摘要
目的 了解北京市平谷区常住居民碘营养状况及甲状腺功能减退症（甲减）的患病情况，探讨甲减的影响因素。方法 应用一次性横断面研究的方法，纳入北京市平谷区连续居住5年以上的734例健康人群作为研究对象，采集随意1次晨尿，采用尿中 碘的砷铈催化分光光度测定方法（WS／T 107-2006）检测尿碘；采集家庭食用盐，采用直接滴定法（GB／T 13025.7-1999）检测盐 碘；抽取空腹血，游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）、促甲状腺激素（TSH）、甲状腺球蛋白抗体（TgAb）及甲状腺过氧化物酶抗体（TPOAb）检测采用电化学发光法；甘油三酯（TG）检测采用全自动生化分析仪；糖化血红蛋白（HbA1c）检测采用高压液相法。对研究对象进行体格检查及甲状腺彩超检查，并填写调查问卷。结果 共收集尿样696份，尿碘中位数为125.25 μg／L，其中男性（287份）为125.19 μg／L，女性（409份）为125.79 μg／L。共采集盐样734份，其中无碘盐49份（6.7%）， 合格碘盐647份（88.1%），不合格碘盐38份（5.2%）。研究对象中65例甲减主要以亚临床甲减（58例，89.2%）为主。TG增高［比 值比（OR） = 3.298，95%置信区间（CI）：1.112 - 9.785］、年龄≥60岁（OR = 8.657， 95%CI：1.015 - 73.863）是男性患甲 减的独立危险因素；体力劳动者（OR = 3.576，95%CI：1.323 - 9.670）、TgAb增高（OR = 2.306，95%CI：1.099 - 4.841）、弥 漫性甲状腺改变（OR = 5.177，95%CI：1.944 - 13.787）是女性患甲减的独立危险因素。结论 北京市平谷区常住居民碘营养状况 良好，甲减以亚临床甲减为主，年龄、弥漫性甲状腺改变等是甲减的影响因素。
Objective To examine the situation of iodine nutritional status and the prevalence of hypothyroidism in Pinggu District of Beijing City, and analyze the illness-related factors. Methods A cross- sectional survey was performed in 734 adults who had lived more than five years in Pinggu District, a random urine sample was collected in the morning from each adult, urine iodine was tested via the arsenic cerium catalytic spectrophotometry method （WS/T 107-2006）; edible salt samples were collected, salt iodine was tested via the method of direct titration （GB/T 13025.7-1999）; fasting blood samples were collected, electrochemiluminescence was used to measure three free triiodothyronine （FT3）, free thyroid hormone （FT4）, thyroid-stimulating hormone （TSH）, thyroglobulin antibodies （TgAb） and thyroid peroxidase antibody （TPOAb）; automatic biochemical analyzer was used to measure triglyceride （TG）; high pressure liquid phase method was used to measure glycosylated hemoglobin （HbA1c）. The results of routine physical examination, thyroid examination by color Doppler ultrasound and questionnaires were collected. Results A total of 696 urine samples were collected, the median of urine iodine was 125.25 μg/L, and the values of male （287 cases） and female （409 cases） were 125.19 and 125.79 μg/L, respectively. Forty-nine non-iodized salt samples （6.7%）, 647 qualified iodized salt samples （88.1%）, and 38 unqualified iodized salt samples were detected （5.2%）, respectively. Subclinical hypothyroidism （58 cases, 89.2%） in all hypothyroidism （65 cases） was the most common hypothyroidism. Independent risk factors for hypothyroidism of male were increased TG [odds ratio （OR） = 3.298, 95% confidence interval （CI）： 1.112 - 9.785] and over 60 years old （OR = 8.657, 95%CI： 1.015 - 73.863）; independent risk factors for hypothyroidism of female were physical work （OR = 3.576, 95%CI： 1.323 - 9.670）, increased TgAb （OR = 2.306, 95%CI： 1.099 - 4.841） and diffused change of thyroid （OR = 5.177, 95%CI： 1.944 - 13.787）. Conclusions The iodine nutritional status of residents in Pinggu District of Beijing City is good. Main type of hypothyroidism is subclinical hypothyroidism. Age, diffused change of thyroid, etc. are the influencing factors of hypothyroidism.
作者
屈宏宇
阮春来
Qu Hongyu;Ruan Chunlai(Department for Infectious Diseases and Endemic Disease Control, Pinggu Center for Disease Control and Prevention,Pinggu 101200, China （Qu HY;Planned Immunity Division, Pinggu Center for Disease Control and Prevention, Pinggu101200, China)
出处
《中华地方病学杂志》
CAS
CSCD
北大核心
2018年第6期467-472,共6页
Chinese Journal of Endemiology
