Zel'tser M E, Mezinova N N, Kobzar' N N, Bazarbekova R B, Nazyrov A T, Kim G G, Nurbekova A A, Nugmanova M I
Probl Endokrinol (Mosk). 1994 Sep-Oct;40(5):20-2.
Anemia is a highly prevalent condition among pregnant women in the Republic of Kazakhstan. The causes of this anemia are not quite clear, as is the problem of resistance of this type of anemia to therapy with iron preparations. The authors propose that this may be explained by the fact that many regions of the Republic are foci of endemic goiter, because tentative studies indicate a relationship between endemic goiter and hypothyrosis. The present study was aimed at examination of the thyroid status in pregnant women suffering from anemia in the town of Alma-Ata, a region endemic for goiter. Altogether 120 anemic pregnant women were examined, 60 of these with goiter and 60 without it. Control group consisted of 20 healthy pregnant women. Clinical and ultrasonic examinations, puncture biopsy of the thyroid, measurements of blood levels of TTH, total and free triiodothyronine and thyroxin, thyroxin-binding globulin, as well as of peripheral blood red cell counts, levels of hemoglobin, serum iron, assessment of total iron-binding capacity of the serum and saturation coefficient, were carried out. Healthy pregnant women from a focus of endemic goiter were found to represent a group at risk of anemia in the third pregnancy trimester. In anemic pregnant women endemic goiter aggravated anemia. Chronic iodine deficiency is conductive to formation in pregnant women of subclinical hypothyrosis whose severity increased in the presence of anemia, more so if anemia is paralleled by goiter.
贫血在哈萨克斯坦共和国的孕妇中是一种非常普遍的病症。这种贫血的病因尚不完全清楚，这类贫血对铁制剂治疗的抵抗问题也是如此。作者提出，这可能是因为该国许多地区是地方性甲状腺肿的病灶，因为初步研究表明地方性甲状腺肿与甲状腺功能减退之间存在关联。本研究旨在检查阿拉木图市（一个甲状腺肿流行地区）贫血孕妇的甲状腺状况。共检查了120名贫血孕妇，其中60名患有甲状腺肿，60名没有。对照组由20名健康孕妇组成。进行了临床和超声检查、甲状腺穿刺活检、测定促甲状腺激素、总三碘甲状腺原氨酸和游离三碘甲状腺原氨酸以及甲状腺素的血液水平、甲状腺素结合球蛋白，以及外周血红细胞计数、血红蛋白水平、血清铁、血清总铁结合能力评估和饱和系数。发现来自地方性甲状腺肿病灶地区的健康孕妇是妊娠晚期贫血的高危人群。在贫血孕妇中，地方性甲状腺肿会加重贫血。慢性碘缺乏会导致孕妇形成亚临床甲状腺功能减退，在贫血情况下其严重程度会增加，若贫血伴有甲状腺肿则更是如此。
