Chiovato L, Lapi P, Santini F, Fiore E, Vitti P, Aghini-Lombardi F, Pinchera A
Istituto di Endocrinologia, Università degli Studi, Pisa.
Ann Ist Super Sanita. 1994;30(3):309-16.
Iodine is the essential constituent of thyroid hormones. Iodine deficiency disorders, ranging from endemic goiter to cretinism, result from low dietary intake of iodine. The fetus and the newborn are more sensitive than adults to a reduced environmental iodine supply, and in iodine-deficient areas, transient neonatal hypothyroidism is frequently observed. This transient thyroid failure may be associated with neonatal goiter. Border-line elevated neonatal TSH levels frequently occur in iodine deficient areas, and result in a higher recalling rate in the screening for congenital hypothyroidism. Iodine prophylaxis is highly effective in preventing the development of iodine deficiency disorders including transient neonatal hypothyroidism. Since iodine prophylaxis in Italy is inadequate, variable degrees of iodine deficiency are still present all-over the Country, and are responsible of a higher incidence of transient neonatal hypothyroidism or hyperthyrotropinemia. Educational programs for the general population, health professionals, and decision makers are essential for a successful iodine prophylaxis. Elimination of iodine deficiency by the year 2000 has been recently pledged by WHO/UNICEF. This goal is feasible if pursued with sufficient vigor and resources.
碘是甲状腺激素的重要组成部分。碘缺乏症，从地方性甲状腺肿到克汀病，都是由于饮食中碘摄入量低所致。胎儿和新生儿比成年人对环境碘供应减少更敏感，在碘缺乏地区，经常观察到短暂性新生儿甲状腺功能减退。这种短暂性甲状腺功能衰竭可能与新生儿甲状腺肿有关。在碘缺乏地区，新生儿促甲状腺激素（TSH）水平临界升高经常发生，导致先天性甲状腺功能减退筛查中的召回率更高。碘预防在预防包括短暂性新生儿甲状腺功能减退在内的碘缺乏症的发生方面非常有效。由于意大利的碘预防措施不足，全国各地仍然存在不同程度的碘缺乏，这也是短暂性新生儿甲状腺功能减退或促甲状腺激素血症发病率较高的原因。针对普通人群、卫生专业人员和决策者的教育项目对于成功的碘预防至关重要。世界卫生组织/联合国儿童基金会最近承诺到2000年消除碘缺乏。如果以足够的力度和资源来追求这一目标，这个目标是可行的。
