Bhattacharya Udayan, Chandra Amar K
Senior Research Fellow, Endocrinology and Reproductive Physiology Laboratory, Department of Physiology, University College of Science and Technology, University of Calcutta, Kolkata, West Bengal, India.
UGC Emeritus Professor, Endocrinology and Reproductive Physiology Laboratory, Department of Physiology, University College of Science and Technology, University of Calcutta, 92, A.P.C. Road, Kolkata - 700 009, West Bengal, India.
J Pediatr Endocrinol Metab. 2019 Feb 25;32(2):143-149. doi: 10.1515/jpem-2018-0344.
Background To compare the state of iodine nutrition among school age children (SAC) in high- (HSGs) and low-socioeconomic groups (LSGs) during a post iodation scenario in Kolkata. Methods Clinical examinations of the goiter, median urinary iodine (MUI), mean urinary thiocyanate (MUSCN) in SAC (6-12 years) from both sexes in the different socioeconomic groups were carried out and the iodine content of edible salt was measured. Results A total of 5315 SAC, of which 2875 SAC were from a HSG and another 2440 SAC from an LSG were clinically examined for goiter. In the HSGs the total goiter prevalence (TGP) was 3.2% and in the LSGs the TGP was 9.1% and the difference was statistically significant (p<0.001). The MUI of the HSGs was 242 μg/L as compared to 155 μg/L in the LSGs (p<0.001). MUSCN of the HSGs was 0.77±0.45 mg/dL while in the LSGs it was 0.94±0.44 mg/dL and the difference was statistically significant (p<0.01). In the HSGs 19.4% salt samples had 15-30 ppm iodine and 80.6% salt samples were above 30 ppm as compared to 26.3% salt samples which were below 15 ppm, 37.1% salt samples which were between 15 and 30 ppm and 36.6% salt samples which were above 30 ppm in the LSGs. Conclusions The population of the LSGs was clinically mildly iodine deficient having no biochemical iodine deficiency while in the HSGs it was more than the adequate requirement and the HSG children are possibly at risk of excess iodine induced thyroid diseases. Existing goiter prevalence in the LSGs was from their relatively high consumption of dietary goitrogens. Therefore, socioeconomic status plays a pivotal role in the management of iodine nutrition even in a post salt iodation scenario.
比较加尔各答实施碘盐普及措施后，高社会经济群体（HSGs）和低社会经济群体（LSGs）中学龄儿童（SAC）的碘营养状况。方法：对不同社会经济群体中6至12岁SAC（男女）的甲状腺肿进行临床检查，测量其尿碘中位数（MUI）、尿硫氰酸盐均值（MUSCN），并测定食用盐的碘含量。结果：共对5315名SAC进行了临床甲状腺肿检查，其中2875名来自HSG，2440名来自LSG。HSG中甲状腺肿总患病率（TGP）为3.2%，LSG中TGP为9.1%，差异有统计学意义（p<0.001）。HSG的MUI为242μg/L，而LSG为155μg/L（p<0.001）。HSG的MUSCN为0.77±0.45mg/dL，LSG为0.94±0.44mg/dL，差异有统计学意义（p<0.01）。HSG中19.4%的盐样碘含量为15 - 30ppm，80.6%的盐样碘含量高于30ppm；相比之下，LSG中26.3%的盐样碘含量低于15ppm，37.1%的盐样碘含量在15至30ppm之间，36.6%的盐样碘含量高于30ppm。结论：LSG人群临床存在轻度碘缺乏，无生化碘缺乏；而HSG人群碘摄入量超过适宜水平，HSG儿童可能有碘过量致甲状腺疾病的风险。LSG中现有的甲状腺肿患病率源于其相对较高的膳食致甲状腺肿物质摄入量。因此，即使在碘盐普及后，社会经济地位在碘营养管理中仍起着关键作用。
