Gupta Puneet, Raizada Nishant, Giri Subhash, Sharma A K, Goyal Sandeep, Jain Nishesh, Madhu S V
Department of Medicine, UCMS and GTB Hospital, Dilshad Garden, New Delhi, India.
Department of Endocrinology, UCMS and GTB Hospital, Dilshad Garden, New Delhi, India.
Indian J Endocrinol Metab. 2020 Mar-Apr;24(2):202-205. doi: 10.4103/ijem.IJEM_645_19. Epub 2020 Apr 30.
Several studies from India, performed prior to 2010, have reported a goiter prevalence of greater than five per cent in school going children. There has been considerable success in universal salt iodization efforts in the past decade. We studied the prevalence of goiter and thyroid autoimmunity in school going children in Delhi between 2010 and 2014 to assess the impact of salt iodization.
The study employed the population proportionate to size (PPS) cluster sampling methodology to select subjects between the age of six and 14 years, from all 34 wards of 9 districts of Delhi. Cluster randomization sampling design was followed and in this way we identified 30 wards, from each of which 90 children were recruited for the study. The total sample size was 2700 children. Estimation of fT3, fT4, TSH, anti-TPO antibodies and urine iodine concentration (UIC) was done for 10% of the study population.
The prevalence of goiter in this study in the 6-14 years age group was 6.4%. The prevalence of goiter was higher in females (7.7% compared to 5.3% in males, = 0.01). In the 270 subjects who were selected for biochemical evaluation, subclinical hypothyroidism was seen in 18.4% and positive anti-TPO antibodies were seen in 14.8%. The median UIC was 150 μg/L.
There is improvement in goiter prevalence in the post-iodization period in Delhi. But still, residual goiter rates are above five per cent suggesting presence of other causes of goiter in this area. There is a high prevalence of thyroid autoimmunity in this population.
印度在2010年之前进行的多项研究报告称，学龄儿童甲状腺肿患病率超过5%。在过去十年中，全民食盐加碘工作取得了相当大的成功。我们研究了2010年至2014年德里学龄儿童甲状腺肿和甲状腺自身免疫的患病率，以评估食盐加碘的影响。
本研究采用按规模比例抽样（PPS）整群抽样方法，从德里9个区的所有34个病房中选取6至14岁的受试者。采用整群随机抽样设计，通过这种方式我们确定了30个病房，每个病房招募90名儿童进行研究。总样本量为2700名儿童。对10%的研究人群进行了游离三碘甲状腺原氨酸（fT3）、游离甲状腺素（fT4）、促甲状腺激素（TSH）、抗甲状腺过氧化物酶抗体（anti-TPO）和尿碘浓度（UIC）的检测。
本研究中6至14岁年龄组的甲状腺肿患病率为6.4%。女性甲状腺肿患病率较高（7.7%，男性为5.3%，P = 0.01）。在270名接受生化评估的受试者中，亚临床甲状腺功能减退的发生率为18.4%，抗-TPO抗体阳性的发生率为14.8%。UIC中位数为150μg/L。
德里在碘盐普及后的时期，甲状腺肿患病率有所改善。但仍有残留甲状腺肿率高于5%，表明该地区存在甲状腺肿的其他原因。该人群中甲状腺自身免疫的患病率较高。
