Aghini-Lombardi F, Antonangeli L, Pinchera A, Leoli F, Rago T, Bartolomei A M, Vitti P
Institute of Endocrinology, University of Pisa, Italy.
J Clin Endocrinol Metab. 1997 Apr;82(4):1136-9. doi: 10.1210/jcem.82.4.3867.
It is well established that an adequate iodine intake prevents iodine deficiency disorders. Prophylaxis through iodized salt is able to correct urinary iodine deficiency and to prevent goiter endemia, but scanty data are available about its effect on decreasing the thyroid size in goitrous children born before prophylaxis. The prevalence of goiter was evaluated by ultrasound in the school-children population of an area of Eastern Tuscany (Tiberina Valley) characterized by moderate iodine deficiency in 1985. At present, after the implementation of voluntary iodized salt consumption, iodine urinary excretion was borderline sufficient (median, 98 micrograms/L). Goiter prevalence was higher at ultrasound (17%) than by palpation (10%). The median thyroid volume ranged from 3.1 mL in 7-yr-old children to 9.2 mL in 14-yr-old children. In the 7-10 yr age class (i.e. in children born after iodine prophylaxis), no statistical difference in thyroid volume was found with respect to controls. In older children (11-14 yr) born before the institution of iodine prophylaxis, the median thyroid volume was significantly higher than that in age-matched controls. Moreover, in this cluster of subjects, the median thyroid volume in nongoitrous children was higher than that in controls. In conclusion, the data of the present study indicate that the iodized salt prophylaxis is able to prevent the development of goiter in children born after the implementation of iodized salt consumption and to further control thyroid enlargement in older children, but is less effective (or rapid) in reducing goiter size in children exposed to iodine deficiency in the first years of life.
充足的碘摄入可预防碘缺乏症，这一点已得到充分证实。通过碘盐进行预防能够纠正尿碘缺乏，并预防甲状腺肿地方病，但关于其对预防前出生的甲状腺肿儿童甲状腺大小减小的影响的数据却很少。1985年，在托斯卡纳东部（蒂贝里纳山谷）一个碘缺乏程度中等的地区，通过超声对学龄儿童人群的甲状腺肿患病率进行了评估。目前，在实施自愿食用碘盐后，尿碘排泄处于临界充足水平（中位数为98微克/升）。超声检查显示的甲状腺肿患病率（17%）高于触诊结果（10%）。甲状腺体积中位数在7岁儿童中为3.1毫升，在14岁儿童中为9.2毫升。在7至10岁年龄组（即碘预防措施实施后出生的儿童）中，甲状腺体积与对照组相比无统计学差异。在碘预防措施实施前出生的较大儿童（11至14岁）中，甲状腺体积中位数显著高于年龄匹配的对照组。此外，在这组受试者中，非甲状腺肿儿童的甲状腺体积中位数高于对照组。总之，本研究数据表明，碘盐预防措施能够预防碘盐消费实施后出生的儿童甲状腺肿的发生，并进一步控制较大儿童的甲状腺肿大，但在减小生命最初几年暴露于碘缺乏环境中的儿童甲状腺肿大小方面效果较差（或起效较慢）。
