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目的评价大骨节病与外环境碘和体内碘代谢的关系。方法检索中国期刊全文数据库、中国生物医学文献数据库、中文科技期刊全文数据库、万方数据库、PubMed、Cochrane图书馆、EMBASE和ISI Web of knowledge数据库,检索时间均为建库至2013年4月,纳入大骨节病病区与非病区的水、土壤和粮食中碘水平比较,大骨节病患儿与健康人群、病区与非病区健康人群血碘、尿碘、发碘、T3、T4和TSH水平比较的文献。采用RevMan5.10软件进行Meta分析。结果 6篇文献进入分析。①Meta分析结果显示,病区与非病区水碘(SMD=0.32,95%CI:-0.70～1.34)和小麦中碘水平(MD=-128.21,95%CI:-288.17～-31.74)差异无统计学意义。②大骨节病患儿与健康人群中尿碘(SMD=-0.01,95%CI:-0.25～0.24)、血清TT3(SMD=0.49,95%CI:-0.20～1.19)、TT4(SMD=0.31,95%CI:-0.24～0.85)和TSH水平(SMD=-0.35,95%CI:-1.04～0.35)差异无统计学意义,血清FT3(SMD=1.93,95%CI:0.80～3.07)和FT4水平(SMD=2.13,95%CI:0.67～3.59)高于健康人群。③病区和非病区健康人群血清FT3(SMD=0.54,95%CI:-0.53～1.61)、TT3(SMD=0.50,95%CI:-0.46～1.47)、TT4(SMD=0.80,95%CI:-0.22～1.81)、TSH(SMD=-0.35,95%CI:-2.43～1.72)和尿碘水平(SMD=-21.60,95%CI:-118.37～75.17)差异无统计学意义。结论现有证据显示,外环境中碘与大骨节病无明确关系,大骨节病患儿体内可能存在甲状腺激素的代谢紊乱。
Objective To evaluate the relationship between Kashin-Beck disease and external environment iodine and iodine metabolism in vivo. Methods The databases of Chinese Journal Full-text Database, Chinese Biomedical Literature Database, Chinese Science and Technology Periodical Full-text Database, Wanfang Database, PubMed, Cochrane Library, EMBASE and ISI Web of knowledge databases were retrieved. The search time was from the database to April 2013, Kashin-Beck disease and non-ward water, soil and food levels of iodine, children with Kashin-Beck disease and healthy population, ward and non-ward healthy population of iodine, iodine, iodine, T3, T4 and TSH level comparison of the literature. Meta-analysis was performed using RevMan5.10 software. Results Six articles entered the analysis. (1) The results of Meta analysis showed that there was no significant difference between iodine (MD = -128.21, 95% CI: -288.17 ~ -31.74) and water iodine (SMD = 0.32,95% CI: -0.70 ~ 1.34) Statistical significance. Urinary iodine (SMD = -0.01, 95% CI: -0.25-0.24), TT3 (SMD = 0.49, 95% CI: -0.20-1.19) and TT4 (SMD = 0.31 , 95% CI: -0.24-0.85) and TSH level (SMD = -0.35,95% CI: -1.04-0.35). There was no significant difference in serum FT3 (SMD = 1.93,95% CI: 0.80-3.07) FT4 level (SMD = 2.13, 95% CI: 0.67 ~ 3.59) was higher than healthy people. (3) TT3 (SMD = 0.50, 95% CI: -0.46-1.47), TT4 (SMD = 0.80, 95% CI: CI: -0.22-1.81), TSH (SMD = -0.35, 95% CI: -2.43-1.72) and urinary iodine (SMD = -21.60, 95% CI: -118.37-75.17). Conclusion The available evidence shows that there is no clear relationship between iodine and Kashin-Beck disease in the external environment. There may be metabolic disorder of thyroid hormone in children with Kashin-Beck disease.