碘与甲状腺疾病

碘是人体必需的微量元素,是合成甲状腺激素（thyroid hormone,TH）的主要原料。人体内的碘主要从饮水及食物中获取。碘的摄入缺乏或过量,不仅对TH的合成及分泌有至关重要的影响,而且与甲状腺形态及多种甲状腺疾病的发生、发展及转归密切相关。加碘盐的推广有效预防了碘缺乏可能引起的相关疾病;而碘过量导致的甲状腺疾病谱和发病率的急剧变化,也引起各界高度重视。流行病学调查表明,碘的摄入量与甲状腺功能亢进、自身免疫性甲状腺炎、甲状腺功能减退、甲状腺肿大和甲状腺癌等疾病的发病率密切相关。针对碘的相关生物学问题,对近年来的基础研究和人群研究进行综述,希望借此抛砖引玉,引起相关部门的重视,提高人民群众对碘营养的科学认识水平。     

Inhibition of thyroid-restricted genes by follicular thyroglobulin involves iodinated degree

Follicular thyroglobulin (TG) reflects the storage of both iodine and thyroid hormone. This is because it is a macromolecular precursor of thyroid hormone and organic iodinated compound in follicular lumen. Thus, it may have an important feedback role in thyroid function. In this study, monolayer cells were cultured and follicles were reconstituted with primary pig thyroid cells in vitro. Reconstituted follicles were treated with iodine and methimazole (MMI), a drug that blocks iodine organification and reduces the degree of TG iodination in follicular lumen. The high degree of iodinated TG in follicular lumen was observed to inhibit thyroid-restricted gene expression. To confirm this finding, monolayer thyroid cells were treated with a different degree of TG iodination at the same concentration. These iodinated TG were extracted from reconstituted follicles of different groups. In this manner, this study provides firsthand evidence suggesting that follicular TG inhibits the expressions of thyroid-restricted genes NIS, TPO, TG, and TSHr.     

Iodine Deficiency Among Hypothyroid Patients Living in Jeddah

The objective was to determine the prevalence of iodine deficiency among hypothyroid patients and the effect of dietary goitrogens on indices of iodine and thyroid status. This is a case-control study of 106 subjects who were recruited from King Abdulaziz University Hospital, Jeddah. Blood and urine were collected for serum thyroid hormones, thyroid autoantibodies, thyroglobulin (Tg) and urinary iodine concentration (UIC). Dietary iodine and goitrogenic food intake were assessed by questionnaire. Using World Health Organization (WHO) cutoff values for UIC, both controls and cases were iodine deficient (85% and 83%, respectively). Furthermore, dietary iodine was deficient in 23% of controls and 36% of cases. In cases, there was a positive association between UIC levels and serum thyroid stimulating hormone (r = 0.405, p < 0.01) and a negative association with serum fT₄ (r = −0.358, p < 0.01). Serum Tg antibody titers were also positively associated with dietary iodine (r = 0.328, p < 0.05). Patients with elevated serum autoantibodies had lower UIC and dietary iodine than those with normal serum autoantibodies. UIC was associated with dietary goitrogens including turnip (r = 0.280, p < 0.05) and pine (r = 0.289, p < 0.05) among cases. Iodine deficiency is common and the consumption of dietary goitrogens is high among euthyroid and hypothyroid subjects living in Jeddah.     

Iodine and breast cancer A 1982 update

Research has been directed towards investigating the role of the trace element, iodine, in breast cancer etiology, diagnosis, and therapy. In many controled studies, iodine has been established as a requirement for breast tissue normalcy, since deficiency of the element results in histopathology consistent with dysplasia and atypia in rodents. Clinically severe hyperplasia and fibrocystic disease is seen in the breasts of women who have low iodine levels. These precancerous lesions result in a high-risk state as well as persistent symptomatology in women. Iodine replacement therapy has been shown to be efficacious in reducing these conditions in clinical trials. Basic research is directed towards intracellular pathways and metabolism for breast iodide, emulating those seen in the thyroid gland. Thus, using a rat model, iodine intracellular organification is being correlated with risk factors for breast cancer including early and late pregnancies, onset of puberty, menopause, and aging. From our research there is significant evidence that iodine maintains homeostasis in reproductive, effected tissues and is responsible for breast tissue growth and development.     

Prepartal wheat grain feeding improves energy and calcium status of periparturient Holstein heifers

Wheat grain (WG) is unique in possessing extensive starch and nitrogen fermentation (i.e. >85% in ground and steam-processed WG), low cation-anion difference and high-intake properties, making it a potentially useful prepartal dietary choice. The objective was to determine the effects of WG provision to pre-partum first-calf heifers on metabolic, health and productive criteria during the transition period. WG replaced barley grain that was commonly used earlier. Fifteen Holstein heifers at 31 ± 6 days pre partum were blocked based on expected calving date and assigned to three treatments or feeding totally mixed rations containing either (i) barley grain (13.8%) and wheat bran (6.1%), (ii) 10% WG (WG10) or (iii) 18% WG (WG18; dry matter (DM) basis) from 31 days pre partum until calving. In replacing WG for barley grains, some changes in WG use and slight changes in soybean and cottonseed meals use were made to properly formulate balanced rations for net energy for lactation, CP, calcium and P. Prepartal diets contained no supplemental anionic salts. Cows were monitored until 21-day post partum and received the same early lactation diet. The prepartal provision of WG and related dietary changes reduced urine pH at 7-day pre partum, and elevated blood calcium and glucose at 7-day pre partum and at 3-day post partum. Milk fat and protein yields were increased during the 21 days post partum by prepartal WG provision and related diet changes. Blood albumin, globulins, total proteins and urea concentrations were similar among treatments. Feeding diets with WG did not affect body condition score, calving difficulty, calf weight, placenta weight and the time interval from calving to placenta expulsion. It is suggested that prepartal provision of WG with necessary dietary changes led to simultaneous improvements in energy and calcium status of the heifers experiencing their first periparturient phase without compromising parturition status.     

A Comparative Toxicological Assessment of Perchlorate and Thiocyanate Based on Competitive Inhibition of Iodide Uptake as the Common Mode of Action

Thiocyanate and perchlorate are known to competitively inhibit thyroidal iodide uptake at the sodium-iodide symporter. Estimates of their relative potencies have recently been refined; thiocyanate is 15 times less potent than perchlorate on a serum concentration basis. Numerous studies have been published relating serum thiocyanate concentrations (or surrogate measures) with thyroid function in various populations including pregnant women and neonates in regions with varying degrees of iodine deficiency. Fifteen published studies were located that relate serum thiocyanate concentrations with thyroid function. In the absence of severe iodine deficiency or iodine excess, adverse thyroidal effects occur with chronic serum thiocyanate concentrations ≥ 200 μ mol/L whereas non-adverse effects are observed with concentrations in the range of 65–85 μ mol/L. No adverse or non-adverse effects are observed at serum concentrations below 50 μ mol/L, even among sensitive subpopulations. Recently, studies relating serum perchlorate concentrations with perchlorate dose have become available, thus making it possible to predict the perchlorate dose associated with a serum perchlorate concentration. Serum thiocyanate concentrations found to induce non-adverse or adverse thyroid effects can thereby be used to predict the perchlorate concentration and thus the perchlorate dose that would be expected to induce similar effects. To place a perspective on environmental perchlorate exposure, a serum thiocyanate concentration of 50 μ mol/L is equivalent to a serum perchlorate concentration of 3.3 μ mol/L in terms of iodine uptake inhibition. This serum perchlorate concentration would require a perchlorate dose of 0.27 mg/kg-day, or a drinking water equivalent level of 9 mg/L using standard default assumptions of a 70 kg adult drinking 2 liters of water daily.     

Iodine and zinc, but not selenium and copper, deficiency exists in a male Turkish population with endemic goiter

Although endemic goiter has been shown to have a high prevalence in Turkey, little is known about the concentration of urinary iodine, plasma selenium (Se), copper (Cu), and zinc (Zn) in these patients. We studied on 140 male patient with endemic goiter (mean age: 22.2 ± 0.19 yr) and 140 healthy male subjects (mean age: 21.8 ± 0.28 yr). Daily urinary iodine excretion was determined by the ionometric method. Plasma Se, Zn, and Cu were determined by using atomic absorption spectrometry. Daily urinary iodine excretion was found to be significantly lower in the patient group (38.7 ± 2.26 μg/d) than that of controls (50.73 ± 2.56 μg/day,p = 0.001). Plasma Zn concentrations were also found to be significantly lower in the patient group (1.04 ± 0.03 μg/mL) than that of controls (1.16 ± 0.02 μg/mL,p = 0.001). No significant difference was determined in Se and Cu concentrations between the patient and control groups. Our study shows that a moderate iodine deficiency exists in both patients with endemic goiter and control subjects, which indicates the important role of iodine deficiency in the etiopathogenesis of endemic goiter in Turkey. Zinc deficiency may also contribute to the pathogenesis of endemic goiter. However, Se and Cu do not seem to have any role in the etiopathogenesis of endemic goiter in Turkey. A community-based iodine fortification program throughout the country may be proposed to take over the problem, which also can prevent the contributing effects of other element deficiencies that occur when iodine deficiency is the prevailing factor.     

Iodine speciation in human serum by reversed-phase liquid chromatography-ICP-mass spectrometry

Reversed-phase liquid chromatography-inductively coupled plasma mass spectrometric hyphenation was used for iodine speciation in human serum. First investigations showed that iodine species nearly quantitatively were eluted in the void volume. The result indicated that protein-linked thryoid hormones were not interacting with the stationary phase, thus being not retained. Investigations were performed about T4-TBG (thyroxin-thyroxin-binding globulin) complex generation and its retention during chromatography. It was shown that T4-TBG was not retained on the column. Therefore, a protease treatment was introduced for serum sample preparation. The analysis of “normal” sera (after protease) gave reasonable results lying in the range published in literature: I-:11; di-iodothyrosine (DIT): 2.1; mono-iodothyrosine (MIT): 1.6; reversed tri-iodothyronine (rT3): 3.9; T3: 5.9; T4: 60; each micrograms iodine per liter. The method also proved to recognize abnormalities in a pathologic serum, having rT3 as the predominant species. In this case the method obviously was superior compared to standard immunoassay methods, as it is monitoring the iodine in the species (physiologically active iodine species), whereas immunoassay methods may sometimes detect deiodinated (inactive) compounds.     

Effect of different feeding strategies on lactation performance of Holstein and Normande dairy cows

The dairy farming systems of Western Europe are based on a simple feeding system composed of grazed and preserved grass, maize silage and concentrates in variable proportions. There is, nevertheless, a great diversity of feeding strategies between dairy farms. Over 5 years, we studied the direct and delayed effects of four feeding strategies on the lactation and reproduction performances of Holstein and Normande dairy cows. The four feeding strategies (denoted Hh, Hl, Lh and Ll) correspond to two total mixed rations applied in winter from calving to turnout (maize silage with 30% concentrate or grass silage with 15% concentrate), which were subsequently crossed with two levels of concentrate supplementation at grazing to 210 days. Each year, 72 dairy cows managed in grouped winter calving were assigned to the four strategies. Finally, the results of 325 lactations and 295 inseminated cows were analysed. The four strategies resulted in considerable variation in nutrient intake and, in particular, in differences in concentrates consumed, with values of 1407, 1026, 773 and 392 kg dry matter per cow for strategies Hh, Lh, Hl and Ll, respectively. Total milk production (7567, 7015, 6720 and 6238 kg per cow for treatments Hh, Lh, Hl and Ll, respectively), milk fat content (39.0, 37.1, 40.3 and 38.5 g/kg, respectively), milk protein content (33.0, 31.8, 33.1 and 31.6 g/kg, respectively), and the character of the lactation and body condition curves were all highly sensitive to the strategies applied. While no significant interaction was detected on total lactation yield, the Holstein cows reacted more dramatically to each dietary change at each period, compared with the Normande cows. Winter feeding did not affect the production of milk at pasture whereas, at pasture, the milk from the cows of the H groups in winter was higher in milk fat and protein content. Reproduction performance was unaffected by feeding strategy. The Holstein cows, well fed and producing the most milk (Hh and Hb), had the lowest rate of success at first artificial inseminations (21.5%). The dual-purpose Normande cows had a pregnancy rate 10 points higher than Holstein cows. This comparison of strongly contrasting feeding strategies confirms the immediate reactivity of dairy cows (in terms of milk performance and body condition) to variations of nutritive intake throughout lactation, with a weak carryover effect from feeding levels early in lactation. In contrast, reproduction performance was less sensitive to variation in nutrient supply.     

Propensity Score-Matched Analysis to Identify Pathways Associated with Loss of Sodium Iodide Symporter in Papillary Thyroid Cancer

Sodium iodide symporter (NIS) expression in thyroid follicular cells plays an important role in normal physiology and radioactive iodine therapy for thyroid cancer. Loss of NIS expression is often seen in thyroid cancers and may lead to radioiodine refractoriness. To explore novel mechanisms of NIS repression beyond oncogenic drivers, clinical and RNA-seq data from the thyroid cancer dataset of The Cancer Genome Atlas were analyzed. Propensity score matching was used to control for various genetic background factors. We found that tumoral NIS expression was negatively correlated with tumor size. Additionally, low NIS expression was the only factor associated with recurrence-free survival in a Cox multivariate regression analysis. After matching for clinicopathologic profiles and driver mutations, the principal component analysis revealed distinct gene expressions between the high and low NIS groups. Gene set enrichment analysis suggested the downregulation of hedgehog signaling, immune networks, and cell adhesions. Positively enriched pathways included DNA replication, nucleotide excision repair, MYC, and Wnt/β-catenin pathways. In summary, we identified several potential targets which could be exploited to rescue the loss of NIS expression and develop redifferentiation strategies to facilitate radioactive iodine therapy for thyroid cancer.     

Iodine nutrition status amongst neonates in Kangra district,Himachal Pradesh

Iodine deficiency (ID) is an endemic health problem in Kangra district, Himachal Pradesh (HP) state. ID leads to mental retardation, deaf mutism, squint, dwarfism, spastic diplegia, neurological defects and congenital anomalies. Iodine nutrition status amongst neonates can be assessed by estimating thyroid stimulating hormone (TSH). The present study was conducted with an objective to assess the iodine nutrition status amongst Neonates in Kangra district, HP. All of the hospitals in the district which provide obstetric services were enlisted, of which three were selected for this survey. A total of 613 umbilical cord blood samples of neonates were collected on filter paper and analyzed for TSH. WHO (2007) reported that that a <3% frequency of TSH concentrations above 5 mIU/L in samples collected 3–4 days after birth indicates iodine sufficiency in a population. In our study we found that 73.4% of the neonates had TSH levels of more than 5 mlU/l, thus indicating ID in the population studied. Iodine deficiency continues to be a public health problem in Kangra district, Himachal Pradesh.     

Management of adenomas and toxic multinodular goiters with Iodine 131

In accordance with all the guidelines of the various international scientific societies, treatment using radioiodine (RAI) of autonomous toxic adenomas and toxic multinodular goiters is highly recommended and its effectiveness its efficacy has now been widely demonstrated and established. RAI treatment is effective to normalise thyroid function, remove functional autonomy and reduce thyroid volume. According to published data on several thousand patients treated with RAI, the success rates ranges between 85% and 100%. Moreover, with more than 70 years of experience, this treatment does not present any particular risk for patients. However, as regards pregnancy, there are no absolute contra-indications to radioiodine treatment. To date, these results include a relatively high rate of hypothyroidism in the long term and approximately one patient out of five treated, will require thyroid hormone substitution. It would be more effective to harmonise and work up on dosimetric personalized models allowing the calculation of the effective dose to be delivered to the autonomous nodule to be treated while preserving the normal thyroid parenchyma in order to optimise the patient's outcome and to favor extensive euthyroidism.     

Representing infant feeding: content analysis of British media portrayals of bottle feeding and breast feeding

ObjectiveTo examine how breast feeding and bottle feeding are represented by the British media.DesignContent analysis.Subjects Television programmes and newspaper articles that made reference to infant feeding during March 1999.SettingUK mass media.ResultsOverall, 235 references to infant feeding were identified in the television sample and 38 in the newspaper sample. Bottle feeding was shown more often than breast feeding and was presented as less problematic. Bottle feeding was associated with “ordinary” families whereas breast feeding was associated with middle class or celebrity women. The health risks of formula milk and the health benefits of breast feeding were rarely mentioned.ConclusionsThe media rarely present positive information on breast feeding, even though this feeding practice is associated with the most health benefits. Health professionals and policy makers should be aware of patterns in media coverage and the cultural background within which women make decisions about infant feeding.     

Infradian rhythmicity in lactogenic hormone (prolactin,growth hormone,cortisol and thyroid hormone) secretion throughout the lactation cycle in mithun cows (Bos frontalis): variation among strains

The role of lactogenic hormones (prolactin, growth hormone, cortisol and thyroid hormone) on lactation yield in Mithun cows as well as their rhythmicity throughout the lactation cycle were studied in Mizoram (n = 4) and Nagaland (n = 7) strain of mithun (Bos frontalis). Blood samples were collected from all the animals from the day of calving to the complete dry off at an interval of 15 days. All the hormones were estimated in the serum by commercially available ELISA kits. Plasma level of cortisol (μg/dl), growth hormone (GH, in ng/ml), prolactin (PRL, in μIU/ml), triiodothyronine (T₃, in nmol/μl) and thyroxin (T₄, in ng/ml) were 20.84 ± 0.29, 28.08 ± 0.56, 9.87 ± 0.20, 27.82 ± 0.56 and 51.33 ± 0.48, respectively, in mithun irrespective of strains during the lactation period. Levels of all the hormones varied significantly (p ≤ 0.01) during different days of lactation cycle but, there was no significant difference among strain. Levels of PRL, GH, cortisol and T₃ were significantly (p < 0.01) higher around calving and declined sharply. The hormones remained in almost steady state during mid-lactation and declined during late lactation. All the hormones stated above were positively correlated with lactational yield thus their role on lactogenesis and galactopoiesis was established.     

Native American Exposure to 131Iodine from Nuclear Weapons Testing in Nevada

A great deal of work has been done to reconstruct doses from Nevada Test Site fallout, yet the unique exposures of Native American communities continue to be neglected. It is possible to estimate the exposures of these communities through a process of collaborative information gathering and analysis. This article builds on a previous exercise that demonstrated the substantial doses received through the consumption of contaminated game. The updated model includes new information on the deposition of ¹³¹iodine, an assessment of the neonatal thyroid doses received through breast milk, an exploration of the effect of population mobility on dose estimates, and estimates of thyroid cancer risk. All thyroid dose estimates from the rabbit exposure pathway are comparable in magnitude to National Cancer Institute comprehensive dose estimates that assume exposure to contaminated milk from backyard cows and goats. Dose estimates from the rabbit exposure pathway are larger than estimated doses from store-bought milk by an average factor of six. Taking historical population mobility patterns into account may result in slightly lower estimates of dose. The quantification of this exposure pathway is considered be an advance toward a more appropriate dose reconstruction for communities with diets high in wild game.     

超声诊断结节性甲状腺肿合并甲状腺微小乳头状癌的价值

目的:探讨超声诊断结节性甲状腺肿合并甲状腺微小乳头状癌的价值。方法:2010年1月至2014年12月选择来我院进行诊治的结节性甲状腺肿患者80例,病理诊断为结节性甲状腺肿合并甲状腺微小乳头状癌30例(恶性组)和单纯结节性甲状腺肿50例(良性组),都进行常规二维超声、超声弹性成像和超声造影检查。结果:恶性组结节多呈现单发、内部低回声、钙化形态不规则特征,与良性组对比差异有统计学意义(P0.05)。恶性组病灶内的血流最小流速明显小于良性组(P0.05),阻力指数与搏动指数明显高于良性组(P0.05)。良性组弹性成像多为2~3分,恶性组多为4~5分,组间对比差异都有统计学意义(P0.05)。恶性组的造影剂平均通过时间明显少于对照组(P0.05),两组的显影时间、达峰时间、峰值强度对比差异无统计学意义(P0.05)。结论:常规超声诊断结节性甲状腺肿合并甲状腺微小乳头状癌的良恶性有一些特异性的征象,超声弹性成像与超声造影可为临床诊断提供补充,有助于提高甲状腺微小乳头状癌的诊断准确率。