青海省部分地区藏族成人碘营养状况和促甲状腺激素水平变化研究

Iodine nutritional status and thyroid stimulating hormone level of adult Tibetan in some regions of Qinghai Province

目的 评价青海省藏区居民食盐加碘后的碘营养状况及促甲状腺激素（TSH）水平,分析变化规律,为藏区成人补碘提供指导.方法 2012、2013年在青海省果洛州、海南州,采用分层整群抽样方法,抽取20岁以上藏区居民,采集空腹晨尿5ml,砷铈催化分光光度法测定尿碘水平;采集晨起空腹静脉血5 ml,电化学发光法检测血清TSH水平.同时对尿碘的影响因素进行Logistic回归分析.结果 采集藏族成人尿样、血样均为936份,尿碘中位数为220.9 μg,/L,血清TSH中位数为1.92 mU/L.尿碘及血清TSH水平有随年龄增加而下降的趋势,20～ 45岁居民碘营养大于适宜量.女性血清TSH中位数为1.96 mU/L,男性为1.43 mU/L,女性高于男性（U=-2.207,P＜0.01）.回归分析发现,血清TSH与尿碘相关[比值比（OR）=1.046,P＜0.05].结论 青海藏区45岁以下成人碘营养大于适宜量,可能影响TSH水平,年轻女性应定期监测甲状腺功能和尿碘.

Objective To evaluate the iodine nutritional status and thyroid stimulating hormone （TSH） level in adult Tibetan of Qinghai Province after Universal Salt Iodization,to analyze the change rules and provide guidance for adult iodine supplementation in Tibetan areas.Methods Guoluo Prefecture and Hainan Prefecture of Qinghai Province were chosen in 2012 and 2013,residents over 20 years old were extracted using stratified cluster sampling method,fasting morning urine 5 ml was collected,arsenic cerium catalytic spectrophotometry method was used to determinate the urinary iodine level.Morning fasting venous blood 5 ml was collected,serum TSH level was detected with electrochemiluminescence immunoassay.And the factors influencing urinary iodine levels were analyzed using logistic regression analysis.Results The number of adult Tibetan urine and blood samples was both 936.The median of urine iodine was 220.9 μg/L,the median of serum TSH was 1.92 mU/L.There were downward trends of urine iodine and serum TSH levels with increasing age.The iodine level of 20-45 years old was greater than the appropriate amount.The median of women＇s urinary iodine was 1.96 mU/L,men＇s was 1.43 mU/L,female＇s was higher than that the male＇s （U =-2.207,P 〈 0.01）.The results of regression analysis indicated that serum TSH levels were closely related to urinary iodine （OR =1.046,P 〈 0.05）.Conclusions The iodine nutrition of adults over 45 years old is more than the sufficient quantity in Qinghai Tibetan areas,which may affect the level of serum TSH level.Young women should regularly inspect their thyroid function and urinary iodine level.