Siavash Dastjerdi Mansour, Hashemipour Mahin, Rezvanian Hasan, Kazemi Fatemeh, Najafian Alireza, Mohammady Mohammad, Aminorroaya Ashraf, Amini Masoud, Kachuei Ali, Hassan Moaddab Mohammad
Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Horm Res. 2006;66(1):45-50. doi: 10.1159/000093473. Epub 2006 May 19.
Iodine deficiency produces the spectrum of iodine deficiency disorders (IDDs): endemic goiter, hypothyroidism, cretinism, and congenital anomalies. Other factors, including goitrogens and micronutrient deficiencies, may influence the prevalence and severity of IDDs and response to iodine supplementation. This cross-sectional, descriptive study was performed in 2003 on elementary school children of Semirom, a mountainous region of Iran, where goiter was hyper-endemic in 1994, but the goiter prevalence had not decreased as expected many years after salt iodization and iodine injection. Some possible risk factors associated with goiter in that area were evaluated, and the results of iron study are presented here.
1,869 cases were selected by a multistage cluster sampling procedure. Grade 2 goitrous children were compared with equal number of nongoitrous children for serum iron, ferritin, transferrin, thyroxin, TSH and urine iodine concentrations (UIC).
210 children (105 goiter grade 0 and 105 goiter grade 2) entered this sub-study. Of 210 participants, 70 children had low transferrin saturation, 13 had low serum ferritin and 9 children had both problems. There was no significant difference in goiter rate between children with low iron indices and others. There was no significant correlation between serum iron, ferritin or transferrin saturation with other variables including T4, UIC and goiter stage.
The present study reveals that in the area studied, iron deficiency cannot explain the high prevalence of goiter, so other responsible factors should be investigated.
碘缺乏会导致一系列碘缺乏病(IDD),包括地方性甲状腺肿、甲状腺功能减退、克汀病和先天性异常。其他因素,包括致甲状腺肿物质和微量营养素缺乏,可能会影响碘缺乏病的患病率和严重程度以及对碘补充的反应。这项横断面描述性研究于2003年在伊朗山区塞米尔罗姆的小学生中进行,该地区1994年甲状腺肿高度流行,但在食盐碘化和碘注射多年后,甲状腺肿患病率并未如预期那样下降。评估了该地区一些与甲状腺肿相关的可能危险因素,并在此展示铁研究的结果。
通过多阶段整群抽样程序选取了1869例病例。将2级甲状腺肿儿童与数量相等的非甲状腺肿儿童比较血清铁、铁蛋白、转铁蛋白、甲状腺素、促甲状腺激素和尿碘浓度(UIC)。
210名儿童(105名0级甲状腺肿和105名2级甲状腺肿)进入了这项子研究。在210名参与者中,70名儿童转铁蛋白饱和度低,13名儿童血清铁蛋白低,9名儿童存在这两个问题。铁指标低的儿童与其他儿童的甲状腺肿发生率无显著差异。血清铁、铁蛋白或转铁蛋白饱和度与包括T4、UIC和甲状腺肿分期在内的其他变量之间无显著相关性。
本研究表明,在所研究的地区,缺铁不能解释甲状腺肿的高患病率,因此应调查其他相关因素。