北京45～50岁居民碘营养状况与甲状腺结节关系

Correlation between iodine nutrition and thyroid nodule among 45-50 years old residents in Beijing

目的调查分析45~50岁北京市居民甲状腺结节患病与碘营养状况的相关性。方法于2014年在北京市4个区的体检中心随机抽样方法选取1 041名45~50岁正常体检人群,问卷调查人口学信息及甲状腺结节发病可能的危险因素,收集晨尿测定尿碘含量,B超诊断甲状腺结节情况。结果共收集调查对象1 041人,总人群尿碘为1.3~2 660.4μg/L,中位数为143.3μg/L,男性尿碘中位数(154.2μg/L)高于女性(127.3μg/L),郊区(158.8μg/L)高于城区(113.8μg/L),差异均有统计学意义(均P<0.05);B超共检出有甲状腺结节者366人(甲状腺结节组),占35.2%,女性检出率(43.9%)高于男性(28.2%);甲状腺结节组尿碘中位数为134.9μg/L,对照组尿碘中位数为145.8μg/L,2者差异无统计学意义;logistic回归分析结果显示,女性(OR=1.903)和遗传因素(OR=2.300)为患有甲状腺结节的危险因素。结论北京市45~50岁居民碘营养水平处于适宜范围,而甲状腺结节患病率较高,甲状腺结节的高发与碘摄入量的不足或过量无统计学意义,其危险因素仍需进一步研究。

Objective To analyze the correlation between thyroid nodule disease and iodine nutritional status among residents aged 45 to 50 years in Beijing. Methods Totally 1 041 healthy residents of 45 to 50 years old visiting 2 urban and 2 suburban physical examination centers in Beijing for routine checkup were randomly selected and surveyed with a questionnaire to collect demographic and other relevant information;B ultrasonic examination was carried out for diagnosis of thyroid nodule disease and morning urine samples were collected to determine urine iodine among all participants in 2014. Results Among the residents, the urine iodine ranged from 1.3μg/L to 2 660. 4 μg/L, with a median of 143.3 μg/L;there were significant differences in the median of urine iodine between the male and female residents （154. 2 vs. 127.3μg/L） and those living in suburban and urban areas （158.8 vs. 113.8μg/L） （P 〈0. 05）. The overall thyroid nodule detection rate was 35.2% （366） and the detection rate of the females （43.9%） was higher than that of the males （28.2%）. There was no significant difference in the median of urinary iodine between the residents with thyroid nodule （ 134.9 μg/L） and without the abnormal condition （ 145.8μg/L）. Logistic regression analysis results showed that female gender （ odds ratio [ OR] = 1. 903 ） and familial history of thyroid diseases （ OR = 2. 300） were significant risk factors of thyroid nodule. Conclusion Iodine nutrition is at a normal level, while the prevalence of thyroid nodule is high and the high prevalence is not related to iodine nutrition status among the residents aged 45 - 50 years in Beijing.