Iodine deficiency disorders in Bangladesh

An extensive iodine deficiency disorders survery was conducted in Bangladesh in 1993 to assess the latest iodine nutriture status of the country. The clinical variables of the survey were goitre and cretinism, and the biochemical variable was urinary iodine. The “EPI-30 cluster” sampling methodology was followed for selecting the survey sites. In each survey site, the study population consisted of boys and girls, aged 5–11 years, and men and women, aged 15–44 years, in about equal populations. the total number of survey sites was 78 and the total number of respondents was 30 072. The total number of urine samples was 4512 (15% sub-sample). The current total goitre rate (grade 1+grade 2) in Bangladesh is 47.1% (hilly, 44.4%; flood-prone, 50.7%; and plains, 45.6%). The prevalence of cretinism in the country is 0.5% (hilly, 0.8%; flood-prone, 0.5%; and plains, 0.3%). Nearly 69% of Bangladeshi population have biochemical iodine deficiency (urinary iodine excretion [UIE]<10 mg/dl) (hilly, 84.4; flood-prone, 67.1%; and plains 60.4%). Women and children are more affected than men, in terms of both goitre prevalence and UIE. The widespread severe iodine deficiency in all ecological zones indicates that the country as a whole is an iodine-deficient region. Important recommendations of global interest are made from the experience of the survey. An erratum to this article is available at .     

地方性克汀病人听觉传导路中神经元胞体的形态定量研究

对地方性克汀病人大脑的听觉传导路进行了病理检查，对上橄榄核，内侧膝状体及颞横回中神经元胞体进行了体视学的测量。发现部分神经元变性坏死，并可见卫星现象，神经元胞体的体积密度和数密度均比正常人明显减少，证实地克病人听觉传导路存在病变。     

云南兰坪小儿神经型克汀亚克汀病的临床调查——附55例临床分析

本文对云南兰坪县金顶镇菁门办事处55例小儿神经型克汀及亚克汀患儿进行了综合临床调查。全部患儿进行了详细体格检查、甲状腺功能检测、甲状腺摄碘率测定、听力和前庭功能测定以及神经系统检查和智商求取。分析表明克汀病、亚克汀病患儿的生长发育(生理指标)明显低于对照组;克汀、亚克汀病患儿均无明显甲状腺肿大,甲状腺功能、摄碘率及尿碘基本在正常范同,显示神经型克汀,亚克汀病并无现症甲减,而丰要表现为智力低下和牛长发育迟缓;克汀病患儿不仅普遍(88.46％)存在有锥体系受损,而且不少患儿(53.83％)同时存在锥体外系受损;亚克汀病患儿是当地小学教学质量难以提高的主要原因。     

The distribution patterns of trace elements in the brain and erythrocytes in a rat experimental model of iodine deficiency

Cretinism is a disease characterized by neurological defects associated with severe iodine deficiency. In a rat model of severe iodine deficiency, we investigated the distribution pattern of trace elements (iodine [I], selenium [Se], and bromine [Br] in brain tissue samples; potassium [K], calcium [Ca], manganese [Mn], iron [Fe], copper [Cu], zinc [Zn], rubidium [Rb], and lead [Pb] in erythrocytes) after supplementing the rats with I and/or Se. Neutron activation analysis, proton induced x-ray emission and x-ray fluorescence were used. The serum levels of total and free thyroxine (T4, FT4), and of total, free, and reverse triiodothyronine (T3, FT3, rT3, respectively) were assessed by radioimmunoassay. The results were statistically evaluated by one-way analysis of variance and bivariate correlation. The study indicated that the levels of T4, FT4, and rT3 increased in the serum of iodine-deficient rats supplemented with I or I + Se. In the same animals, we documented alterations of the content of Br in the brain, and of Zn, Mn, Cu, and Rb in erythrocytes, whereas the brain content of I and Se was unchanged. Thus, I and I + Se supplementation improves thyroid hormone metabolism but affects the content of selected trace elements in erythrocytes and of Br in the brain. The data stimulate further clarification of the role of trace elements in the central nervous system.     

Iodine deficiency disorders and their prevention in India

New insights on the high prevalence of functional decompensation of the thyroid among newborn and children from several states of India as well as neighbouring countries of Nepal and Bhutan helped to prevent nutritional iodine deficiency and iodine deficiency disorders through country-wide iodized salt prophylaxis. Presently on the basis of scientific studies, salt iodization in India is saving millions of children from neonatal hypothyroidism related psycho-physical retardation.     

地方性甲状腺肿、地方性克汀病流行区人群血清、水、土微量元素调查报告

本文就我省大别山区霍山县地方性甲状腺肿和地方性克汀病流行区——太平乡185例成人血清铜、锌、锰、镁测定结果与非病区正常成人495例均值相比较,发现锰、铜、铜/锌比值高:锌、镁低,均具有统计学意义。对当地水、土壤检测这些元素也有相应发现。推测在当地地甲病和地克病的病因和发病原理上,除缺碘为基础外,这些元素含量的异常也可能起着重要影响。在今后的防治中,除补碘外,对这些有关元素也应考虑作相应补充或驱除。     

云南省兰坪县地方性克汀亚克汀病的听力及前庭功能检测分析

通过纯音测听(部分用语言测听)和冰水试验对克汀病患者72例,亚克汀病患者31例和无病对照者87例进行听力和前庭功能检测,发现克汀及亚克汀病患者的听力和前庭功能多有明显损伤,且损伤程度与病情轻重呈正比。故听力及前庭功能检测结果可作为临床诊断克汀、亚克汀病较可靠的依据之一。     

甲状腺激素合成不足与脑髓化障碍

作者测定了用低碘饲料饲养的低碘大鼠脑组织的脑苷脂,脂蛋白和胆固醇。20日龄时全脑胆固醇显著低于对照组,脑苷脂和脂蛋白明显下降,小脑表现更为突出,但42日龄时的脑苷脂已无显著差异。提示甲状腺激素不足使脑组织髓化形成障碍,髓鞘发育落后。脑苷脂的发育延迟可能是可逆的。     

缺碘地区7—14岁儿童亚临床克汀病的流行趋势

缺碘地区供应碘盐后，重度缺碘地区亚克汀病患病率呈下降趋势，轻度缺碘地区各年龄组与对照组比较差异无显著意义（Ｐ〉０．０５）。缺碘地区儿童智商明显低于对照组（Ｐ〈０．０１），低年龄组智商高于本地区高年龄组（Ｐ〈０．０５），但与对照组同年龄比较仍有显著差别（Ｐ〈０．０５）。