Risks of iodine-induced hyperthyroidism after correction of iodine deficiency by iodized salt
Risks of iodine-induced hyperthyroidism after correction of iodine deficiency by iodized salt
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DOI：
10.1089/thy.1999.9.545
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发表时间：
1999-06-01
期刊：
影响因子：
6.6
通讯作者：
Alnwick, D
中科院分区：
文献类型：
--
作者：
Delange, F;de Benoist, B;Alnwick, D
在引入碘盐后不久，两个严重缺碘的非洲国家（津巴布韦和刚果民主共和国，RDC）就报告了甲状腺功能亢进症的生化症状，甚至是明显的、可能致命的临床甲状腺功能亢进症。这两个国家可以获得博茨瓦纳以及该地区其他 5 个国家（即喀麦隆、尼日利亚、肯尼亚、坦桑尼亚和赞比亚）生产的碘盐。因此，我们在这7个国家进行了一项多中心研究，以评估引入碘盐后碘诱发的甲状腺功能亢进症（IM）的发生是否是普遍现象，还是与这两个受影响国家的具体当地情况相对应。 7个国家中每一个都选择了2个或3个有严重缺碘史且最近补充了碘盐的地区。对这些地区的4423名学童进行了甲状腺肿患病率测定，对2258名学童进行了尿碘浓度测定。走访了盐厂和卫生机构，评估了碘盐的质量和可能发生IM的情况。研究表明，所有调查地区都消除了碘缺乏症，自从引入加碘盐以来，甲状腺肿的患病率显着下降。这是公共卫生领域的一项了不起的成就。然而，一些地区现在出现碘过量的情况，主要是由于对碘盐质量和人口碘摄入量监测不力。在这些地区或国家，IM 仅在最近开始引入碘盐时发生（
Biochemical signs of hyperthyroidism, or even overt and possibly lethal clinical hyperthyroidism were reported in 2 severely iodine-deficient African countries (Zimbabwe and Democratic Republic of Congo, RDC) soon after the introduction of iodized salt. The 2 countries had access to iodized salt produced in Botswana, as well as 5 other countries in the region, namely Cameroon, Nigeria, Kenya, Tanzania, and Zambia. Therefore, a multicenter study was conducted in these 7 countries to evaluate whether the occurrence of iodine-induced hyperthyroidism (IM) after the introduction of iodized salt was a general phenomenon or corresponded to specific local situations in the 2 affected countries. Two or 3 areas with a past history of severe iodine deficiency that had recently been supplemented with iodized salt were selected in each of the 7 countries. The prevalence of goiter was determined in 4423 schoolchildren in these areas and the concentration of urinary iodine in 2258. Salt factories and health structures were visited for the evaluation of the quality of iodized salt and the possible occurrence of IM. The study showed that iodine deficiency had been eliminated in all areas investigated, and that the prevalence of goiter had markedly decreased since the introduction of iodized salt. This is a remarkable achievement in terms of public health. However, some areas were now exposed to iodine excess due mostly to a poor monitoring of the quality of the iodized salt and of the iodine intake of the population. In these areas or countries, IM occurred only when the introduction of iodized salt had been of recent onset (