摘要
目的 探讨三个不同碘摄入量地区人群硒营养状态与甲状腺功能异常的关系。方法盘山、彰武和黄骅地区分别为低碘、碘充足和高碘地区。将各地区流行病学调查中发现的 32 9例甲状腺功能异常者 (包括临床甲减、亚临床甲减、临床甲亢和亚临床甲亢 )以及同地区的 183名正常人作为研究对象。测定上述研究对象的血清硒、促甲状腺激素 (TSH)和游离甲状腺激素 (FT3及FT4 )水平。结果 盘山、彰武和黄骅地区正常对照组的血清硒中位数分别为 91 4、89 1和 83 2 μg L。各地区甲减、亚甲减及甲亢患者血清硒水平与正常对照比较均无差异 ;只有亚甲亢患者与对照组相比血清硒水平明显下降 (血清硒中位数分别为 82 6 μg L和 87 3μg L) ;且亚甲亢患者与正常对照比较FT3 FT4值下降 ,FT4值升高 ,FT3值无差异。未发现性别和年龄对正常人群血清硒水平有明显影响。各地区正常对照人群血清硒水平与TSH负相关 ,且血清硒≤ 80 μg L组与血清硒 80～ 10 0 μg L及 10 0～ 12 0 μg L组相比TSH值明显升高 (TSH中位数分别为 2 10、1 2 9和 1 2 8mU L)。彰武地区甲状腺过氧化物酶抗体 (TPOAb)阳性的甲状腺功能异常者血清硒与TPOAb滴度负相关 ,且高度阳性组 (TPOAb >6 0 0IU ml)血清硒水平显著低于TPOAb低度和中度阳性组
Objective To investigate the relationship between selenium status and thyroid dysfunction in 3 areas with different iodine intake.Methods An epidemiological research was performed in the rural communities of Panshan County (iodine-deficient area) and Zhangwu County (iodine-sufficient area), Liaoning Province, and Huanghua County, Hebei Province (iodine-excessive area).Serum selenium, TSH, FT3 and FT4 levels were examined in 329 patients with thyroid dysfunction (including clinical hypothyroidism, subclinical hypothyroidism, clinical hyperthyroidism and subclinical hyperthyroidism) and 183 normal inhabitants.Results The median serum selenium concentrations in Panshan, Zhangwu and Huanghua were 91.4, 89.1, and 83.2 μg/L respectively.There was no difference in serum selenium levels between the patients with subclinical hypothyroidism, clinical hypothyroidism, and clinical hyperthyroidism and their normal controls.The median serum selenium concentration of the subclinical hyperthyroidism patients was 82.6 μg/L, significantly lower than that of the normal controls (87.3 μg/L). The FT3/FT4 ratio was decreased, the FT4 level was increased in the subclinical hyperthyroidism patients in comparison with the normal controls, and no significant difference in FT3 level was found between them.No significant effect of sex and age was found on serum selenium level of normal inhabitants.In normal controls serum selenium was inversely correlated with serum TSH level, and the subjects with serum selenium ≤80 μg/L had the median TSH level of 2.10 mU/L, markedly higher than that of the subjects with the serum selenium of 80～100 μg/L (1.29 mU/L) and that of the subjects with the serum selenium of 100～120 μg/L (1.28 mU/L).For thethyroid dysfunction patients with positive thyroid auto-antibody (TPOAb) in Zhangwu County, the serum selenium was negatively associated with TPOAb level.The serum selenium level of the TPOAb highly positive group (TPOAb> 600 IU/ml)was 83.6 IU/ml, significantly lower than those of the TPOAb lowly positive group and TPOAb moderately positive group (83.6, 92.9 and 95.6 μg/L respectively). Conclusion No obvious effect of selenium status is found on the development of thyroid dysfunction in these three areas.But selenium deficiency can impair thyroid function by means of disturbing thyroid hormone metabolism and decreasing antioxidant ability of the thyroid.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2003年第23期2036-2039,共4页
National Medical Journal of China
基金
国家自然科学基金资助项目 ( 3 9970 3 5 0 )
