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不同碘摄入量对农村学龄儿童甲状腺疾病及智商水平的影响
引用本文:高天舒,滕卫平,单忠艳,金迎,关海霞,滕晓春,杨帆,王微波,史晓光,佟雅洁,李丹,陈威.不同碘摄入量对农村学龄儿童甲状腺疾病及智商水平的影响[J].中华医学杂志,2001,81(8):453-456.
作者姓名:高天舒  滕卫平  单忠艳  金迎  关海霞  滕晓春  杨帆  王微波  史晓光  佟雅洁  李丹  陈威
作者单位:中国医科大学附属第一医院内分泌科,
基金项目:国家自然科学基金资助项目(39970350);美国中华医学会基金会资助项目(98688IITD)
摘    要:目的 了解不同摄入量地区儿童甲状腺功能和智商水平,探讨高碘对儿童的影响。方法 在低碘报 量的辽宁盘山地区尿碘中位数(MUI)为99μg/L],中度碘摄入量的辽宁彰武地区(MUI为338μg/L),高碘摄入量的河北黄骅地区(MUI为631μg/L)分别选择190、236和313名儿童进行中国联合型瑞文智力测验,对其中的116、110和112名儿童进行甲状腺功能,甲头腺自身抗体(TAA)和尿碘测定。结果 盘山、武、黄骅地区临床甲状腺功能亢进症(甲亢)、亚临床甲亢和临床甲状腺功能减低症(甲减)患病率比较差异无显著意义,但是亚临床甲减的患病率差异有显著意义(P=0.001),黄骅和彰武亚临床甲减患病率分别是盘山的4.76倍和3.37倍,所有这些亚临床甲减病人血清TAA除1例阳性外,其他均为阴性。甲状腺过氧化物酶抗体(TPOAb)和甲状腺球蛋白抗体(TGAb)阳性率3个地区之间比较差异无显著意义。黄骅地区血清甲状腺球蛋白(TG)值显著高于其他2个地区(P=0.0157),彰武高于盘山,但差异无显著意义。黄骅儿童智商值明显高于彰武(P=0.0012),盘山儿童智商值高于彰武,低于黄骅,但差异无显著意义。结论 高碘摄量使儿童患亚临床甲减的危险性增加,高碘地区儿童亚临床甲减多数是非自身免疫源性的。未发现高碘对儿童智力发育的影响。

关 键 词:甲状腺疾病  流行病学研究    摄入量  智力发育  儿童
修稿时间:2000年10月9日

Effect of iodine intake on thyroid diseases and intelligence among schoolchildren in rural areas
T Gao,W Teng,Z Shan.Effect of iodine intake on thyroid diseases and intelligence among schoolchildren in rural areas[J].National Medical Journal of China,2001,81(8):453-456.
Authors:T Gao  W Teng  Z Shan
Institution:Department of Endocrinology, First Hospital Affiliated to China Medical University, Shenyang 110001, China.
Abstract:OBJECTIVE: To understand the throid function and intelligence among the schoolchildren in three rural areas with different iodine intakes in China to probe the side-effect of excessive iodine intake on intelligence of schoolchildren. METHODS: Chinese version of Raven's test was made among rural schoolchildren, 190 from Panshan County, Liaoning Province, a low iodine intake area with the median urinary iodine (MUI) of 99 microgram/L among its inhabitants, 236 from Zhangwu County, Liaoning Province, a moderate iodine intake area with the MUI of 338 microgram/L, and 313 from Huanghua County, Hebei Province, an excessive iodine intake area with the MUI of 631 microgram/L. Thyroid function, thyroid autoantibody (TAA), and MUI were determined among 116, 110 and 112 from the above-mentioned schoolchildren from these three areas respectively. RESULTS: There was no significant difference among the prevalence rates of overt hyperthyroidism, subclinical hyperthyroidism and overt hypothyroidism in the areas of Panshan, Zhangwu and Huanghua. However, a significant difference was found among the prevalence rates of subclinical hypothyroidism in theses three areas (P = 0.001). The prevalence rates of subclinical hypothyroidism in Huanghua and Zhangwu were 4.76 and 3.37 times higher than that in Panshan (P = 0.001). TAA was negative among all of the schoolchildren with subclinical hypothyroidism except for one. No significant difference was found among the positive rates of thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TGAb) in these three areas. Serum thyroglobulin (TG) values in Huanghua were markedly higher than those in the other two areas (P = 0.015 7). Serum TG value in Zhangwu was higher than that in Panshan but with no significant difference. The IQ value of the schoolchildren in Huanghua was markedly higher than that in Zhangwu (P = 0.001 2). The IQ value of the schoolchildren in Panshan was lower than that in Huanghua and higher than that in Zhangwu but with no significant difference. CONCLUSION: The increase of iodine intake may increase the risk of subclinical hypothyroidism among schoolchildren. In the area with excessive iodine intake, most of the subclicical hypothyroidism cases among schoolchildren are not of autoimmune origin. No obvious effect of excessive iodine intaue is found on mental development of schoolchildren.
Keywords:Iodine  Thyroid diseases  Intelligence  Schoolchildren
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