摘要
目的利用不同碘摄入量的3个农村社区甲状腺疾病的流行病学随访研究资料,探讨甲状腺功能正常人群甲状腺自身抗体发生和转归的规律和意义,以及环境因素碘对其的影响。方法1999年本研究组对轻度碘缺乏、超足量碘摄人和过量碘摄人的盘山、彰武和黄骅3个社区进行了甲状腺疾病的流行病学研究,2004年再次对同一人群进行了随访研究,前后采用同样方法采血清测定TSH、甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TgAb)和甲状腺球蛋白(Tg)水平,采尿样测定尿碘浓度及行甲状腺B超检查。结果(1)初访时TSH正常人群5年后TPOAb的阳性率在彰武社区较前升高,TgAb的阳性率在黄骅社区较前升高(均P＜0．05)。(2)初访时TSH正常但TPOAb或TgAb阳性者多维持抗体阳性,且抗体水平越高随访抗体阳性维持率越高。(3)随访发现1999年TPOAb和(或)TgAb阳性者较抗体阴性者更易发生甲状腺功能异常(P＜0．01),黄骅和彰武社区的抗体阳性者5年随访发生甲状腺功能减低的比率显著高于盘山社区,以黄骅社区最高(P＜0．05)。(4)彰武社区TPOAb阳性的5年累积发生率在3个社区中最高。黄骅社区TgAb阳性的5年累积发生率在3个社区中最高,与盘山相比差异有统计学意义(P＜0．05)。结论甲状腺自身抗体阳性者发生甲状腺功能异常的比率显著高于抗体阴性者,而碘摄入量增加能增加抗体阳性者发生甲减的危险性。持续处于过量碘摄入状态使甲状腺自身抗体阳性的发生率增加。
Objective To perform a follow-up survey about thyroid disorders in three rural communities with different iodine intakes in China, observe the incidences and natural outcomes of positive thyroid autoantibodies in euthyroid population, and also explore the influence of iodine intakes on these outcomes and autoantibodies. Methods In 1999, a cross-sectional study on thyroid disorders was performed in three rural communities of Pansan （ mild iodine deficient area）, Zhangwu （ more than adequate iodine intake area） and Huanghua （excessive iodine intake area） in China. The 5-year follow-up study was performed in 2004. Both in 1999 and 2004, serum levels of TSH, thyroid peroxidase antibody （TPOAh） and thyroglohulin antibody （TgAb） were measured with the same method. Iodine in urine and B ultrasound on thyroid were also examined. Results Among the euthyroid subjects with normal TSH level in 1999, an increased prevalence of positive TPOAb in Zhangwu and an increased prevalence of positive TgAb in Huanghua were observed in 2004 （ both P 〈 0.05）. Most of euthyroid subjects with positive TPOAb or positive TgAb in 1999 remained positive thyroid antibodies in 2004. The percentage was even higher in those with high levels of antibodies. Thyroid dysfunction was more frequent in subjects with positive TPOAb and/or TgAb than in those without thyroid antibodies （ 14.44% vs 3.11%, P 〈 0.01 ）. For those with positive antibodies in 1999, the incidence of hypothyroidism in 2004 was 1.32%, 8.46% and 15.38% in Pansan, Zhangwu and Huanghua, respectively （P 〈0.05）. The 5-year cumulative incidences of positive TPOAb （ ≥50 U/ml） and TgAb （ 940 U/ml） were 2.81% and 3.82%, respectively. The incidence of positive TPOAb was the highest in Zhangwu （ 3.84% ）. The incidence of positive TgAb was the highest inHuanghua （5.07%）, significantly higher than those in other two areas （ P 〈 0.05 ）. Conclusion The incidence of thyroid dysfunction is higher in subjects with positive antibodies than that in those with negative antibodies. The high iodine intake is a risk factor of hypothyroidism in subjects with positive thyroid antibodies. Sustained excessive iodine intake increases the incidence of positive thyroid antibodies.
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2006年第6期518-522,共5页
Chinese Journal of Endocrinology and Metabolism
基金
国家自然科学基金(30370680)
辽宁省科技攻关计划(2003225005)
关键词
自身抗体
甲状腺过氧化物酶
抗体
甲状腺球蛋白
流行病学研究
随访研究
碘
Autoantibodies
Antibodies, thyroid peroxidase
Antibodies, thyroglobulin
Epidemiologicstudies
Follow-up studies
Iodine
