摘要
目的探讨四川省8~10岁儿童体格发育对甲状腺容积的影响,探索适合学龄儿童的甲状腺容积校正方法,用以精准防控碘缺乏病。方法2020年6-7月,选择成都市双流区、眉山市彭山区、攀枝花市米易县和广元市青川县作为调查县(区),每个县(区)按东、西、南、北、中5个方位各抽取1个乡(镇、街道),每个乡(镇、街道)抽取1所小学校,每所小学校抽取40名8~10岁儿童(性别、年龄均衡)作为调查对象,测定身高、体重,计算体质指数(BMI)及体表面积(BSA),采用B超测定甲状腺容积,并分别计算不同甲状腺容积指数[身高容积指数1(HVI1)、身高容积指数2(HVI2)、体块容积指数(BMIV)、体重身高容积指数(WHVI)、体表面积容积指数(BSAV)]。采集即时尿样并测定尿碘。分析不同测量指标与儿童生长发育指标的关联。结果共调查8~10岁儿童805名,其中男生403名、女生402名;8、9、10岁组分别为312、288、205名。采集尿样805份,尿碘中位数为251.4μg/L。甲状腺容积性别间比较差异无统计学意义(Z=-0.44,P=0.661),但年龄间比较差异有统计学意义(H=64.95,P<0.001)。在各年龄组,甲状腺容积与身高、体重均呈正相关性(8岁组:r=0.29、0.42,P均<0.001;9岁组:r=0.29、0.41,P均<0.001;10岁组:r=0.34、0.47,P均<0.001)。在各年龄组,经HVI1校正后甲状腺容积与身高、体重均呈正相关性(8岁组:r=0.13、0.32,P均<0.05;9岁组:r=0.12、0.30,P均<0.05;10岁组:r=0.18、0.37,P均<0.05)。在各年龄组,经HVI2校正后甲状腺容积与体重均呈正相关性(8岁组:r=0.20,P<0.001;9岁组:r=0.17,P=0.004;10岁组:r=0.26,P<0.001)。在8、10岁组,经BMIV校正后甲状腺容积与身高均呈正相关性(r=0.20,P<0.001;r=0.21,P=0.003)。在各年龄组,经WHVI校正后甲状腺容积与身高、体重均呈负相关性(8岁组:r=-0.35、-0.37,P均<0.001;9岁组:r=-0.38、-0.39,P均<0.001;10岁组:r=-0.31、-0.38,P均<0.001)。在8岁组,经BSAV校正后甲状腺容积与体重呈正相关性(r=0.11,P=0.045)。结论甲状腺容积与体格发育密切相关,仅基于年龄来判定儿童甲状腺肿大可能已不合适;初步比较5种校正方法,发现BSAV校正效果较好。
Objective To explore the effect of physical development on thyroid volume of children aged 8-10 years in Sichuan Province,and explore the thyroid volume correction method suitable for school-age children,so as to accurately prevent and control iodine deficiency disorders.Methods From June to July 2020,Shuangliu District of Chengdu City,Pengshan District of Meishan City,Miyi County of Panzhihua City and Qingchuan County of Guangyuan City were selected as the survey counties(districts).One township(town and street)was selected from each county(district)according to the five directions of East,West,South,North and Middle,one primary school was selected from each township(town and street),and 40 children aged 8-10 years(gender and age balanced)were selected as the survey subjects from each primary school,height and weight were measured,the body mass index(BMI)and body surface area(BSA)were calculated.Thyroid volume was measured by B-ultrasound,and the different thyroid volume indexes[height volume index 1(HVI1),height volume index 2(HVI2),body mass volume index(BMIV),weight and height volume index(WHVI),body surface volume index(BSAV)]were calculated,respectively.Urine samples of all children were collected,the iodine concentration in urine was measured,and the correlation between different measurement indexes and children's growth and development indexes was analyzed.Results A total of 805 children aged 8-10 years were investigated,including 403 boys and 402 girls.There were 312,288 and 205 children in the 8-,9-and 10-year-old groups,respectively.A total of 805 urine samples were collected,and the median urinary iodine was 251.4μg/L.There was no statistically significant difference in thyroid volume between boys and girls(Z=-0.44,P=0.661),but was statistically significant difference between ages(H=64.95,P<0.001).In all age groups,thyroid volume was positively correlated with height and weight(8-year-old group:r=0.29,0.42,P<0.001;9-year-old group:r=0.29,0.41,P<0.001;10-year-old group:r=0.34,0.47,P<0.001).In all age groups,after HVI1 correction,thyroid volume was positively correlated with height and weight(8-year-old group:r=0.13,0.32,P<0.05;9-year-old group:r=0.12,0.30,P<0.05;10-year-old group:r=0.18,0.37,P<0.05).In all age groups,there was a positive correlation between thyroid volume and weight after HVI2 correction(8-year-old group:r=0.20,P<0.001;9-year-old group:r=0.17,P=0.004;10-year-old group:r=0.26,P<0.001).In the 8-and 10-year-old groups,there was a positive correlation between thyroid volume and height after BMIV correction(r=0.20,P<0.001;r=0.21,P=0.003).In all age groups,there was a negative correlation between thyroid volume and height and weight after WHVI correction(8-year-old group:r=-0.35,-0.37,P<0.001;9-year-old group:r=-0.38,-0.39,P<0.001;10-year-old group:r=-0.31,-0.38,P<0.001).In the 8-year-old group,there was a positive correlation between thyroid volume and weight after BSAV correction(r=0.11,P=0.045).Conclusions Thyroid volume is closely related to height and weight.It may be inappropriate to judge goiter in children only based on age.After the preliminary comparison of five correction methods,it is found that BSAV is better.
作者
宋选波
李津蜀
张莉莉
吴芙蓉
简鸿帮
Song Xuanbo;Li Jinshu;Zhang Lili;Wu Furong;Jian Hongbang(Department of Iodine Deficiency Disorders,Institute of Endemic Disease,Sichuan Center for Disease Control and Prevention,Chengdu 610041,China)
出处
《中华地方病学杂志》
CAS
北大核心
2022年第8期664-668,共5页
Chinese Journal of Endemiology
基金
四川省疾病预防控制中心自立课题项目(2020)。
关键词
儿童
甲状腺容积
校正指数
Child
Thyroid volume
Correction index
