摘要
目的了解一般体检人群碘营养状态以及不同尿碘水平甲状腺异常率发生情况。方法以2018年3 - 12月来内蒙古自治区国检体检中心的2 650名体检人群为研究对象,年龄(46.2 ± 12.5)岁,其中男性697人、女性1 953人。采集血样进行甲状腺功能5项[促甲状腺激素(TSH)、甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TgAb)、游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)]检查,按检查结果分组:甲状腺功能正常、亚临床甲状腺功能减退、亚临床甲状腺功能亢进、甲状腺功能减退、甲状腺功能亢进、自身免疫性抗体异常、其他异常组。采集尿样进行尿碘水平检测,分析各组人群及不同尿碘水平时甲状腺异常率。甲状腺功能5项检查应用全自动电化学发光免疫分析仪,尿碘检测采用砷铈催化分光光度法。结果2 650名体检人群中,甲状腺异常者有1 270人,总异常率为47.92%。男、女性异常率分别为28.84%(201/697)、54.74%(1 069/1 953),女性异常率高于男性(χ^2 = 376.19,P < 0.05)。上述各组人群尿碘中位数分别为145.38、152.60、103.21、176.31、134.17、138.92、127.00 μg/L,均在碘适宜范围(100 ~ 199 μg/L)。尿碘≥300 μg/L(碘过量)组和< 100 μg/L(碘缺乏)组甲状腺异常率[55.56%(125/225)、50.86%(445/875)]高于100 ~ 199 μg/L组[44.70%(460/1 029),χ^2 = 12.65、12.61,P均< 0.05]。甲状腺异常者中,自身免疫性抗体异常者最多,占69.61%(884/1 270)。尿碘水平与FT4、FT3呈正相关(r = 0.04、0.05,P均< 0.05);FT4与TSH、TgAb呈负相关(r =- 0.20、- 0.73,P均< 0.05),与FT3呈正相关(r = 0.52,P < 0.05);TPOAb与TgAb呈正相关(r = 0.64,P < 0.05)。结论一般体检人群尿碘均在碘适宜范围,表明整体碘营养状态良好。但部分人群仍存在碘过量和碘缺乏,二者均导致了甲状腺异常率升高。
Objective To understand the iodine nutritional status of medical examination people and the thyroid dysfuction rates under different urinary iodine. Methods A total of 2 650 medical examination people from Inner Mongolia National Examination Medical Center from March to December of 2018 were selected. The average age was (46.2 ± 12.5) years old, including 697 males and 1 953 females. Blood samples were collected for determination of thyroid function [thyroid stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb), free thyroxine (FT4), and free triiodothyronine (FT3)], and according to the results of the examination, people were divided into normal thyroid function, subclinical hypothyroidism, subclinical hyperthyroidism, hypothyroidism, hyperthyroidism, autoimmune antibody abnormalities, and other abnormal groups. Urine samples were collected to detect urinary iodine levels, to analyze the thyroid dysfuction rates of each group people and different urinary iodine. The thyroid function was detected by automatic electrochemiluminescence immunoassay analyzer, the urinary iodine was determined by arsenic cerium catalytic spectrophotometry. Results Among the 2 650 medical examination people, there were 1 270 patients with abnormal thyroid function, and the total abnormal rate was 47.92%. The abnormal rates of males and females were 28.84%(201/697) and 54.74%(1 069/1 953), respectively, and the abnormal rate of females was higher than that of males (χ^2 = 376.19, P < 0.05). The urinary iodine medians of each group were 145.38, 152.60, 103.21, 176.31, 134.17, 138.92, and 127.00 μg/L, all in the appropriate range of iodine (100 - 199 μg/L). Thyroid abnormal rates [55.56%(125/225), 50.86%(445/875)] of urinary iodine ≥300 μg/L (iodine excess) group and < 100 μg/L (iodine deficiency) group were higher than that of 100 - 199 μg/L group [44.70%(460/1 029),χ^2 = 12.65, 12.61, P < 0.05]. Among thyroid abnormal people, autoimmune antibody abnormalities people was the most, accounting for 69.61%(884/1 270). Urinary iodine was positively correlated with FT4 and FT3 (r = 0.04, 0.05, P < 0.05);FT4 was negatively correlated with TSH and TgAb (r =- 0.20,- 0.73, P < 0.05), and it was positively correlated with FT3 (r = 0.52, P < 0.05);TPOAb was positively correlated with TgAb (r = 0.64, P < 0.05). Conclusions Urinary iodine of medical examination people is in the appropriate range of iodine, indicating that the overall iodine nutritional status is good. However, some people still have iodine excess and iodine deficiency, both of which lead to an increase in thyroid abnormal rate.
作者
那布其
张小玲
王姝懿
郭宏宇
左媛媛
乔佳楠
夏雅娟
Na Buqi;Zhang Xiaoling;Wang Shuyi;Guo Hongyu;Zuo Yuanyuan;Qiao Jianan;Xia Yajuan(Graduate School of Inner Mongolia Medical University, Hohhot 010059, China;Outpaiient Department, Inner Mongolia National Examination Medical Center, Hohhot 010020, China;Institute of Endemic and Chronic Diseases, Inner Mongolia Integrated Center for Disease Control and Prevention, Hohhot 010020, China)
出处
《中华地方病学杂志》
CAS
CSCD
北大核心
2019年第3期235-238,共4页
Chinese Journal of Endemiology
基金
内蒙古自治区应用技术研究与开发项目(201602107).
