摘要
目的构建尿碘与甲状腺结节患病率的非对称U型响应曲线关系。方法以“碘”“尿碘”“甲状腺”“甲状腺结节”为中文关键词,以“Urine Iodine”“Goiter Prevalence”“Thyroid Nodule”为英文关键词,分别检索中国生物医学文献数据库、中国知网、万方数据知识服务平台、PubMed、Springer数据库中有关尿碘浓度与甲状腺结节患病率关系的文献,时间范围定为2000年1月至2019年12月,语种限定为中文与英文。共纳入46篇文献(国内、国外文献分别为24、22篇)。采用分位数回归方法,以Sigmoid函数模型分别对低尿碘至适宜尿碘浓度区间、适宜尿碘至高尿碘浓度区间的尿碘与甲状腺结节患病率的剂量效应关系进行拟合,评估中国居民甲状腺结节患病率情况。结果所拟合的低尿碘至适宜尿碘浓度区间、适宜尿碘至高尿碘浓度区间的甲状腺结节患病率与尿碘中位数对数值剂量效应曲线,较好模拟了尿碘水平与甲状腺结节患病率的非对称U型曲线定量关系,分段函数分界点的尿碘中位数为198μg/L。根据纳入文献的总样本人数进行加权计算,得出中国居民甲状腺结节患病率(95%CI)为23.0%(17.3%~30.7%)。结论基于分段函数构建U型的甲状腺结节患病率对尿碘水平响应曲线实用性较强,且有较好拟合效果。
Objective To establish an asymmetric U-shaped response relationship between urinary iodine level and thyroid nodule prevalence.Methods Taking"Iodine""Urine Iodine""Thyroid"and"Thyroid Nodule"as Chinese keywords,and"Urine Iodine""Goiter"and"Thyroid Nodule"as English keywords,literatures about urine iodine level and thyroid nodule prevalence were searched in China Biology Medicine disc,China National Knowledge Internet,Wanfang Data,PubMed and Springer databases from January 2000 to December 2019 respectively.The language of literatures was restricted in Chinese and English.There were 46 articles(24 domestic and 22 foreign)included in the study.The quantile regression method and Sigmoid function model were used to fit the dose-response relationship between different levels of urinary iodine and thyroid nodule prevalence to estimate the prevalence of thyroid nodule in Chinese residents.Results The fitted dose-response curves between different levels of urine iodine,ranging from low level to appropriate level and then to high level,and thyroid nodule prevalence had a good performance on the simulation of the asymmetric U-shaped relationship between urine iodine level and thyroid nodule prevalence.The median level of urinary iodine at the cut-off point of the piecewise function was 198μg/L.Based on the weighted calculation of the total sample size included in the literature,the prevalence of thyroid nodules(95%CI)in Chinese residents was 23.0%(17.3%-30.7%).Conclusion The asymmetric U-shaped response relationship between urinary iodine level and thyroid nodule prevalence based on piecewise function has good feasibility and fitting effect.
作者
何纳轮
李华
安伟
杨敏
He Nalun;Li Hua;An Wei;Yang Min(Research Center for Eco-Environmental Sciences,Chinese Academy of Sciences,University of Chinese Academy of Sciences,Beijing 100049,China;Department of Mathematical Science,Tsinghua University,Beijing 100084,China)
出处
《中华预防医学杂志》
CAS
CSCD
北大核心
2020年第11期1268-1274,共7页
Chinese Journal of Preventive Medicine
基金
国家自然科学基金(21976205、11771241)
水污染防治科技重大项目(2018ZX07502001)。
关键词
碘
尿
甲状腺结节
剂量效应
U型曲线
Iodine
Urine
Thyroid nodule
Dose effect
U-shaped curve
