Department of Endocrinology, Metabolism and Diabetes, Evgenideion Hospital, Athens University School of Medicine, Athens, Greece.
Hormones (Athens). 2009 Oct-Dec;8(4):296-302. doi: 10.14310/horm.2002.1246.
Environmental factors are involved in goiter development. An increased number of goitrous patients were identified among outpatients in Gyrocaster, a mountainous region in Southwestern Albania. We examined possible associations of thyroid enlargement with nutritional factors.
112 consecutive patients, 104 females, aged 52.8 +/-12.1 (mean+/-SD), who either were taking thyroxine (n=27) or were suspected to have thyroid disease were examined. Thyroid parameters and nutritional habits were recorded and serum selenium and urine iodine levels were determined; thyroid ultrasound was performed.
The median thyroid volume (TV) was 20.4 ml (range 4.4-97.6). All consumed food was home-produced. TV correlated negatively with the frequency of lamb-goat meat and vegetables consumption (p=0.05 and p=0.03, respectively). Mean TV was significantly lower in those eating lamb-goat >1 times/week (21.4+/-13.3 vs 31.9+/-23 ml, p<0.01). The association of TV with lamb meat consumption was independent of sex, education or occupation (p < 0.009). Selenium levels ranged from 30.6-138 microg/L (reference range 43-190). There was no association between selenium levels and TV. 43% of the subjects had TSH < 0.3 mU/L (those on thyroxine were excluded). Log TSH correlated negatively with TV and fT4 levels (p < 0.007), indicating the presence of autonomy (TSHRab positive in two subjects). Mean urinary iodine excretion was 99.8+/-35.3 microg/gr creatinine (normal >100).
Nutritional factors may be involved in the development of goiter in Southwestern Albania. No role of selenium was found. The higher consumption of lamb-goat meat and vegetables, all non-industrialized, appeared to be protective. This finding may reflect better socioeconomic status, although this was not identified. Unrecognized subclinical hyperthyroidism, probably due to thyroid autonomy, was quite common.
环境因素与甲状腺肿的发生有关。在阿尔巴尼亚西南部山区的 Gyrocaster 地区，门诊患者中发现了越来越多的甲状腺肿患者。我们研究了甲状腺肿大与营养因素的可能关联。
连续检查了 112 名患者（104 名女性，年龄 52.8+/-12.1[均值+/-标准差]），其中 27 名正在服用甲状腺素，其余患者怀疑患有甲状腺疾病。记录甲状腺参数和营养习惯，测定血清硒和尿碘水平；进行甲状腺超声检查。
甲状腺体积（TV）中位数为 20.4ml（范围 4.4-97.6）。所有食用的食物均为自家生产。TV 与羊肉/羊肉和蔬菜的食用频率呈负相关（p=0.05 和 p=0.03）。每周食用羊肉/羊肉超过 1 次者的平均 TV 显著较低（21.4+/-13.3 比 31.9+/-23ml，p<0.01）。TV 与羊肉消费的关联独立于性别、教育程度或职业（p<0.009）。硒水平范围为 30.6-138μg/L（参考范围 43-190）。硒水平与 TV 之间无关联。43%的受试者 TSH<0.3mU/L（排除服用甲状腺素者）。LogTSH 与 TV 和 fT4 水平呈负相关（p<0.007），表明存在自主性（两名患者 TSHRab 阳性）。平均尿碘排泄量为 99.8+/-35.3μg/gr 肌酐（正常>100）。
营养因素可能参与了阿尔巴尼亚西南部甲状腺肿的发生。未发现硒的作用。羊肉/羊肉和蔬菜的较高消费，均为非工业化产品，似乎具有保护作用。这一发现可能反映了更好的社会经济地位，尽管这一点并未得到明确。未被识别的亚临床甲状腺功能亢进症（可能由于甲状腺自主性所致）相当常见。
