Kaiserman I, Siebner R, Sack J
Pediatric Endocrinology Unit, Chaim Sheba Medical Center, Tel Hashomer, Israel.
J Endocrinol Invest. 1995 Sep;18(8):595-601. doi: 10.1007/BF03349776.
It is well known that the incidence of congenital hypothyroidism (CH) differs significantly among different parts of the world. Northern Israel has been shown to be an iodine deficient area with a relatively high incidence of CH. This study aimed to compare the incidence of CH between different regions of Israel and to examine the temporal fluctuations of this disease in each region. All 303 primary CH infants born in Israel during the 10-year period between April 1978 and March 1988 were classified by hospital of birth and place of residence. Using these data we calculated the incidence of CH in the different subdistricts and districts of Israel. We also calculated the annual incidence of CH in each district. The incidence of CH in each hospital was compared to the filter paper T4 levels of all newborns born in that hospital during 1993. The incidence of CH decreased gradually from northern to southern Israel. This trend was also observed for thyroid agenesis, but the incidence of ectopic thyroid was highest in central Israel. Dyshormonogenesis (DHG) was on average 3.5 fold more frequent in the Arab compared to the Jewish populations, but did not show any clear geographic pattern. A significantly increased CH incidence in north-central Israel in 1985 was opposed by a low incidence in the South. A clear correlation exists between the incidence of CH in each hospital and the mean newborns' T4 level in that hospital. The incidence of primary CH in general, and of thyroid agenesis and ectopic thyroid specifically, has a clear regional-temporal pattern. Thus, some of the factors causing CH in Israel may be local factors that show local annual fluctuations.
众所周知，先天性甲状腺功能减退症（CH）在世界不同地区的发病率存在显著差异。以色列北部已被证明是一个碘缺乏地区，CH发病率相对较高。本研究旨在比较以色列不同地区CH的发病率，并研究该疾病在每个地区的时间波动情况。1978年4月至1988年3月这10年间在以色列出生的所有303例原发性CH婴儿，根据出生医院和居住地点进行分类。利用这些数据，我们计算了以色列不同分区和地区的CH发病率。我们还计算了每个地区CH的年发病率。将每家医院CH的发病率与1993年在该医院出生的所有新生儿的滤纸T4水平进行比较。CH的发病率从以色列北部到南部逐渐降低。甲状腺缺如也观察到了这种趋势，但异位甲状腺的发病率在以色列中部最高。与犹太人群相比，阿拉伯人群中激素合成障碍（DHG）的平均发生率高3.5倍，但未显示出任何明显的地理模式。1985年以色列中北部CH发病率显著增加，而南部发病率较低。每家医院CH的发病率与该医院新生儿的平均T4水平之间存在明显的相关性。一般原发性CH的发病率，特别是甲状腺缺如和异位甲状腺的发病率，具有明显的区域-时间模式。因此，在以色列导致CH的一些因素可能是表现出局部年度波动的局部因素。
