河北部分高水碘地区居民甲状腺功能及血脂水平调查

Thyroid function and serum lipids of adults living in areas of excessive iodine in water in Hebei Province

目的了解河北高水碘地区成人的碘营养状况、甲状腺疾病患病及血脂异常情况。方法选择河北省沧州市海兴县为调查地区,收集成人空腹晨尿及静脉血,测定其尿碘、血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺激素(FT4)、灵敏促甲状腺激素(sTSH)、血清胆固醇(CHO)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)及甲状腺球蛋白抗体(TGAb)和甲状腺过氧化物酶抗体(TPOAb)水平。结果成人尿碘中位数为1094.92μg/L(627.38～1511.81μg/L);甲状腺疾病患者有66(22.0%)人,其中甲状腺功能亢进患者3(1.0%)人,亚临床甲状腺功能亢进患者7(2.3%)人,甲状腺功能减退患者12(4.0%)人,亚临床甲状腺功能减退患者44(14.7%)人;CHO、TG、HDL-C和LDL-C水平分别为(5.46±1.06)mmol/L、2.19(1.70～2.96)mmol/L、1.18(1.03～1.45)mmol/L和(3.08±1.05)mmol/L;不同甲状腺疾病状态人群的血脂水平差异无显著性。结论该高水碘地区人群血脂异常比率偏高。

Objective To investigate the iodine status and the prevalence of thyroid disease and dyslipidemia in adults living in areas of excessive iodine in water in Hebei Province, and to explore the impact of excessive iodine intake on dyslipidemia. Methods Subjects were selected from Haixing County in Cangzhou, Hebei. Fasting morning urine and venous blood were collected to test the levels of urinary iodine and serum free triiodothyronine （ FT3 ）, free thyroxine （ FT4 ） , and sensitive thyroid-stimulating hormone （ sTSH）. Thyroid peroxidase antibody （TPOAb）, thyroglobulin antibody （TGAb） and total cholesterol （CHO）, triglyceride （TG）, high density lipoprotein cholesterol （HDL-C） and low density lipoprotein cholesterol （LDL-C） were also measured. Results The median of urinary iodine was 1094. 92 （627.38 - 1511.81 ） μg/L. There were 66 （22.0%） adults diagnosed as thyroid disorder, including 3 （ 1.0% ） hyperthyroidism patients, 7 （2. 3% ） subclinical hyperthyroidism patients, 12 （4. 0% ） hypothyroidism patients and 44 （ 14. 7% ） subclinical hypothyroidism patients. The levels of CHO, TG, HDL-C and LDL-C were （5.46＋1.06） mmol/L, 2. 19（1.70-2.96） mmol/L, 1.18 （1.03-1.45） mmol/L and （3.08 ＋ 1.05） mmol/L respectively, no significant difference was observed between the thyroid disorder patients or non-patients. Conclusion The prevalence of dyslipidemia in adults living in areas of excessive iodine in water was high.