Siavash Mansour, Hashemipour Mahin, Keshteli Ammar H, Amini Masoud, Aminorroaya Ashraf, Rezvanian Hassan, Kachuei Ali, Kelishadi Roya
Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
J Nutr Sci Vitaminol (Tokyo). 2008 Dec;54(6):430-4. doi: 10.3177/jnsv.54.430.
Despite long-standing iodine supplementation in Iran, the prevalence of goiter remains high in some areas. This suggests other nutritional deficiencies may be considered as responsible factors for goiter persistence. In the present study we investigated the possible role of vitamin A deficiency (VAD) and low vitamin A status in the etiology of endemic goiter in Semirom, Iran.
In this cross-sectional study, 1,828 students from 108 primary schools of urban and rural areas of Semirom were selected by multistage random cluster sampling. Thyroid size was estimated in each child by inspection and palpation. Urinary iodine concentration (UIC) and serum retinol (SR) were measured.
Overall, 36.7% of schoolchildren had goiter. The median UIC was 18.5 microg/dL. The mean+/-SD of SR in goitrous and nongoitrous children was 38.84+/- 10.98 and 39.17+/-10.85 microg/dL respectively (p=0.82). There were two children with VAD (SR less than 20 microg/dL); one in the goitrous and one in the nongoitrous group. The prevalence of subjects with low vitamin A status (SR less than 30 microg/dL) in the goitrous and nongoitrous groups was 26.2 and 21.5% respectively (p=0.42).
Goiter is still a public health problem in this region. Iodine deficiency, VAD or low vitamin A status is not among the contributors of goiter persistence in schoolchildren of Semirom. The role of other micronutrient deficiencies or goitrogens should be investigated.
尽管伊朗长期进行碘补充,但某些地区甲状腺肿的患病率仍然很高。这表明其他营养缺乏可能被视为甲状腺肿持续存在的责任因素。在本研究中,我们调查了维生素A缺乏(VAD)和低维生素A状态在伊朗塞米尔罗姆地方性甲状腺肿病因中的可能作用。
在这项横断面研究中,通过多阶段随机整群抽样从塞米尔罗姆城乡地区的108所小学选取了1828名学生。通过检查和触诊估计每个儿童的甲状腺大小。测量尿碘浓度(UIC)和血清视黄醇(SR)。
总体而言,36.7%的学童患有甲状腺肿。UIC中位数为18.5微克/分升。甲状腺肿儿童和非甲状腺肿儿童的SR均值±标准差分别为38.84±10.98和39.17±10.85微克/分升(p = 0.82)。有两名维生素A缺乏儿童(SR低于20微克/分升);一名在甲状腺肿组,一名在非甲状腺肿组。甲状腺肿组和非甲状腺肿组中维生素A水平低(SR低于30微克/分升)的受试者患病率分别为26.2%和21.5%(p = 0.42)。
甲状腺肿在该地区仍然是一个公共卫生问题。碘缺乏、VAD或低维生素A状态不是塞米尔罗姆学童甲状腺肿持续存在的促成因素。应调查其他微量营养素缺乏或致甲状腺肿物质的作用。