School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, People's Republic of China.
Tianjin Centers for Disease Control and Prevention, 6 Huayue Road, Hedong District, Tianjin, 300011, China.
Biol Trace Elem Res. 2024 Oct;202(10):4431-4439. doi: 10.1007/s12011-023-04035-x. Epub 2024 Jan 3.
Although there are now a large number of studies confirming that high iodine levels can cause goiter, there is controversy and a lack of quantitative data. A systematic search of PubMed, Web of Science, China National Knowledge Infrastructure, Wanfang Database, and China Biomedical Database for literature on high iodine and goiter in children was performed with a time limit from January 2013 to October 2023. After screening the literature based on the inclusion criteria, extracting the literature data, and evaluating the risk of bias of the included studies, a single-arm meta-analysis was performed using R 4.0.4 software. Twenty-three studies with a total of 50,980 subjects were included. Meta-analysis showed that the prevalence of goiter among children in water-borne iodine-excess areas was 6.0% [95% CI (4.3%, 7.6%)], and subgroup analyses showed that the prevalence of goiter in children with water iodine 100.1-150 µg/L, 150.1-300 µg/L, and > 300 µg/L was 7.5% [95% CI (0.0%, 15.8%)], 5.5% [95% CI (3.1%, 8.0%)], and 10.2% [95% CI (6.7%, 13.6%)], respectively, and the difference was statistically significant (P < 0.01); The prevalence of goiter among children in the northern China (5.8% [95% CI (4.1%, 7.5%)]) was higher than that in the southern China (3.5% [95% CI (1.0%, 6.0%)]) (P < 0.01); the prevalence of goiter in children with urinary iodine levels 100-199 µg/L, 200-299 µg/L, and ≥ 300 µg/L was 2.4% [95% CI (1.9%, 2.9%)], 3.3% [95% CI (1.9%, 4.8%)], and 7.3% [95% CI (4.4%, 9.9%)], respectively, the difference was statistically significant (P < 0.01); the prevalence of goiter in children aged 8, 9, 10, 11, and 12 years old was 5.1% [95% CI (3.9%, 6.4%)], 8.0% [95% CI (4.0%, 11.9%)], 6.2% [95% CI (3.9%, 8.5%)], 5.5% [95% CI (0.0%, 13.2%)], and 5.4% [95% CI (0.0%, 15.1%)], and when age ≥ 9 years, the relationship between goiter prevalence and age showed a trend toward decreasing with age, but the relationship between different age was no statistical difference in the prevalence of goiter between ages. urinary iodine. The prevalence of goiter in children was higher in areas with high water iodine; the prevalence of goiter in children in the north was significantly higher than that in the south; the prevalence of goiter in children tends to increase with increased urinary iodine levels.
尽管现在有大量研究证实高碘水平可导致甲状腺肿,但仍存在争议且缺乏定量数据。我们对 2013 年 1 月至 2023 年 10 月期间发表的关于儿童高碘和甲状腺肿的 PubMed、Web of Science、中国国家知识基础设施、万方数据库和中国生物医学数据库的文献进行了系统检索。根据纳入标准筛选文献、提取文献数据,并评估纳入研究的偏倚风险后,使用 R 4.0.4 软件进行单臂荟萃分析。共纳入 23 项研究,总计 50980 例受试者。Meta 分析显示,水碘过量地区儿童甲状腺肿的患病率为 6.0%[95%CI(4.3%,7.6%)],亚组分析显示,水碘 100.1-150μg/L、150.1-300μg/L 和 >300μg/L 地区儿童甲状腺肿的患病率分别为 7.5%[95%CI(0.0%,15.8%)]、5.5%[95%CI(3.1%,8.0%)]和 10.2%[95%CI(6.7%,13.6%)],差异具有统计学意义(P<0.01);北方地区儿童甲状腺肿的患病率(5.8%[95%CI(4.1%,7.5%)])高于南方地区(3.5%[95%CI(1.0%,6.0%)])(P<0.01);尿碘水平为 100-199μg/L、200-299μg/L 和 ≥300μg/L 地区儿童甲状腺肿的患病率分别为 2.4%[95%CI(1.9%,2.9%)]、3.3%[95%CI(1.9%,4.8%)]和 7.3%[95%CI(4.4%,9.9%)],差异具有统计学意义(P<0.01);8、9、10、11 和 12 岁儿童甲状腺肿的患病率分别为 5.1%[95%CI(3.9%,6.4%)]、8.0%[95%CI(4.0%,11.9%)]、6.2%[95%CI(3.9%,8.5%)]、5.5%[95%CI(0.0%,13.2%)]和 5.4%[95%CI(0.0%,15.1%)],当年龄 ≥9 岁时,甲状腺肿患病率与年龄的关系呈随年龄增长而下降的趋势,但不同年龄之间甲状腺肿患病率无统计学差异。尿碘。儿童甲状腺肿的患病率在高水碘地区较高;北方地区儿童甲状腺肿的患病率明显高于南方地区;儿童甲状腺肿的患病率随着尿碘水平的增加而增加。