摘要
目的分析桥本甲状腺炎(HT)患者尿碘水平的差异,探讨不同碘营养状况下尿碘水平与HT可能存在的关系,为HT患者合理摄碘提供参考。方法选取入院就诊的HT患者101例为HT组,依据甲状腺功能分为3组:HT合并甲状腺功能亢进组41例;HT合并甲状腺功能正常组25例;HT合并甲状腺功能减退组35例。另外,选取健康体检者30例为对照组。采用化学发光法检测血清促甲状腺激素(TSH)、三碘甲状腺原氨酸(T_(3))、甲状腺素(T_(4))、甲状腺过氧化物酶抗体(TPOAb)及甲状腺球蛋白抗体(ATG)水平;超声诊断仪检查甲状腺器官的大小及形态结构;砷铈催化分光光度法检测尿碘水平。根据尿碘水平将人群碘营养状况分为碘缺乏(<100μg/L)、碘适宜(100~199μg/L)、碘足量(200~299μg/L)、碘过量(≥300μg/L)。采用非参数检验比较HT组与对照组尿碘水平差异,单因素方差分析、t检验比较HT分组与对照组尿碘水平差异及Spearman相关分析不同碘营养状况下尿碘水平与T_(3)、T_(4)、TSH、ATG、TPOAb的相关性。结果与对照组比较,HT组ATG、TPOAb水平升高(P<0.001),尿碘水平升高(P<0.05),差异有统计学意义;不同甲状腺功能状态下HT分组与对照组尿碘水平比较,仅HT合并甲状腺功能减退组升高(P<0.01),差异有统计学意义;Spearman相关分析显示总纳入对象中碘过量状况下尿碘水平与ATG、TPOAb水平呈正相关(P<0.05),HT患者中碘足量、碘过量状况下尿碘水平与TSH水平呈正相关(P<0.05)。结论HT患者尿碘水平较正常人偏高。居民尿碘水平≥300μg/L时,摄碘易发生HT;HT患者尿碘水平≥200μg/L时,摄碘易发生甲状腺功能减退,需限制碘摄入。
Objective To analyze the difference of urinary iodine level in Hashimoto thyroiditis(HT)patients,and to explore the possible relationship between urinary iodine level and HT under different iodine nutritional status,so as to provide some references for reasonable iodine intake in HT patients.Methods A total of 101 hospitalized HT patients were selected as HT group and divided into 3 groups according to thyroid function:HT group with hyperthyroidism(41 cases).There were 25 cases in HT group with normal thyroid function.There were 35 cases in HT combined with hypothyroidism group.In addition,30 healthy subjects were selected as control group.Serum levels of thyroid stimulating hormone(TSH),triiodothyronine(T_(3)),thyroxine(T_(4)),thyroid peroxidase antibody(TPOAb)and thyroglobulin antibody(ATG)were detected by chemiluminescence assay.The size and morphological structure of thyroid organs were examined by ultrasonography.Urinary iodine was determined by catalytic spectrophotometry with arsenic and cerium.The nutritional status of iodine was classified into iodine deficiency(<100μg/L),iodine adequacy(100-199μg/L),iodine adequacy(200-299μg/L)and iodine excess(≥300μg/L).Non-parametric test was used to compare urinary iodine level between HT group and control group,one-way ANOVA and t test were used to compare urinary iodine level between HT group and control group,and Spearman correlation analysis was used to compare the correlation between urinary iodine level and T_(3),T_(4),TSH,ATG and TPOAb under different iodine nutrition status.Results Compared with control group,ATG and TPOAb levels in HT group increased(P<0.001),and urinary iodine levels increased(P<0.05),with statistical significance.Compared with the control group in different thyroid function states,only the HT group with hypothyroidism increased the urinary iodine level(P<0.01),and the difference was statistically significant.Spearman correlation analysis showed that urine iodine level was positively correlated with ATG and TPOAb levels in iodine excess condition(P<0.05),and urine iodine level was positively correlated with TSH level in iodine sufficient condition and iodine excess condition in HT patients(P<0.05).Conclusion The urinary iodine level of HT patients was higher than that of normal people.When the urinary iodine level of residents is≥300μg/L,iodine intake is prone to HT.When the urinary iodine level of HT patients is≥200μg/L,iodine consumption is prone to hypothyroidism,and iodine intake should be limited.
作者
李晓蝶
徐永霞
王芬
郭文露
贾伟
王雪锋
郎烺
朱德发
Li Xiaodie;Xu Yongxia;Wang Fen;Guo Wenlu;Jia Wei;Wang Xuefeng;Lang Lang;Zhu Defa(Dept of Geriatric Endocrinology,The First Affiliated Hospital of Anhui Medical University,Hefei 230022)
出处
《安徽医科大学学报》
CAS
北大核心
2024年第1期144-148,共5页
Acta Universitatis Medicinalis Anhui
基金
国家自然科学基金(编号:81272152)。
关键词
尿碘
碘营养
碘过量
桥本甲状腺炎
甲状腺功能减退
相关性
urine iodine
iodine nutrition
iodine excess
Hashimoto's thyroiditis
hypothyroidism
correlation
