当心碘缺乏

碘缺乏病是世界上流行最广泛,危害人数最多的一种疾病,是全 世界尤其是发展中国家的一个严重的公共卫生问题。我国智力残 缺病人中,因缺碘导致弱智的占80％,有报告称我国至少有800 万-1000万因碘不足而造成智力低下的儿童。     

有机碘和无机碘对人甲状腺细胞凋亡的影响

目的 研究有机碘和无机碘对体外培养的人甲状腺细胞形态和凋亡相关蛋白Bcl-2和Bax表达的影响.方法 取正常人甲状腺细胞进行培养,分别设对照(培养液)组和KI组(碘浓度分别为10-7、10-5、10-3 mol/L)及3,5-二碘酪氨酸(DIT)组(碘浓度分别为10-7、10-5、10-3 mol/L),分别加入相应浓度用培养液稀释的DIT和KI溶液,继续培养48 h.采用免疫组织化学技术测定细胞凋亡相关蛋白表达的情况.结果 与对照组相比,10-5、10-3 mol/L KI组和10-3 mol/L DIT组甲状腺细胞Bcl-2表达量较低,10-5、10-3 mol/L KI及DIT暴露甲状腺细胞Bax表达量较高,差异均有统计学意义(P＜0.05,P＜0.01);且随着KI或DIT暴露浓度的升高,甲状腺细胞Bcl-2表达量呈下降趋势,Bax表达量呈上升趋势.与相同剂量KI组相比,10-5、10-3 mol/L DIT组甲状腺细胞Bcl-2表达量较高,Bax表达量较低,差异均有统计学意义(P＜0.05,P＜0.01).结论 高碘可引起甲状腺细胞形态的改变并增强其细胞凋亡的发生,且DIT对甲状腺细胞的影响弱于KI.     

Rapeseed glucosinolates and iodine in sows affect the milk iodine concentration and the iodine status of piglets.

I in the chain sow diet --> blood serum of sow --> sow milk --> piglet serum was investigated in two experiments with a total of eighty-one sows and their piglets. In experiments conducted during the last trimester of gravidity and the 28 d of lactation, diets with glucosinolates (1.9 mmol/kg diet via 100 g ground rapeseed/kg diet (Expt 1) and 2.1 and 4.2 mmol/kg diet via 75 and 150 g rapeseed press cake/kg diet (Expt 2)) were compared with control groups without rapeseed products. From 0 to 600 microg I/kg was added to sow diets during lactation. Diets without supplementary I decreased the I concentration particularly in milk and piglet serum. The presence of rapeseed and rapeseed press cake were indicated by a thiocyanate concentration increase, mainly in sow serum. The diets with glucosinolates decreased the milk and piglet serum I concentration. Spot urine and faeces samples from sows eating the rapeseed-press cake diets had increased I concentration. The sows' serum I and thyroxine did not respond to glucosinolates (Expt 1) or these diets caused an increase in concentration (Expt 2). Both these criteria seem unsuitable for the diagnosis of I status of adult animals. Glucosinolates and their degradation compounds may affect the thyroid and the mammary glands resulting in lower I milk transfer and higher renal and intestinal I excretion.     

碘缺乏、补碘、高碘对儿童智力影响的Meta分析

目的 量化分析碘缺乏，补碘，高碘对儿童智力的影响。方法 采用Meta分析，利用检索工具收集尽可能多的文献。纳入研究的标准是：研究来自碘缺乏病区或高碘地区，文献采取对照实验设计，提及研究组与对照组的社会经济文化发展水平相近。纳入研究归入碘缺乏，补碘和高碘三个组。结果 纳入碘缺乏，补碘和高碘三组的研究分别为62，36，30项，三组内各单项研究的Hunter齐性检验没有显著的统计学意义（P＞0．05），合并计算的平均效应值依次是0．69（10．4个智商分，95％CI＝9．9－10．9），0．81（12．2个智商分，95％CI＝11．5－12．9）和0．21（3．2个智商分，95％CI＝2．5－4．0）。结论 碘缺乏和补碘对病区儿童智力干扰明显或极为明显；碘缺乏造成儿童智商损失约10分，在脑发育关键期补碘出生的儿童智商比未补碘儿童高约12分；目前尚不能肯定高碘对儿童智力有影响。     

PCR-RFLP鉴定儿童唾液中幽门螺杆菌的意义

采用聚合酶链反应 限制性片段长度多态性 (ｐｏｌｙｍｅｒａｓｅｃｈａｉｎｒｅａｃｔｉｏｎ ｒｅｓｔｒｉｃｔｉｏｎｆｒａｇｍｅｎｔｌｅｎｇｔｈ ｐｏｌｙｍｏｒｐｈｉｓｍ ,ＰＣＲ ＲＦＬＰ)技术对儿童唾液与胃黏膜中的幽门螺杆菌(Ｈｅｌｉｃｏｂａｃｔｅｒｐｙｌｏｒｉ,Ｈｐ)进行基因型分析 ,以探讨其在Ｈｐ流行病学中的价值。1.对象与方法 :(1)研究对象 :在广西医科大学第一临床医院就诊的 198例儿童接受胃镜检查 ,其中男 135例 ,女 6 3例 ,年龄 2～ 14岁 ,所有患儿均有不同程度的上消化道症状。(2 )方法 :参照Ｄｏｒｅ等[1 ] 的方法…     

严重缺碘地区无碘缺乏病流行:西藏牧区人群碘营养及病情状况调查

目的 调查西藏牧区和农区人群碘营养状况和甲状腺肿患病情况.方法 在拉萨市当雄县牧区和曲水县农区各抽取30户家庭,采集饮用水样和盐样检测碘含量,随机抽取8～10岁儿童、育龄妇女和成年男性人群至少50人,检测尿碘含量;在采集尿样的儿童和育龄妇女中,各随机抽取50人进行甲状腺触诊检查.结果 牧区和农区水碘均不足2 μg/L;牧区研究对象全部食用非碘盐,农区对照人群碘盐食用率为90%;牧区人群尿碘中位数仅为50.2μg/L,显著低于农区(193.2μg/L);牧区儿童和育龄妇女甲状腺肿率显著低于农区.结论 牧区人群碘摄入严重不足,但无碘缺乏病流行,该现象值得思考和进一步研究.     

天津市非水源性高碘地区成人碘营养状况及总膳食碘折算方法

目的  了解天津市非水源性高碘地区成人居民碘营养状况及来源分布,并比较3 d膳食调查法和24 h尿碘法折算总膳食碘的方法学差异。 方法  根据中国成人慢性病与营养监测方案,在天津市河西区、南开区、红桥区、武清区、津南区、宝坻区、蓟州区共计调查1 634名成人,使用3 d膳食回顾法和调味品称重法相结合获得总膳食碘状况,描述居民碘营养状况及各部分碘的贡献率,从中随机抽取403名调查者收集24 h尿液进行尿碘检测,比较3 d膳食调查法和尿碘折算法估计总膳食碘的方法学差异。 结果  天津市非水源性高碘地区成人居民总膳食碘摄入量为207.13 μg/标准人日,70.3%的被调查者处于碘适宜状态;盐碘是总膳食碘最主要的来源（78.2%）,其次是食物碘（13.2%）和水碘（8.6%）;整体上看,3 d膳食调查法比24 h尿碘折算法高估约10%。 结论  天津市非水源性高碘地区成人居民碘营养状况总体处于适宜水平,盐碘是膳食碘最主要的来源,3 d膳食调查法和24 h尿碘折算法估计总膳食碘摄入量差异不大。     

离子选择性电极法测定碘强化饮料中的碘

目的:探讨碘强化饮料中的碘离子浓度的测定方法。方法:采用标准加入法,用理论测量范围为10-1-5×10-7mol/L、实际检测下限为6.3×10-7mol/L的碘离子选择性电极分别对奶类、碳酸类和蔗糖类三种碘强化饮料中的碘离子浓度进行测定。结果:变异系数分别为5.1%、6.7%、5.3%,平均加标回收率分别为99.0%、97.5%、102.5%。结论:此方法的精密度和准确度较好,操作简单、快速,便于基层推广和应用。     

Physiopathology of iodine deficiency

The process of goitrogenesis is likely to be the consequence of an increased TSH stimulation linked to an initial reduction of circulating thyroid hormone caused by iodine deficiency (ID). Other growth factors associated to TSH may have a role in the pathogenesis of goiter. Natural history of goiter is the evolution towards nodularity and functional autonomy. This phenomenon is due to the heterogeneity of thyroid follicular cells, some of which, with an intrinsic elevated growth rate, under the stimulation of ID progress to nodule formation and hyperfunction. In multinodular goiter TSH receptor mutations activating adenylate cyclase-cAMP pathway were found. In a recent epidemiological survey it was shown that nodular goiter increased with the age, being about 1% in schoolchildren and 23% in the adults (56-75 years). Also nodular autonomy and hyperthyroidism were more frequent in the 36-75 year age group. Severe ID is also cause of endemic cretinism. In Europe minor neuropsychological impairments and cognitive deficits were described in areas of moderate ID. The exposure to a mild ID during fetal life causes minor neuropsychological damage. In conclusion, ID is responsible of goiter and its evolution towards nodularity and functional autonomy. Severe ID is also cause of endemic cretinism, while cognitive deficits and minor neuropsychological impairments were found in mild to moderate ID.     

碘摄入量对妇女碘营养水平的影响

目的 了解深圳市妇女碘营养水平，为调控碘的使用提供依据。方法 点状采集连续居住在该市市区、郊区3年以上的正常未孕妇女、孕早期、孕中期和哺乳期妇女所食用的食盐、饮用水及她们的尿样，测定碘含量。结果 郊区324份、市区603份饮用水的碘含量中位数分别为3.3μg／L（0.5-15.44μg／L）和24.1μg/L（6.80-42.58μg/L）。盐碘含量中位数均接近32mg／kg。尿碘未孕组的基本水平郊区均值为240.1μg/L、市区为312.5μg/L。市区未孕组及哺乳期组尿碘水平均超过碘营养适宜水平。尿碘水平郊区不同组中，含量〈100μg/L的孕中期组为9.2％，哺乳期组为11.2％，显著高于市区同组。结论 郊区水碘含量过低，使郊区妇女碘营养缺乏；市区水碘对孕期组碘缺乏有明显的遏制作用，建议深圳市区内不宜继续实施食盐加碘措施。     

Urinary iodine excretion correlates with milk iodine content in seven British towns.

In February and May 1986, weekly samples of whole pasteurised milk were collected from the 24 dairies supplying seven British towns. A random sample of 96 women aged 25-64 was drawn from general practitioners' lists in each town, and catch specimens of early morning urine were collected by post from 194 subjects in February and from 186 subjects in May. Median milk iodine concentration was significantly greater in February (235 micrograms/l) than in May (119 micrograms/l). The median urine iodine concentration (expressed per g of creatinine) was also greater in February (106 micrograms/g) than in May (78 micrograms/g). There was a strong and statistically significant correlation between milk and urine iodine concentrations in the seven towns in February (Spearman's r = 0.79, p = 0.04). Within the towns, the change in milk iodine levels between February and May was positively associated with the change in the iodine:creatinine ratio over the same period. There is concern that an excess of dietary iodine may be harmful to some individuals. Should it prove desirable to reduce iodine intakes at the community level, the present results suggest that this could be achieved by a reduction in milk iodine levels, which can be readily brought about by adjusting the levels of iodine in cattle feed.     

Determining median urinary iodine concentration that indicates adequate iodine intake at population level

OBJECTIVE: Urinary iodine concentration is the prime indicator of nutritional iodine status and is used to evaluate population-based iodine supplementation. In 1994, WHO, UNICEF and ICCIDD recommended median urinary iodine concentrations for populations of 100- 200 micro g/l, assuming the 100 micro g/l threshold would limit concentrations <50 micro g/l to 100 micro g/l. The total population was 55 892, including 35 661 (64%) schoolchildren. Median urinary iodine concentrations were 111-540 (median 201) micro g/l for all populations, 100-199 micro g/l in 23 (48%) populations and >/=200 micro g/l in 25 (52%). The frequencies of values <50 micro g/l were 0-20.8 (mean 4.8%) overall and 7.2% and 2.5% in populations with medians of 100-199 micro g/l and >200 micro g/l, respectively. The frequency reached 20% only in two places where iodine had been supplemented for <2 years. CONCLUSION: The frequency of urinary iodine concentrations <50 micro g/l in populations with median urinary iodine concentrations >/=100 micro g/l has been overestimated. The threshold of 100 micro g/l does not need to be increased. In populations, median urinary iodine concentrations of 100-200 micro g/l indicate adequate iodine intake and optimal iodine nutrition.     

水碘对深圳市不同人群碘营养水平的影响

目的　了解水碘含量对不同人群碘营养水平的影响。方法　点状采集连续居住在该市 3年以上的 8～10岁儿童、市区未孕期、孕早期和孕中期及哺乳期妇女的尿、居民饮用水及食盐 ,测定碘含量。结果　郊区 2 11份和市区 32 5份居民饮用水的碘含量中位数 (M )分别为 3 2 μg/L(0 5～ 15 4 4 μg/L)和 2 3 6 μg/L(6 80～ 4 2 5 8μg/L) ,盐碘M均接近 32mg/kg,尿碘 <10 0 μg/L郊区 8～ 10岁儿童占 6 7% ,市区占 15 0 % ;市区孕早期及孕中期妇女尿碘 <10 0 μg/L分别占 14 6 %和 2 7% ,未孕期和哺乳期均未超过 6 0 % ;碘营养超过适宜范围 ,市区 8～ 10岁儿童占6 5 5 % ,未孕期及哺乳期分别占 5 4 1%及 80 0 %。结论　郊区水碘含量过低 ,对碘营养缺乏有直接影响 ,市区水碘对孕期妇女碘缺乏有明显的阻遏作用 ,对其他人群碘营养过剩有协同作用。食盐加碘不宜在深圳市区继续实施。     

Use of iodine for water disinfection: iodine toxicity and maximum recommended dose

Iodine is an effective, simple, and cost-efficient means of water disinfection for people who vacation, travel, or work in areas where municipal water treatment is not reliable. However, there is considerable controversy about the maximum safe iodine dose and duration of use when iodine is ingested in excess of the recommended daily dietary amount. The major health effect of concern with excess iodine ingestion is thyroid disorders, primarily hypothyroidism with or without iodine-induced goiter. A review of the human trials on the safety of iodine ingestion indicates that neither the maximum recommended dietary dose (2 mg/day) nor the maximum recommended duration of use (3 weeks) has a firm basis. Rather than a clear threshold response level or a linear and temporal dose-response relationship between iodine intake and thyroid function, there appears to be marked individual sensitivity, often resulting from unmasking of underlying thyroid disease. The use of iodine for water disinfection requires a risk-benefit decision based on iodine's benefit as a disinfectant and the changes it induces in thyroid physiology. By using appropriate disinfection techniques and monitoring thyroid function, most people can use iodine for water treatment over a prolonged period of time.     

宣城市消除碘缺乏病后居民碘营养状况评估

目的动态评价人群碘营养状况及病情的消长趋势,为适时采取有针对性的防治措施和科学调整干预策略提供依据方法采取随机抽样方法,对居民户食用盐、8～10岁儿童尿碘、甲状腺肿大率、居民饮用水碘等指标进行监测分析;对小学生及家庭主妇碘缺乏病防治知识知晓率进行问卷调查结果碘盐覆盖率为99.95%,合格碘盐率为99.90%。8～10岁儿童甲状腺肿大率为1.00%,尿碘中位数为253.29ug/L,居民饮用水碘中位数为2.92ug/L,人均食盐使用量中位数为8.84g/d,小学生及家庭主妇碘缺乏病防治知识知晓率分别为96.29%、91.11%。结论宣城市消除碘缺乏病后居民碘营养水平基本适宜,但儿童摄入碘量略偏高;外环境缺碘状态未改变,需建立科学长效防治机制,保持长期消除缺乏病状态。