Fountoulakis Stelios, Philippou George, Tsatsoulis Agathocles
Department of Endocrinology, University of Ioannina, Ioannina, Greece.
Hormones (Athens). 2007 Jan-Mar;6(1):25-35.
The thyroid gland is dependent on dietary iodine for the production of thyroid hormones, normal iodine requirement being about 150-200 microg/day. Long-term deficiency in iodine intake is associated with the development of goiter. When the prevalence of goiter in a population rises above 5-10%, the problem is considered endemic. Greece is a country with a recent history of moderate iodine deficiency, endemic goiter being prevalent in the 1960s in inhabitants of mountainous regions. Despite recognition of the problem, an iodine prophylaxis program was never officially implemented. Instead, "silent iodine prophylaxis" took place during the 1980s and 1990s with Greece's improvement in socioeconomic conditions. This resulted in the elimination of iodine deficiency and a parallel decrease in the prevalence of goiter among schoolchildren in formerly iodine deficient areas. However, the transition from iodine deficiency to iodine sufficiency or excess was followed by the emergence of autoimmune thyroiditis, especially among young girls, indicating that exposure to excess iodine may trigger thyroid autoimmunity. Thus, the modification of an environmental factor, ie dietary iodine, over the last 40 years in Greece has been associated with changes in the phenotypic expression of thyroid disease from endemic goiter to goiter associated with autoimmune thyroiditis.
甲状腺依赖膳食碘来产生甲状腺激素，正常碘需求量约为每日150 - 200微克。长期碘摄入不足与甲状腺肿的发生有关。当人群中甲状腺肿的患病率超过5% - 10%时，该问题被视为地方性问题。希腊是一个近期有中度碘缺乏历史的国家，20世纪60年代山区居民中地方性甲状腺肿很普遍。尽管认识到了这个问题，但碘预防计划从未正式实施。相反，在20世纪80年代和90年代，随着希腊社会经济状况的改善，“隐性碘预防”发生了。这导致碘缺乏得到消除，以前碘缺乏地区学童的甲状腺肿患病率也相应下降。然而，从碘缺乏到碘充足或过量的转变之后，自身免疫性甲状腺炎出现了，尤其是在年轻女孩中，这表明接触过量碘可能引发甲状腺自身免疫。因此，在过去40年里，希腊环境因素即膳食碘的改变与甲状腺疾病表型表达从地方性甲状腺肿到与自身免疫性甲状腺炎相关的甲状腺肿的变化有关。
