摘要
背景甲状腺疾病作为内分泌代谢系统第二大疾病,近年来发病率不断攀升,但目前国内尚无大型研究报道围绝经期和绝经后女性甲状腺疾病患病情况及特点。目的调查乌鲁木齐地区围绝经期及绝经后女性甲状腺疾病患病情况,并探讨围绝经期及绝经后女性甲状腺功能筛查的意义。方法2017年5-6月,采用整群随机抽样法,从乌鲁木齐城区随机抽取两个社区,纳入社区常住的符合研究标准的40~60岁女性(n=620)为研究对象。检测研究对象的甲状腺激素〔促甲状腺素(TSH)、游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)〕及甲状腺自身抗体〔甲状腺过氧化酶抗体(TPOAb)、抗甲状腺球蛋白抗体(TGAb)〕水平。记录研究对象甲状腺疾病患病情况。比较不同月经状态(月经规律、围绝经期、绝经后)、不同年龄段(40~44岁、45~49岁、50~54岁、55~60岁)女性TSH、甲状腺自身抗体及甲状腺疾病患病率。结果620例女性中月经规律284例(45.8%)、围绝经期117例(18.9%)、绝经后219例(35.3%);40~44岁173例(27.9%)、45~49岁185例(29.8%)、50~54岁115例(18.6%)、55~60岁147例(23.7%)。乌鲁木齐地区40~60岁女性甲状腺功能减退症(17例)、亚临床甲状腺功能减退症(148例)、甲状腺功能亢进症(3例)、亚临床甲状腺功能亢进症(6例)患病率分别为2.7%、23.9%、0.4%、1.0%,桥本甲状腺炎患病率为35.0%(217/620),单纯TGAb阳性率22.6%(140/620),单纯TPOAb阳性率为27.6%(171/620),甲状腺结节患病率为32.4%(201/620)。不同月经状态女性TPOAb水平、甲状腺结节患病率、单纯TPOAb阳性率比较,差异有统计学意义(P<0.05)。不同年龄段女性甲状腺结节患病率比较,差异有统计学意义(P<0.05)。不同月经状态女性甲状腺功能减退症、亚临床甲状腺功能减退症、甲状腺功能亢进症、亚临床甲状腺功能亢进症、桥本甲状腺炎患病率及单纯TGAb阳性率比较,差异均无统计学意义(P>0.05);不同年龄段女性甲状腺功能减退症、亚临床甲状腺功能减退症、桥本甲状腺炎患病率及单纯TPOAb阳性率、单纯TGAb阳性率比较,差异均无统计学意义(P>0.05)。结论新疆乌鲁木齐地区40~60岁女性群体亚临床甲状腺功能减退症、桥本甲状腺炎及甲状腺结节患病率较高,高于当地总人群水平;且不同月经状态、年龄段女性甲状腺结节患病率不同,不同月经状态女性单纯TPOAb阳性率不同。
Background Thyroid disease is the second most-common endocrine and metabolic system disease,with increasing incidence recently.However,there are no large-scale studies on the prevalence and characteristics of thyroid diseases in peri-and post-menopausal women.Objective To investigate the prevalence of thyroid diseases in peri-and postmenopausal women in Urumqi,and to explore the significance of thyroid function screening in this population.Methods From May to June 2017,by use of clustering random sampling,eligible women aged 40-60 years old(n=620)were recruited from two randomly selected urban communities of Urumqi.Thyroid hormones(thyroid-stimulating hormone,free thyroxine,free triiodothyronine)and thyroid autoantibodies〔thyroid peroxidase antibody(TPOAb),anti-thyroglobulin antibody(TGAb)〕were measured and thyroid disease was screened.The levels of thyroid-stimulating hormone and thyroid autoantibodies and the prevalence of thyroid diseases were compared across groups stratified by menstrual status(regular,peri-and post-menopausal menstruation)and by age(40-44,45-49,50-54,55-60).Results Of the participants,the prevalence of regular,periand post-menopausal menstruation was 45.8%(284/620),18.9%(117/620),and 35.3%(219/620),respectively,and the percentages of age groups of 40-44,45-49,50-54 and 55-60 were 27.9%(173/620),29.8%(185/620),18.6%(115/620),and 23.7%(147/620),respectively.The prevalence of hypothyroidism,subclinical hypothyroidism,hyperthyroidism and subclinical hyperthyroidism were 2.7%(17/620),23.9%(148/620),0.4%(3/620)and 1.0%(6/620),respectively.The prevalence of Hashimoto thyroiditis,TGAb positivity,TPOAb positivity,and thyroid nodules was 35.0%(217/620),22.6%(140/620),27.6%(171/620),and 32.4%(201/620),respectively.The mean TPOAb level,and prevalence of thyroid nodule and TPOAb positivity differed significantly across groups of regular,peri-and post-menopausal menstruation(P<0.05).There was significant difference in the prevalence of thyroid nodules among the 4 age groups(P<0.05).There was no significant difference in the prevalence of hypothyroidism,subclinical hypothyroidism,hyperthyroidism,subclinical hyperthyroidism,Hashimoto thyroiditis or TGAb positivity in groups of regular,peri-and post-menopausal menstruation(P>0.05).There was no significant difference in the prevalence of hypothyroidism,subclinical hypothyroidism,hyperthyroidism,subclinical hyperthyroidism,Hashimoto thyroiditis,TPOAb positivity or TGAb positivity in different age groups(P>0.05).Conclusion The prevalence of subclinical hypothyroidism,Hashimoto thyroiditis or thyroid nodules in 40-60-year-old women was higher than that of general population in Urumqi,Xinjiang.The prevalence of thyroid nodules varied by menstrual status and age.The prevalence of TPOAb positivity varied by menstrual status.
作者
加孜热亚·再依拿提
邢淑清
热那姑丽·艾克拜尔
张凯迪
张玉媛
邢蓓
王新玲
郭艳英
JIAZIREYA·Zaiyinati;XING Shuqing;RENAGULI·Aikebaier;ZHANG Kaidi;ZHANG Yuyuan;XING Bei;WANG Xinling;GUO Yanying(Department of Endocrinology,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China)
出处
《中国全科医学》
CAS
北大核心
2021年第3期310-315,共6页
Chinese General Practice
基金
国家自然科学基金资助项目(81860148)
新疆维吾尔自治区自然科学基金资助项目(2017D01C105)
新疆维吾尔自治区人民医院院内项目(20190105)。
