Gaitan E
Department of Medicine, University of Mississippi School of Medicine, Jackson.
Annu Rev Nutr. 1990;10:21-39. doi: 10.1146/annurev.nu.10.070190.000321.
Epidemiologic and experimental evidence reviewed in this article emphasizes the complex and multifactorial etiology of endemic goiter. The important role of iodine deficiency as an etiologic factor in endemic goiter is firmly established, but there is evidence that other environmental factors can play an equally important role in the pathogenesis of this condition. Chemical categories, sources, and sites of action of the various classes of naturally occurring goitrogens and antithyroid agents are reviewed in this article. Evidence of the presence of these compounds in foodstuffs and drinking water is discussed. Bacterial contamination of water supplies also appears to be important in the development of goiter. Microorganisms appear to intervene in the biosynthesis and degradation of organic goitrogenic pollutants or may induce thyroid growth-promoting activity in the host, or both. Malnutrition and poor socioeconomic conditions, as for iodine deficiency, enhance the action of environmental goitrogens. Thus, a coordinated multidisciplinary approach is essential to solving this public health problem.
本文回顾的流行病学和实验证据强调了地方性甲状腺肿病因的复杂性和多因素性。碘缺乏作为地方性甲状腺肿病因中的一个重要因素已得到确证，但有证据表明，其他环境因素在该疾病的发病机制中也可发挥同样重要的作用。本文综述了各类天然存在的致甲状腺肿物质和抗甲状腺药物的化学类别、来源及作用部位。讨论了这些化合物在食品和饮用水中的存在证据。水源的细菌污染在甲状腺肿的发生发展中似乎也很重要。微生物似乎会干预有机致甲状腺肿污染物的生物合成和降解，或可能在宿主体内诱导促甲状腺生长活性，或两者皆有。与碘缺乏一样，营养不良和社会经济条件差会增强环境致甲状腺肿物质的作用。因此，采取协调一致的多学科方法对于解决这一公共卫生问题至关重要。
