摘要
目的观察碘摄入量对血清甲状腺球蛋白（Tg）水平的影响。方法对1999年盘山（轻度碘缺乏地区）、彰武（碘超足量地区）和黄骅（碘过量地区）血清Tg水平正常的3099人进行随访，将2004年随访到的2448人作为研究人群。测定Tg、甲状腺球蛋白抗体（TgAb）、甲状腺过氧化物酶抗体（TPOAb）、促甲状腺素（TSH）、甲状腺容积，并询问甲状腺疾病的家族史和个人史。分析Tg的影响因素。结果1999年初访时，不同碘摄人地区他水平差异显著[盘山7．5（4．4～13．1）μg／L、黄骅6．8（3．6～11．2）μg／L、彰武5．9（3．2～10．7）μg／L，P〈0．01]；年龄、性别、TgAb阳性、甲状腺肿大、TSH异常及甲状腺疾病个人史对Tg水平的影响亦显著。为排除混杂因素的影响，对TgAb、甲状腺容积、TSH、甲状腺疾病个人史均无异常的1856人的随访数据进行分析，其初访及随访的取水平均有显著地区差异，轻度碘缺乏以及碘过量地区都显著高于碘超足量地区。三地区随访时Tg水平均显著升高，且增加值（△Tg）存在显著地区差异[盘山3．1（-0．2—8．0）μg／L、黄骅3．5（0．5～9．0）μg/L vs彰武2．5（0．3-6．1）μg/L，P〈0．01]；碘摄入量、初访时的Tg水平、TSH水平及年龄为△Tg的独立影响因素。结论碘摄入量显著影响血清Tg水平，当用血清瞻水平来估计地区碘摄入水平及其变化时，应该同时考虑年龄及TSH等因素。
Objective To clarify the effect of iodine intake on serum thyrnglobulin （Tg）. Methods A 5- year prospective study was conducted in the 3 different iodine intake areas in China[ Panshan （mild deficiency）, Zhangwu （more than adequate） and Huanghua （excess） ]. A total of 3 099 people with normal serum levels of Tg in 1999 were followed and 2 448 of these participants were feasible to be observed in 2004 and included in the present study. The serum levels of Tg, thyroglobulin antibody（ TgAb ）, thyroid peroxidase antibody （TPOAb） and TSH, thyroid volume, family and personal histories of thyroid diseases were measured and inquried. The general linear model （GLM） was used to explore the determinants of Tg. Results Among the study population at baseline, serum Tg were significantly different in three areas[ 7.5 （4.4-13.1） μg/L at Panshan, 6.8 （ 3.6-11.2 ） μg/L at Huanghua, 5.9（3.2-10.7） μg/L at Zhangwu,P〈0.01 ]. They were associated with age, sex and the rate of positive TgAb, abnormal thyroid volume, abnormal TSH and positive personal history of thyroid diseases. In order to control the effects of confounding factors, the data from 1 856 subjects with thyroid-related indexes all in normal range and without personal history of thyroid diseases were analyzed to clarify the effect of iodine intake on Tg. The serum Tg among three areas were significantly different in both 1999 and 2004, they were all increased in 5 years with significant augment （ A Tg） among the three areas [ 3.1 （ -0.2-8.0 ） μg/L at Panshan, 3.5 （ 0.5-9.0 ） μg/L at Huanghua vs 2.5（0.3-6.1 ） μg,/L at Zhangwu,P〈0.01 ]. The GLM analysis revealed that age, Tg and TSH levels at baseline were the determinants of △Tg in addition to iodine intake. Conclusion Iodine intake is a dominant determinant of serum Tg. Age and TSH should also be considered while indicating iodine intake by serum Tg.
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2009年第3期260-263,共4页
Chinese Journal of Endocrinology and Metabolism
基金
基金项目：国家自然科学基金资助项目（39970350、30240013、30370680）
辽宁省科技攻关计划（2003225005）：美国中华医学基金会资助项目（CMB98-688）
