Regalbuto C, Squatrito S, La Rosa G L, Cercabene G, Ippolito A, Tita P, Salamone S, Vigneri R
Cattedra di Endocrinologia, Ospedale Garibaldi, Università di Catania, Italy.
J Endocrinol Invest. 1996 Oct;19(9):638-45. doi: 10.1007/BF03349031.
A longitudinal study was carried out in an area of endemic goiter of north-eastern Sicily. Three different surveys (in 1977, 1983 and 1994) evaluated the epidemiological prevalence of goiter in schoolchildren of the endemic area (towns of Bronte, Troina and Maniaci) in comparison to an iodine sufficient control area (Catania). Biochemical studies were also performed on urinary iodine and thiocyanate (SCN) excretion and 131I thyroid uptake. In the town of Troina an experimental program of active iodine prophylaxis was carried out from 1979 to 1987 by iodinating the municipal water supply. The aim of this study was to evaluate the effect of an active iodine prophylaxis program in comparison to the "silent iodoprophylaxis" due to improved economic conditions and widespread introduction of industrially produced food. In the 1977-94 period a significant decrease of goiter prevalence in schoolchildren was observed in all areas where no active iodoprophylaxis had been introduced. An abnormal prevalence of goiter, however, was still present in Bronte (12.1%) and Maniaci (25.9%) schoolchildren in respect to Catania (0.7%). In Troina, goiter prevalence decreased from 52.2 to 6.1% after only five years of active iodine prophylaxis (1983). It increased to 8.4% seven years after the program was discontinued (1994). In all areas studied average urinary iodine excretion increased by 70-100 micrograms/day except in the more rural area at Maniaci. During the same period urinary SCN values decreased by 30-40% and were lower in Troina (non volcanic soil) than in other towns studied. The balance between iodine and SCN intake appears a relevant factor in the etiology of endemic goiter in these areas and the iodine/SCN ratio inversely correlated with goiter prevalence. The persistence of endemic goiter in spite of the important changes in life style and socio-economic conditions if compared to the dramatic amelioration obtained by an active iodine prophylaxis program, confirms the inadequacy of the silent iodine prophylaxis, and further supports the need of an immediate introduction of active iodine prophylaxis in the areas of endemic goiter in Sicily.
在西西里岛东北部的一个地方性甲状腺肿流行地区开展了一项纵向研究。三项不同的调查（分别于1977年、1983年和1994年进行）评估了该流行地区（布龙泰、特罗伊纳和马尼亚奇镇）学童甲状腺肿的流行病学患病率，并与一个碘充足的对照地区（卡塔尼亚）进行了比较。还对尿碘和硫氰酸盐（SCN）排泄以及131I甲状腺摄取进行了生化研究。在特罗伊纳镇，从1979年至1987年通过对市政供水进行碘化开展了一项积极的碘预防实验项目。本研究的目的是评估积极的碘预防项目的效果，并与由于经济条件改善和工业生产食品的广泛引入而产生的“隐性碘预防”效果进行比较。在1977 - 1994年期间，在所有未引入积极碘预防措施的地区，学童甲状腺肿患病率均显著下降。然而，与卡塔尼亚（0.7%）相比，布龙泰（12.1%）和马尼亚奇（25.9%）的学童中甲状腺肿患病率仍异常偏高。在特罗伊纳，仅经过五年的积极碘预防（1983年）后，甲状腺肿患病率从52.2%降至6.1%。该项目停止七年后（1994年），患病率升至8.4%。在所有研究地区，除了马尼亚奇这个更偏远的农村地区外，平均尿碘排泄量每天增加了70 - 100微克。在同一时期，尿SCN值下降了30 - 40%，且特罗伊纳（非火山土壤）的尿SCN值低于其他所研究的城镇。碘和SCN摄入量之间的平衡似乎是这些地区地方性甲状腺肿病因中的一个相关因素，碘/SCN比值与甲状腺肿患病率呈负相关。尽管生活方式和社会经济条件发生了重大变化，但与积极碘预防项目所取得的显著改善相比，地方性甲状腺肿仍然存在，这证实了隐性碘预防的不足，并进一步支持了在西西里岛地方性甲状腺肿地区立即引入积极碘预防措施的必要性。
