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首页> 外文期刊>The American Journal of Clinical Nutrition: Official Journal of the American Society for Clinical Nutrition >Vitamin A supplementation in iodine-deficient African children decreases thyrotropin stimulation of the thyroid and reduces the goiter rate
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Vitamin A supplementation in iodine-deficient African children decreases thyrotropin stimulation of the thyroid and reduces the goiter rate

机译：在非洲缺碘儿童中补充维生素A可减少甲状腺促甲状腺激素的刺激并降低甲状腺肿大率

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BACKGROUND: Vitamin A (VA) deficiency (VAD) and iodine deficiency (ID) often coexist in children in Africa. VAD may affect thyroid function and the response to iodine prophylaxis. OBJECTIVE: The aim was to investigate the effects of supplementation with iodine or VA alone, and in combination, in children with concurrent VAD and ID. DESIGN: A 6-mo randomized, double-blind, 2 x 2 intervention trial was conducted in 5-14 y-old South African children (n = 404), who, on average, had mild-to-moderate VAD and ID. At baseline and after 3 mo, children received 1) iodine (191 mg I as oral iodized oil) + placebo (IS group), 2) VA (200000 IU VA as retinyl palmitate) + placebo (VAS group), 3) both iodine and VA (IS+VAS group), or 4) placebo. At baseline, 3 mo, and 6 mo, urinary iodine (UI), thyroid volume, thyrotropin (thyroid-stimulating hormone; TSH), total thyroxine (TT(4)), thyroglobulin, serum retinol (SR), and retinol-binding protein (RBP) were measured. RESULTS: SR and RBP increased significantly with VA supplementation (P < 0.05). For UI, SR, and RBP, there were no significant treatment interactions between iodine and vitamin A. The 3-factor and all three 2-factor interactions were significant for thyroid volume, TSH, and thyroglobulin (P < 0.001), whereas none of these interactions were significant for TT(4). There was a clear effect of VAS without IS on TSH, thyroglobulin, and thyroid volume; all 3 variables decreased significantly (P < 0.05). CONCLUSIONS: Iodine prophylaxis is effective in controlling ID in areas of poor vitamin A status. VA supplements are effective in treating VAD in areas of mild ID and have an additional benefit-through suppression of the pituitary TSHbeta gene, VAS can decrease excess TSH stimulation of the thyroid and thereby reduce the risk of goiter and its sequelae.
机译：背景：维生素A（VA）缺乏症（VAD）和碘缺乏症（ID）通常在非洲儿童中共存。 VAD可能会影响甲状腺功能以及对碘预防的反应。目的：研究单独补充碘或VA，以及联合使用对补充VAD和ID的儿童的影响。设计：对5-14岁的南非儿童（n = 404）进行了为期6个月的随机，双盲，2 x 2干预试验，他们平均具有轻度至中度的VAD和ID。在基线和3个月后，儿童接受1）碘（口服碘化油191 mg I）+安慰剂（IS组），2）VA（200000 IU VA棕榈酸视黄酯）+安慰剂（VAS组），3）碘和VA（IS + VAS组），或4）安慰剂。基线时分别为3 mo和6 mo，尿碘（UI），甲状腺容量，促甲状腺激素（促甲状腺激素; TSH），总甲状腺素（TT（4）），甲状腺球蛋白，血清视黄醇（SR）和视黄醇结合测定蛋白质（RBP）。结果：随着VA的补充，SR和RBP显着增加（P <0.05）。对于UI，SR和RBP，碘和维生素A之间没有显着的治疗相互作用。3因子和所有3个2因子相互作用对甲状腺容量，TSH和甲状腺球蛋白均具有显着意义（P <0.001），而这些相互作用对TT（4）具有重要意义。没有IS的VAS对TSH，甲状腺球蛋白和甲状腺容量有明显作用;所有三个变量均显着下降（P <0.05）。结论：在维生素A状况不佳的地区，碘预防可有效控制ID。 VA补充剂可有效治疗轻度ID区域的VAD，并具有通过抑制垂体TSHbeta基因的额外益处，VAS可减少甲状腺对TSH的过度刺激，从而降低甲状腺肿及其后遗症的风险。

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