| Iodine Deficiency Disorders (IDD) is a kind of worldwide epidemic disease.In1980s, it has recognized in China that iodine deficiency can not only lead toendemic goiter may also lead to poor brain development, so that the populationquality reduced in the areas of iodine deficiency.Summit Conference of United Nations passed a declaration in1990thatrequested the elimination of IDD on a global scale before the year of2000.From1959, the implementation of salt iodization control program has beenstarted in some areas of China. And the program of universal salt iodization(USI) carried out in1995has played an essential role in the process of theenhancement of Chinese physical quality, and the results also showed that theeffects on anti-IDD was obviously by this program. With the improvement ofour living standards and iodine intake, USI also caused a number of problems,such as the increased incidence of thyroid diseases, unusual goiter rate and urinary iodine level, etc. induced by abnormal thyroid function or excess iodinecontent. While these problems are not only due to increasing iodine intake, maybe also genetic, autoimmune, environmental factors (infection, stress), but theyled to some questions on iodized salt by the endemic control center and hospitalclinicians. Iodine dosage problem has gradually become one of the public healthproblem cannot to be ignored in China.According to the iodine intake standard of international organizations in2001, the level of urinary iodine exceed the normal value after theadministration of USI in China. The results of national iodine deficiencydisorders monitoring in1999shown that the median urinary iodine of8-10yearsold children in31provinces was306.8μg/L which exceeded the requirementsof eliminated standard on iodine deficiency disorders, and the prevalence ofgoiter was remained on8.8%which did not be lower than5%of the standardsprescribed by the international organizations. Some academic debates anddiscussion on the abnormal level of urinary iodine and goiter rate lead to doubtsand complaints on the universal salt iodization. Some even put forward theimplementation of universal salt iodization has resulted in our iodine-inducedthyroid swelling (iodine-induced goiter, IIG) popular. Therefore, it is necessaryto fully understand and evaluate the effect of universal salt iodization on thyroiddisease, and provide some theoretical basis for the development of saltiodization policies and standards.In order to disscuss extensively on the effects of universal salt iodization tothe constitution of thyroid disease. The information of patients with thyroiddisease of a large hospital in32years was collected. Disease diagnosis is basedon the first discharg diagnosis of medical records. The information of gallbladder surgery patients, which has nothing to do with iodine level, was also included for the comparative study. The number of hospitalizations, diseasepedigree, and disease ranking, surgical rate and other data were analyzed beforeand after universal salt iodization. The main contents of present study include:1. Review and analysis of the literature. Comprehensively overviewed thehistory of the universal salt iodization, and analyzed the four timeperiods of the iodine dosage adjustment and the impact of universal saltiodization for thyroid disease.2. Extraction and collection of the data. The medical records informationof thyroid disease patients and gall bladder surgery patient in thehospital from1979to2010were collected. The discharge diagnosis ofthyroid disease was coded and converted ICD-9codes to ICD-10codes.3. Data analysis: The information of patients of the past32years wasanalyzed in the following6aspects. Through the comparison ofchanging tendency between thyroid disease and gall bladder disease,we try to analyze and discusse the effects of universal salt iodization onthyroid disease more rationally. The results are as followed：(1) The annual growth rate of the number of thyroid patients admitted bythe hospital changed before and after USI. From1979to1995, thenumber of hospitalized patients with an average annual growth rateof2.98%in the first17years before the administration ofuniversal salt iodization, and the rate was11.79%after that.(2) The spectrum of thyroid disease was influenced by excess iodine intake.The growth rate of nodular goiter patients was the highest, and thatof thyroid malignancies patients was higher than thyroid tumors.The rate of hyperthyroidism increased gradually. (3) Gender differences existed in the hospital constitution of thyroiddisease. There are10,128hospitalized patients due to thyroiddisease including28.1%male and71.9%female in the past32years. It was different in the constitution of gender that the numberof female thyroid benign nodular goiter was higher than male, butthe proportion of male was with higher hyperthyroidism thanfemale (P <0.05).(4) The priority of thyroid hospitalized patients changed before and afterUSI, while there are gender differences. For the number of patientswas with the following sequence: non-toxic goiter, thyroid andhyroid malignanc.(5) The surgery times of patients changed before and after USI. Thesurgery rate of all thyroid patients was69%in the past32yearsand keeps stable between1979to1995, but with sharp increasefrom2000to2010.(6) The growth of surgery rate of thyroid patients changed being comparedwith gall bladder patients. From1986to2005, there was nodifference in the growth of surgery rate between thyroid and gallbladder patients, but the rate of thyroid disease was much higherthan that of gall bladder disease from2006to2010.Based on the research data above, the program of universal salt iodizationaffected the number and constitution of thyroid hospitalized patients obviously,and plays an important role in the increased prevalence of thyroid disease. |
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