Evliyaoğlu Olcay, Kutlu Alev, Kara Cengiz, Atavci Sevil G
Department of Pediatric Endocrinology, School of Medicine, University of Kirikkale, Kirikkale, Turkey.
Pediatr Int. 2008 Jun;50(3):276-80. doi: 10.1111/j.1442-200X.2008.02569.x.
Turkey is located in an area of mild to moderate iodine deficiency. The aim of the present study was to investigate the incidence of iodine deficiency in patients with congenital hypothyroidism.
Twenty five patients with a median age of 12 days (6 days-6 months) at diagnosis and followed for a median time of 7 months (1-60 months) were enrolled in the study. Thyroid function tests, thyroid scintigraphy, ultrasonography and urine iodine measurements of the patients and mothers were performed.
Congenital hypothyroidism was diagnosed within postnatal day 13, between days 13 and 30, and after 30 days of age in 68%, 20% and 12% of the patients, respectively. At the time of diagnosis mean serum thyroid-stimulating hormone and total T4 were 85.3 +/- 27.6 mIU/L and 3.9 +/- 2.8 microg/dL, respectively. Incidence of iodine deficiency was 36% in the patients (median, 110 microg/L) and 88% in the mothers (median, 40 microg/L). Thyroid scintigraphy and ultrasound were normal in all of the patients with iodine deficiency. At scintigraphic evaluation, thyroid gland was not visualized in 28% of patients; in the patients whose thyroid glands were not visualized scintigraphically thyroid ultrasonography indicated agenesis in 57%, and hypoplasia in 43%. In all the patients with thyroid agenesis or hypoplasia iodine levels were normal. In 36% of the patients imaging studies of thyroid gland and urine iodine measurements were normal. Despite salt iodization program, incidence of iodine deficiency is still high in patients with congenital hypothyroidism and mothers. National measures are urgently required for correction of iodine deficiency in Turkey.
土耳其位于轻度至中度碘缺乏地区。本研究的目的是调查先天性甲状腺功能减退症患者碘缺乏的发生率。
本研究纳入了25例患者，诊断时的中位年龄为12天（6天至6个月），中位随访时间为7个月（1至60个月）。对患者及其母亲进行了甲状腺功能测试、甲状腺闪烁扫描、超声检查和尿碘测量。
分别有68%、20%和12%的患者在出生后第13天内、第13天至第30天之间以及30天龄后被诊断为先天性甲状腺功能减退症。诊断时，平均血清促甲状腺激素和总T4分别为85.3±27.6 mIU/L和3.9±2.8 μg/dL。患者碘缺乏的发生率为36%（中位数，110 μg/L），母亲为88%（中位数，40 μg/L）。所有碘缺乏患者的甲状腺闪烁扫描和超声检查均正常。在闪烁扫描评估中，28%的患者甲状腺未显影；在甲状腺闪烁扫描未显影的患者中，甲状腺超声检查显示57%为甲状腺缺如，43%为甲状腺发育不全。所有甲状腺缺如或发育不全的患者碘水平均正常。36%的患者甲状腺影像学检查和尿碘测量均正常。尽管实施了食盐碘化计划，但先天性甲状腺功能减退症患者及其母亲的碘缺乏发生率仍然很高。土耳其迫切需要采取国家措施来纠正碘缺乏问题。
