补碘对严重缺碘地区儿童智力发育的影响

目的了解补碘对儿童智力发育的影响。方法在严重缺碘地区采用联合型瑞文测验法测定补碘后出生的儿童智商,并与补碘前进行比较,探讨影响儿童智力发育的因素。结果补碘后出生的儿童的智商总体水平为93.2,明显高于补碘前出生的儿童智商78.6,而且前者儿童轻度智力发育落后的发生率为4.3%,明显低于后者儿童中轻度智力发育落后的发生率(16.4%)。结论母体孕产期服用碘油丸可有效降低轻度智力发育落后的发生率。     

2005年福建省消除碘缺乏病进程分析

目的为了解我省实现消除碘缺乏病目标的进程。方法采用容量比例概率法在全省调查了30个县l200名8～10岁儿童的甲状腺肿大率（B超法和触诊法）和智商、387份尿碘，1196份盐碘。结果8～10岁儿童甲状腺肿大率为1．3％（B超法），尿碘中位数为158．1μg／L，〈50μg／L仅占6．6％，居民户合格碘盐食用率为90．9％，轻度智力发育落后的发生率为1．9％。结论我省在2005年实现省级水平消除碘缺乏病的目标，全民食盐加碘措施实施以后出生的儿童，不再受到碘缺乏的危害。     

补碘后出生儿童骨龄和体格发育与智商水平的关系

目的：了解重,中度碘缺乏病区供应碘盐后出生儿童的骨龄和体格发育状况与智商水平的关系。方法：CRT－C2测7－14岁儿童智商,拍手腕骨X线片判定骨龄,标准量具测身高,体重,结果：碘盐预防后出生儿童的骨龄,身高,体重发育落后率均随人群智商（IQ）水平提高而下降,IQ50－69组儿童骨龄,身高,体重落后率分别为18．3％,17．6％,10．2％,均显著高于IQ70－79,IQ80－119,IQ大于等于120三组儿童（P＜0．01）,轻度智商落后组儿童的骨龄发育落后以尺骨未按时出现为常见,体格发育障碍为身高落后者明显多于体重落后者,骨龄与身高发育落后程度一致。结论：补碘后碘缺乏病区儿童骨龄和体格发育与智商水平密切相关,轻度智商落后组儿童的骨龄,身高,。体重 状况显著落后于同期出生智商水平较高组儿童。     

高碘地区不同碘摄入水平对儿童智力和精神运动功能的影响

目的了解高碘地区不同碘摄入水平的儿童智商水平和精神运动功能,探讨高碘对儿童智力发育和精神运动功能的影响。方法根据高碘地区不同碘摄入水平选择调查点,对调查点的7-14岁学生进行智力测验和精神运动功能测试,并设立对照。结果共对3 059名7-14岁学生进行了智力测验,其中男生 1 597名,女生1 462名。学生智商在性别上差异无统计学意义(P>0．05),在年龄组上差异有统计学意义(P< 0．05);高碘组学生智商明显高于对照组(P<0．01),高碘组智力低下发生率明显低于对照组(P<0．01)。对500 名学生进行精神运动功能测试,高碘组的学生精神运动功能好于对照组(P<0．05)。智力和精神运动功能呈正相关,r=0,332．P<0．05;不同智商水平的学生精神运动功能异常率差异有统计学意义,智力低下者精神运动功能异常率明显高于智商正常者(P<0．05)。结论未发现高碘对儿童智力发育损害的影响,但是不同碘水平儿童的精神运动功能测试结果有差异。精神运动功能和智力水平相关,精神运动功能测试更能反映出儿童神经系统损伤的细微差别,智力测验和精神运动功能测试联合可以筛查和预测智力落后儿童。     

非缺碘地区与碘缺乏病轻病区不同智商水平儿童精神运动功能状况

目的了解和比较农村非缺碘地区、供应碘盐和未防治IDD轻病区不同智商水平儿童精神运动功能状况。方法先用CRT—C，和CRT—RC，测试判定儿童智商，再用JPB和T分数检测确定各智商水平儿童精神运动功能。结果非缺碘地区、供应碘盐轻病区、未防治轻病区轻度智力落后儿童精神运动功能障碍率分别为25％、26、8％、41．2％，边缘智力儿童精神运动功能障碍率分别为7．9％、8％、9．5％，IQ≥80儿童精神运动功能正常；三地轻度智力落后儿童中的IQ50～59儿童精神运动功能障碍率显著高于IQ60～69儿童。结论轻度智力落后儿童精神运动功能明显低于比其智力水平高的儿童；未防治轻病区轻度智力落后儿童精神运动功能损伤率明显高于非缺碘地区和供应碘盐轻病区的轻度智力落后儿童。     

辽宁省地方性亚临床克汀病流行程度调查

目的：了解供应同浓度（1：5万）碘盐后重、中、轻碘缺乏病病区出生儿童的亚克汀病流行程度。方法：用中国联合型瑞文测验图岫和农村儿童智商常模（CRT－C2）测验判定7－14岁儿童智商，用津医精神运动成套测验（JPB）、测听仪、拍X线片、标准度衡器具检出智商值（IQ）50－69儿童的精神运动、听力障碍者和骨龄、体格发育落后者。结果：供应碘盐后重、中、轻病区出生儿童的人群轻度智力落后率分别为6．7％、5．0％、3．5％，轻度智力落后儿童的亚损伤率分别为77．8％、77．0％、40．2％。重、中、轻病区儿童人群亚克汀病患病率分别为5．2％、3．9％、1．4％；评价同浓度碘盐预防后重病区儿童亚克汀病流行程度为重，次之为中度病区，轻病区该病流行程度则轻。结论：居民食用的碘盐合格率低，尤其是孕妇碘不足，致使碘缺乏病病区仍有亚克汀病儿出生。     

长期碘盐预防亚临床损伤效果的研究

目的：了解碘盐预防后重,中度缺碘病区出生儿童亚临床损伤状况,评估病区儿童亚克汀病患病率。方法：采用CRT－C2、JPB,测听仪,拍X线片,标准度衡县检测7－14岁儿童智商、精神运动功能,听力,骨龄,身高和体重。结果：重,中度缺碘病区儿童智商均值96．4,轻度智力落后率5．8％;轻度智力落后儿童精神运动功能障碍率61．6％,听力减退率43．7％,骨龄,身高,体重发育落后率分别为18．3％,17．6％,10．2％,综合判定轻度智力落后儿童伴有神经,甲状腺功能障碍77．4％,只表现为轻度智力落后占22．6％,定量计算重、中度病区供应碘盐后出生儿童亚克汀病患病率为4．5％,其中重度,中度病区儿童亚克汀病患病率分别为5．2％,3．9％。结论：长期碘盐预防明显提高了缺碘病区儿童智力水平,降低了儿童亚克汀病患病率,但重度病区儿童亚克汀病患病率仍高于中度病区。     

食盐加碘对不同地区儿童智商的影响

目的 研究食盐加碘后对不同地区儿童智商的影响。方法 采用《中国联合型瑞文测验》对不同地区儿童进行智商测定。结果 食盐加碘后儿童智商水平发育基本正常，且不同地区儿童的智商水平存在差异，其规律是城市＞市郊＞县级、乡级＞村级；智力落后者(IQ≤69)的比例分别是0．07％、0．96％、1．84％、1．86％、4．0％。不同性别儿童智商差异无显著意义，甲肿率与智商水平无明显相关性。哈尔滨市儿童智商2001年较1994年有明显改善。结论 食盐加碘可以有效地防止低碘对人群智力造成的损害，不同地区人群智商水平存在差异。     

不同碘摄入水平地区学龄儿童的智商水平测定

目的探讨不同碘摄入水平地区学龄儿童智商水平。方法采用整群抽样，以饮用水碘水平进行分组，用中国联合型瑞文测验（CRT—C2）方法测验8～10岁儿童智商（IQ）。结果饮用水碘中位数为20．29、143．23和827．59μg／L的3组地区儿童的IQ值分别为100．76、103．53和101．62，轻度智力低下发生率依次为2．7％、3．5％和3．2％，其各组之间的差异均无统计学意义（P〉0．05）。男、女儿童IQ值为103．91和100．78分，智力低下率为1．9％和4．8％，亦都无统计学差异（P〉0．05）。一至四年级儿童的IQ值分别为102．84、100．69、103．50和99．88分，智力低下率分别9．4％、4．4％、2．3％和0，差异也无统计学意义（P〉0．05）。结论生活在碘过量地区的儿童即使饮用水水碘〉800mg／L时，同时有碘盐覆盖，儿童智商发育也未见异常。     

广东沿海及珠江三角洲地区人群碘营养状况

目的了解广东沿海及珠江三角洲地区人群碘营养状况。方法用人口比例概率抽样法对该地区抽取３０个调查点１２９３名８～１０岁在学儿童进行甲状腺肿大率、尿碘、盐碘调查;同时调查了儿童的智商水平和新生儿脐带血ＴＳＨ。结果Ｂ超法检查甲状腺肿大率１２．４５％,触诊法检查甲状腺肿大率１２．２２％;盐碘覆盖率５６．２％;尿碘中位数１２４．６０μｇ／Ｌ;平均智商为１０３．４,处于边缘状态和智力落后的儿童占６．８５％;ＴＳＨ＞５ｍＵ／Ｌ的占１０．２５％。结论广东沿海及珠江三角洲地区同样存在碘摄入不足的公共卫生问题,但多属轻度缺碘     

Thyroid function and intellectual development of children of mothers taking methimazole during pregnancy

There is some debate regarding the safety of methimazole (MMI) therapy during pregnancy. It is not known whether MMI therapy in mothers during pregnancy is safe for their children or if it causes alterations in thyroid function and intellectual development during childhood. Twenty-three children, whose mothers were hyperthyroid during pregnancy and treated with MMI 5-20 mg were studied from age 3-11 yr. Thyroid function and liver function tests, urinary iodine, anti-thyroid antibodies, intelligence quotient (IQ), verbal and functional components of Wechsler test were performed on 23 children of thyrotoxic mothers and 30 controls. In all children T3, T4, RT3U and TSH concentrations were normal. Mean T3, T4 and TSH values were 147 ng/dl, 9.7 microg/dl and 1.2 mU/l, respectively. Height, weight, thyroid function, and thyroid antibodies did not differ from controls. None of the children had T4 below 6 microg/dl or TSH>3.0 mU/l. Liver enzymes and serum albumin were normal in both groups. Mann-Whitney test showed no difference in verbal and performance IQ and their components between children of thyrotoxic mothers and controls. Total IQ of cases and controls was 117 +/- 11 and 113 +/- 14, respectively. No deleterious effect occurred in thyroid function and physical and intellectual development of children whose mothers were treated during pregnancy with doses of MMI up to 20 mg daily.     

食盐加碘对重庆市小学生智商的影响

目的分析食盐加碘对重庆市小学生智商的影响。方法采用《中国联合型瑞文测验》对重庆市小学生进行智商测定,并测定甲状腺大小及盐碘、尿碘,研究食盐加碘对智商的影响。结果食盐加碘后儿童智商水平基本是正常的。不同尿碘水平的儿童智商差异没有统计学意义(P>0.05),不同年龄儿童的智商存在差异(P<0.05)。结论食盐加碘可以有效地防止低碘对儿童智力造成的损害。     

Measures of Maternal Alcohol Use as Predictors of Development in Early Childhood

The effect of prenatal alcohol exposure on growth, dysmorphology, and cognitive development at 6 years was examined in children whose mothers had completed a self-administered questionnaire during pregnancy. Drinking patterns prior to pregnancy recognition and indications of problem drinking (IPD) were assessed. Heavier alcohol intake was associated with slower growth in height and head circumference and increased dysmorphology, as evidenced by facial features associated with fetal alcohol syndrome (FAS) and the prevalence of probable/possible fetal alcohol effects (FAE). Indications of problem drinking predicted facial features associated with FAS and cognitive deficits (i.e., lower WPPSI Verbal IQ scores and lower scores on a test of receptive language function, the Token Test). Effects of alcohol consumption on head circumference and of indications of problem drinking on Verbal IQ and Token Test scores remained significant, even after excluding children born to mothers having drinkers (over seven drinks a day) and children with probable/possible FAE. Verbal IQ was an average of 7.1 points (95% confidence interval = 0.01, 14.25) lower among children born to mothers having more than one indication of problem drinking than it was among those born to women having fewer indications; Token Test scores were 4.3 points lower (95% confidence interval = 1.38, 7.24). Although the confidence intervals for these estimates are broad in this small, heterogeneous sample, their magnitude, if confirmed, is significant given that the population standard deviation for Verbal IQ is 15, and that for the Token Test is 5.     

The effectiveness of oral iodized oil in the treatment and prophylaxis of endemic goiter

In a longitudinal study carried out for 2 yr in the Darfur region, western Sudan, 2316 school children received a single dose of 2 capsules of iodized oil (400 mg iodine) orally, and 1161 school children received 1 ml of the same preparation im (475 mg iodine); 2393 school children served as controls. One year after treatment, goiter prevalence was reduced from 67.0% to 36.0% among the children who had received oral iodized oil and from 71.0% to 42.0% in those who received it im. The prevalence in the control group did not change. The prevalences in each group were approximately the same 2 yr after treatment. Urinary iodine excretion increased after treatment and remained significantly higher than the initial value during the trial. In subjects from rural Darfur, serum T4 levels were increased 1 yr after treatment with oral iodized oil (P less than 0.001) and im iodized oil (P less than 0.01), and remained high in the former (P less than 0.05) but not in the latter. This increase was accompanied by reduction of serum T3 and TSH levels. Sialadenitis occurred in 3.7% of the children who received oral iodized oil. Thyroid antibodies were not detected before treatment, but microsomal antibodies were detected in 2 of the 128 subjects studied who received iodized oil orally. Comparable results occurred when oral and im iodized oil were given to 841 individuals covering a wider age range. It is concluded that a single oral dose of iodized oil is effective in the correction of iodine deficiency, reducing the goiter size and preventing the recurrence of goiter for at least 2 yr.     

过量碘在母鸡体内分布状况实验研究

各种补碘措施在病区已广为使用,但对于补碘后碘在体内分布状况研究的尚少。我们用不同碘剂、不同途径给产蛋鸡以大剂量碘以探讨补碘后碘在机体内分布状况,寻找其规律,用以指导防治工作。     

碘油和碘盐对碘缺乏病区孕妇碘代谢影响的动态研究

观察了长期供应１／４万－１／２万碘盐的ＩＤＤ病区妊娠妇女在孕前服与未服碘油丸对纠正体内碘代谢动态变化的影响。发现服碘油的孕妇血清ＴＳＨ，Ｔｇ值在孕３，５个月时降低，然后升高，Ｔ４，ＦＴ４升高持续到怀孕７个月，Ｔ３与ＦＴ３在３，５个月时恒定在孕前水平，然后下降，ｒＴ３在孕５个月时明显升高，提示碘油仅能保护孕妇在妊娠期的前５个月不缺碘，在此时应再服一次小剂量碘油丸。     

Antioxidant intake in pregnancy in relation to wheeze and eczema in the first two years of life

Two thousand women were recruited for a prospective investigation of the influence of maternal antioxidant intake in pregnancy on the development of asthma and eczema in children. A food frequency questionnaire was used to characterize diet during pregnancy and blood antioxidant levels were measured. Postal questionnaires were used to follow up the 1,924 singleton children born to the cohort at 6, 12, and 24 months of age. There were no associations between maternal antioxidant intake and wheezing symptoms and eczema in the children's first year. In the children's second year, maternal vitamin E intake during pregnancy was negatively associated with wheeze in the absence of a "cold" (p for trend 0.010) and, in children whose mothers were atopic, there was a negative association between maternal vitamin E intake and childhood eczema (p for trend 0.024). Maternal vitamin C intake during pregnancy was positively associated with "ever wheeze" and eczema during the children's second year. This study suggests that maternal dietary antioxidant intakes during pregnancy may modify the risks of developing wheeze and eczema during early childhood. Further follow up of the cohort will determine whether maternal diet during pregnancy is associated with asthma and atopic disease in later childhood.     

Maternal age, alcohol abuse history, and quality of parenting as moderators of the effects of prenatal alcohol exposure on 7.5-year intellectual function

BACKGROUND: In contrast to the extensive literature documenting IQ deficits in patients with fetal alcohol syndrome, effects on IQ have not generally been reported for children with alcohol-related neurodevelopmental disorder (ARND). This study examined the role of maternal age, MAST, and quality of parenting in moderating the effects of prenatal alcohol exposure on the WISC-III IQ test in moderate-to-heavily exposed children. METHODS: A total of 337 inner-city African American children whose mothers were recruited prenatally were administered the WISC-III at 7.5 years. Alcohol exposure was assesed with a timeline follow-back interview administered at every prenatal clinic visit. Moderating effects of the three risk factors were examined by adding interaction terms to regression analyses and dichotomizing the moderators and performing separate regressions on the two groups. RESULTS: Prenatal alcohol exposure was related to WISC-III Freedom from Distractibility but not to Full Scale IQ for the sample as a whole. However, among children born to older mothers, an alcohol effect emerged on Full Scale IQ and five of seven composite IQ scores. Similarly, adverse effects were seen among children of MAST-positive mothers and children whose parents provided less optimal cognitive stimulation. Each additional ounce of absolute alcohol consumed per day during pregnancy was associated with a 2.9-point decrease in Full Scale IQ and a 5.6-point decrement on Freedom from Distractibility. CONCLUSIONS: This study is the first to demonstrate IQ effects among children with ARND born to older and MAST-positive mothers, particularly in relation to first-trimester drinking. These findings suggest that there are subgroups of more vulnerable and severely affected children whose intellectual performance is compromised. A moderate- to heavy-drinking mother who has given birth to an unaffected child when she was younger needs to be warned that her risk of having an adversely affected child increases as she grows older.     

Iodine supplementation during pregnancy: a public health challenge.

Iodine deficiency remains the most frequent cause worldwide, after starvation, of preventable mental retardation in children. It causes maternal hypothyroxinemia, which affects pregnant women even in apparently iodine-sufficient areas, and often goes unnoticed because L-thyroxine (T4) levels remain within the normal range, and thyroid-stimulating hormone (TSH) is not increased. Even a mild hypothyroxinemia during pregnancy increases the risk of neurodevelopmental abnormalities, and experimental data clearly demonstrate that it damages the cortical cytoarchitecture of the fetal brain. The American Thyroid Association (ATA) recommends a supplement of 150 microg iodine/day during pregnancy and lactation, in addition to the use of iodized salt. We discuss the importance of iodine supplementation to ensure adequate T4 levels in all women who are considering conception and throughout pregnancy and lactation.