy (32.4 +/- 3.0 weeks), or the neonates at birth related to perchlorate in drinking water. Neonatal birth weight, length, and head circumference were not different among the three cities and were consistent with current U.S. norms. Therefore, perchlorate in drinking water at 114 microg/L did not cause changes in neonatal thyroid function or fetal growth retardation. Median urinary iodine among the entire cohort was 269 microg/L, intermediate between that of pregnant women in the United States at National Health and Nutrition Examination Survey (NHANES) I and at NHANES III and consistent with current World Health Organization (WHO) recommendations. Median breast milk iodine was not decreased in the cities with detectable perchlorate. Analysis of maternal urinary perchlorate excretion indicates an additional dietary source of perchlorate.
塔尔塔尔市公共饮用水中高氯酸盐含量为114微克/升,查尼亚拉尔市为6微克/升,安托法加斯塔市为0.5微克/升。我们检验了这样一个假设:在孕期早期,母亲或新生儿出生时长期暴露于这些水平的高氯酸盐可能会导致类似于碘缺乏的情况,从而导致促甲状腺激素(TSH)和甲状腺球蛋白(Tg)水平升高以及游离甲状腺素(FT4)水平降低,或者导致胎儿生长发育迟缓。我们发现,在怀孕早期(16.1±4.1周)、怀孕晚期(32.4±3.0周)的女性中,或者与饮用水中的高氯酸盐相关的出生新生儿中,Tg或TSH均未升高,FT4也未降低。三个城市的新生儿出生体重、身长和头围没有差异,与美国目前的标准一致。因此,饮用水中114微克/升的高氯酸盐不会导致新生儿甲状腺功能改变或胎儿生长发育迟缓。整个队列的尿碘中位数为269微克/升,介于美国国家健康与营养检查调查(NHANES)I和NHANES III中孕妇的尿碘中位数之间,与世界卫生组织(WHO)目前的建议一致。在可检测到高氯酸盐的城市中,母乳碘中位数并未降低。对母亲尿中高氯酸盐排泄的分析表明,高氯酸盐还有额外的饮食来源。