全球碘营养联盟主席Zimmermann:碘缺乏是甲状腺癌的危险因素
发布时间:2017-06-19 浏览次数:

全球碘营养联盟/国际控制碘缺乏病理事会(IGN/ICCIDD)现任主席、瑞士学者Michael Zimmermann教授于2015年在《Thyroid Research》上撰文指出:碘缺乏是甲状腺癌的危险因素,特别是滤泡状甲状腺癌的危险因素,可能还是未分化甲状腺癌的危险因素。


全球碘营养联盟主席Zimmermann:碘缺乏是甲状腺癌的危险因素

此文摘要的中文译文如下:


甲状腺癌是最常见的内分泌恶性肿瘤,甲状腺癌的发生率在大多数国家都正在增长。虽然人群碘摄入量的不同是良性甲状腺疾病的原因之一,但是碘摄入量对甲状腺癌的作用仍不清楚。

为此,我们回顾了动物研究中碘摄入量与甲状腺癌的关系、碘摄入量与分化和未分化甲状腺癌的对比研究、尸检报告中碘摄入量与甲状腺癌和隐匿型甲状腺癌的死亡率,以及甲状腺癌与海产品和奶制品中摄入的碘关系的病例对照和队列研究。

我们运用meta技术分析了收集自病例对照研究中涉及总碘摄入量与甲状腺癌关系的研究报告。并回顾了切尔诺贝利核事故后,涉及辐射暴露与甲状腺癌关系的研究报告。


最后,现有收集到的证据表明:碘缺乏是甲状腺癌的危险因素,特别是滤泡状甲状腺癌的危险因素,可能还是未分化甲状腺癌的危险因素。

支持本结论的依据如下:

1,碘缺乏动物的实验数据一致表明,碘缺乏令甲状腺癌增加(主要是滤泡状甲状腺癌)

2,有可信的发病机理支持,即缺碘引发了TSH(促甲状腺激素)的慢性刺激(这是甲状腺癌发生的机理之一,译者);

3,补碘防治碘缺乏病之前和之后的数据一致表明,补碘减少了滤泡状甲状腺癌和未分化甲状腺癌的发生

4,从2000年到2010年,十年间的碘摄入量变化与甲状腺癌死亡率间没有直接联系;

5,尸解研究发现,微小癌比例的增长与碘摄入缺乏有关;

6,病例对照研究提示,碘摄入总量的增加降低了甲状腺癌发生的危险。



此文的英文摘要:

Thyroid cancer (TC) is the most common endocrine malignancy and in most countries, incidence rates are increasing. Although differences in population iodine intake are a determinant of benign thyroid disorders, the role of iodine intake in TC remains uncertain. We review the evidence linking iodine intake and TC from animal studies, ecological studiesof iodine intake and differentiated and undifferentiated TC, iodine intake and mortality from TC and occult TC at autopsy, as well as the casecontrol and cohort studies of TC and intake of seafood and milk products.

We perform a new meta-analysis of pooled measures of effect from case–control studies of total iodine intake and TC. Finally, we examine the post-Chernobyl studies linking iodine status and risk of TC after radiation exposure. The available evidence suggests iodine deficiency is a risk factor for TC, particularly for follicular TC and possibly, for anaplastic TC.

This conclusion is based on:

a) consistent data showing an increase in TC (mainly follicular) in iodine deficient animals;

b) a plausible mechanism (chronic TSH stimulation induced by iodine deficiency);

c) consistent data from before and after studies of iodine prophylaxis showing a decrease in follicular TC and anaplastic TC;

d) the indirect association between changes in iodine intake and TC mortality in the decade from 2000 to 2010;

e) the autopsy studies of occult TC showing higher microcarcinoma rates with lower iodine intakes; and

f) the case control studies suggesting lower risk of TC with higher total iodine intakes.