我国新疆的碘缺乏地区常伴有严重的铁缺乏。铁缺乏对甲状腺功能有一定的影响。碘缺乏合并铁缺乏时，如何影响甲状腺功能及其严重性的研究尚不深入。本课题采用人群研究、动物实验和离体实验相结合的设计，探讨了碘缺乏、铁缺乏和碘铁联合缺乏对甲状腺功能的损害作用及其发病机理，观察单纯补碘、单纯补铁和碘铁联合补充干预对甲状腺肿和甲状腺功能的改善和治疗作用。结果发现，铁缺乏可影响碘营养不足在碘营养不足的人群中，铁缺乏可影响甲状腺功能，增加亚临床甲减和低T4血症的发生率；动物实验表明碘缺乏、铁缺乏均可导致甲状腺功能减低，两者有协同作用，但碘缺乏的作用更加明显，碘缺乏、铁缺乏所导致的甲状腺功能变化机制不同：碘缺乏主要是由于生成甲状腺激素原料不足造成，可通过TSH反馈调节使TPO活性代偿性升高；铁缺乏则主要由于TPO活性降低，阻碍甲状腺激素的生成过程。肝脏脱碘酶活性的变化主要受血中TSH影响。碘铁补充治疗可纠正上述甲状腺功能异常。体外实验对前述结论进行了验证。本课题初步阐明了铁缺乏在碘缺乏病发病中的作用和意义；提出在碘缺乏伴铁缺乏病区应实施碘铁联合干预策略，对西部贫困地区消除碘缺乏病的工作有重要意义。

Severe iron deficiency exists in Xinjiang of China, a iodine dificiency area. To some extent, iron deficiency can affect thyroid function. How does iodine and iron combined deficiency affect thyroid function and how about its severity? Which is not well known. Our subject is to research on the effects of iodine deficiency, iron deficiency and iodine and iron combined deficiency on thyroid, and its mechanism. In this project, we designed the program with human, animal, and cell samples. Therapeutical effects of iodine and /or iron supplement on goiter and disfunction of thyroid were considered. The results showed in iodine deficiency population iron deficiency could impact thyroid function, including hypothyroidism and hypothyroxinemia. Research on animals showed that both iodine deficiency and iron deficiency could result in hypothyroidism, and there was concerted effect of iodine deficiency and iron deficiency, but iodine deficiency was a stronger factor. Different mechanism involved in hypothyroidism resulting from iodine deficiency and iron deficiency respectively. The former was because of lack of raw material for thyroid hormones synthesis and led to compensatory increase of TPO activity by the higher TSH, but the latter was due to lower TPO activity and retard of thyroid hormones synthesis. iodine and /or iron supplement could rectify the abnormal of throid function above. Activity of D1 in liver was mainly regulated by TSH. Experiments in vitro confirmed conclusion above. This project enunciated effects of iron deficiency in pathogenesis of IDD, and brought forward the strategy that treatment of iodine and iron combined supplement should be carried out in iodine and iron combined deficiency areas. Which is important and essential for elimination of IDD in western poor region of China.

我国新疆的碘缺乏地区常伴有严重的铁缺乏。铁缺乏对甲状腺功能有一定的影响。碘缺乏合并铁缺乏时，如何影响甲状腺功能及其严重性的研究尚不深入。本课题采用人群研究、动物实验和离体实验相结合的设计，探讨了碘缺乏、铁缺乏和碘铁联合缺乏对甲状腺功能的损害作用及其发病机理，观察单纯补碘、单纯补铁和碘铁联合补充干预对甲状腺肿和甲状腺功能的改善和治疗作用。结果发现，铁缺乏可影响碘营养不足在碘营养不足的人群中，铁缺乏可影响甲状腺功能，增加亚临床甲减和低T4血症的发生率；动物实验表明碘缺乏、铁缺乏均可导致甲状腺功能减低，两者有协同作用，但碘缺乏的作用更加明显，碘缺乏、铁缺乏所导致的甲状腺功能变化机制不同：碘缺乏主要是由于生成甲状腺激素原料不足造成，可通过TSH反馈调节使TPO活性代偿性升高；铁缺乏则主要由于TPO活性降低，阻碍甲状腺激素的生成过程。肝脏脱碘酶活性的变化主要受血中TSH影响。碘铁补充治疗可纠正上述甲状腺功能异常。体外实验对前述结论进行了验证。本课题初步阐明了铁缺乏在碘缺乏病发病中的作用和意义；提出在碘缺乏伴铁缺乏病区应实施碘铁联合干预策略，对西部贫困地区消除碘缺乏病的工作有重要意义。