Mickuviene Narseta, Krasauskiene Aurelija, Kazanavicius Gintautas
Institute of Endocrinology, Kaunas University of Medicine, Eiveniu 2, 50009 Kaunas, Lithuania.
Medicina (Kaunas). 2006;42(9):751-8.
Iodine deficiency is an actual problem of public health and mostly manifests as enlargement of the thyroid (goiter).
The aim of the study was to determine the prevalence of goiter using different evaluation criteria and to establish the relationship between changes in thyroid volume and dimensions of the body.
Thyroid palpation and ultrasound examination were performed in 310 (7-11-year-old) randomly selected schoolchildren from two Lithuanian nearby small towns (Birzai and Rokiskis) in the district with lowest urinary iodine excretion (5.4 and 4.5 microg/dl). The size of thyroid gland was determined by inspection and palpation using the World Health Organization criteria. All children were examined ultrasonographically; thyroid volume was assessed by two criteria: F. Delange (1997) and M. B. Zimmermann (2004).
There were no differences in means and medians of age and all body parameters (height, weight, body surface area, body mass index) in boys and girls of the same age. Higher means and medians of the body surface area in all age groups were found in Birzai as compared to Rokiskis (p<0.05). Comparing body mass index of all investigated schoolchildren with upper limits (97th percentile) of body mass index of normal British children, no statistically significant difference in the prevalence of obesity between towns was observed (1.9% - in Rokiskis, 5.0% - in Birzai; p>0.05). Grouping the children according to age revealed a higher prevalence of goiter in Birzai as compared to Rokiskis (88% vs. 63%, respectively, according to M. B. Zimmermann and 25% vs. 10%, respectively, according to F. Delange; p<0.05). There was no significant difference in the prevalence of goiter between the towns when children were grouped by body surface area. In all groups by age and body surface area, the mean thyroid volume exceeded 97th percentile by M. B. Zimmerman and did not exceed by F. Delange.
The prevalence of goiter, assessing the thyroid volume in 7-11-year-old children by the different criteria, is significantly different. We recommend using the criteria based on body surface area in order to evaluate the constitutional characteristics of individual child's development.
碘缺乏是一个实际的公共卫生问题,主要表现为甲状腺肿大(甲状腺肿)。
本研究的目的是使用不同的评估标准确定甲状腺肿的患病率,并建立甲状腺体积变化与身体尺寸之间的关系。
对来自立陶宛附近两个小镇(比尔扎伊和罗基什基斯)的310名7至11岁随机选取的学童进行甲状腺触诊和超声检查,这两个小镇所在地区的尿碘排泄量最低(分别为5.4和4.5微克/分升)。根据世界卫生组织标准通过视诊和触诊确定甲状腺大小。对所有儿童进行超声检查;甲状腺体积通过两种标准进行评估:F. 德兰热(1997年)和M. B. 齐默尔曼(2004年)。
同年龄的男孩和女孩在年龄及所有身体参数(身高、体重、体表面积、体重指数)的均值和中位数方面没有差异。与罗基什基斯相比,比尔扎伊所有年龄组的体表面积均值和中位数更高(p<0.05)。将所有被调查学童的体重指数与英国正常儿童体重指数的上限(第97百分位数)进行比较,未观察到两个城镇之间肥胖患病率的统计学显著差异(罗基什基斯为1.9%,比尔扎伊为5.0%;p>0.05)。按年龄对儿童进行分组显示,与罗基什基斯相比,比尔扎伊的甲状腺肿患病率更高(根据M. B. 齐默尔曼标准分别为88%和63%,根据F. 德兰热标准分别为25%和10%;p<0.05)。按体表面积对儿童进行分组时,两个城镇之间的甲状腺肿患病率没有显著差异。在按年龄和体表面积划分的所有组中,M. B. 齐默尔曼标准下的甲状腺平均体积超过第97百分位数,而F. 德兰热标准下未超过。
使用不同标准评估7至11岁儿童的甲状腺体积时,甲状腺肿的患病率存在显著差异。我们建议使用基于体表面积的标准来评估个体儿童发育的体质特征。