甘肃省武威市成人碘营养及甲状腺功能状态分析

Analysis of iodine nutrition and thyroid function of adults in urban areas of Wuwei city Gansu province

目的了解甘肃省武威市城市成人碘营养水平及甲状腺功能状态，为科学补碘提供依据。方法2009年4月一2010年1月采用横断面调查方法随机调查甘肃省武威市18～45岁成人104人。采集样本人群空腹血样及任意一次尿样，检测FT3、FT4、TT3、Trr4、TSH、TGAb、TMAb及尿碘。结果男、女尿碘中位数分别为139．3和212．6Ixg／L，女性尿碘明显高于男性（P〈0．05）。TT3、TT4、FT3、FT4、TSH均值均在正常值范围内，TT3、TT4、FT3、FT4、TSH异常率分别为1．9％、1．0％、3．8％、1．9％和16．3％。TGAb和TMAb阳性率女性均高于男性（P〈0．05）。甲状腺功能紊乱中以亚甲减最多（14．4％），其中女性高于男性（P〈0．05）。以尿碘水平将调查对象分为碘缺乏、碘适宜、碘过适宜和碘过量4组，TSH、FT3、FT4、TGAb、TMAb异常率组间均无统计学意义，但TGAb、TMAb阳性率有随着尿碘水平升高而上升趋势。除碘缺乏组无甲状腺功能紊乱者，其余3组均有病例，组间差异有统计学意义（P〈0．05）。结论武威市成人碘营养状况基本处于适宜，但女性明显高于男性；甲状腺功能紊乱以亚甲减为主；随着碘摄入量的增加，TGAb、TMAb阳性率呈上升趋势，女性患甲状腺疾病的风险高于男性。

Objective To find out the iodine nutrition and thyroid function of adults in urban areas of Wuwei city Gansu province and to provide a basis for scientific iodine supplementation. Methods A cross-sectional survey was performed in 104 adults in Wuwei city form the April 2009 to January 2010. The morning blood samples and one urine samples selected randomly of different people were collected and three free triiodothyronine （ FT3 ）, free thyroid hormone （ FT4 ）, total triiodothyronine （ TT3 ）, total thyroxine （ TT4 ）, the thyroid-stimulating hormone （ TSH ）, thyroglohulin antibodies （ TGAh ） , thyroid microsomal antibodies （TMAb） in blood samples and iodine in urine samples were detected. Results The medians of urinary iodine were respectively 139.3 μg/L and 212. 6 μg/L for male and female,female was significantly higher than male, there were statisticant differences（P 〈 0.05 ）. TT3, TT4, FT4, FT3 and TSH＇s mean values were in the normal range, the abnormal ratio of TT3, TT4, FT3, FT4, TSH were respectively 1.9%, 1.0%, 3.8%, 1.9%,16.3%.The positive rate of TGAb and TMAb in female were all higher than male, there were statisticant differences （P 〈 0.05 ）. Subclinical hypothyroidism in all thyroid function disorders was most and accounted for 14.4% and female were all higher than male （P 〈 0.05 ）. The survey were divided into iodine deficiency group, adequate iodine group, over adequate iodine group and iodine excess group for urinary iodine level. The abnormal ratio of TT3, TT4, FT3, FT4, TSH in four groups had no statistically differences, but the positive rate of TGAb and TMAb raised with increased urinary iodine level. Thyroid function disorders oecurred in the other three groups except iodine deficiency group,and there were statisticant differences. Conclusion Iodine nutrition level is appropriate for adults in urban areas, but the female was higher than male. Subclinical hypothyroidism in all thyroid function disorders was most, the positive rate of TGAb and TMAb raised with increased urinary iodine level, the risk of female suffered from thyroid disease was higher than male.