碘过量对不同人群甲状腺功能影响及青少年碘安全摄入量的研究

Iodine excess on thyroid function in different groups and young people safe iodine intake

目的探讨碘过量对不同人群甲状腺功能影响及青少年碘安全摄入量的研究。方法根据国家《水源性高碘地区和地方性高碘甲状腺肿病区的划定》(GB/T19380-2003)划定高碘地区,2015年3月选择广东省惠州市惠城区作为高碘调查地区,并选择与其地理位置附邻,经济状况、文化背景、生活环境、饮食习惯相近的博罗县为适碘地区。研究调查成人1 708人,其中男性594人,比例为34.8%,女性1 114人,比例为65.2%,年龄在20~50岁间。研究调查儿童1 042人,其中男性614人,比例为58.9%,女性428人,比例为41.1%,年龄在6~13岁间。对研究对象进行空腹中段晨尿、空腹静脉血样本、生活饮用水及食盐进行样本采集。通过相关指标测试结果进行比较分析。结果高碘区成人和儿童患甲状腺疾病的几率高于适碘区人群,差异均有统计学意义(P<0.05)。适碘区和高碘区成人患病率均高于相应的儿童,差异有统计学意义(P<0.05)。适碘地区和高碘地区,成人亚甲亢、甲减及亚甲减分布差异均有统计学意义(P<0.05)。适碘地区和高碘地区,儿童甲亢、亚甲减分布差异均有统计学意义(P<0.05)。高碘地区和适碘地区患有甲状腺疾病的儿童和成人的sTSH水平高于正常儿童和成人,高碘地区正常儿童及成人和有甲状腺疾病的儿童及成人的sTSH水平均高于相应的适碘地区,差异均有统计学意义(P<0.05)。结论碘过量人群的甲状腺疾病发病率高于碘适量人群。甲状腺功能正常的成人和儿童如果长期高碘摄入,其sTSH水平较高。

Objective To investigate the study of iodine excess on thyroid function in different populations and young people safe iodine intake. Methods According to the national ＂delineation of high iodine areas of water and local iodine goiter＂ （GB/T19380-2003） delineation of high iodine areas, in March 2015 in Huizhou city, Guangdong province, Huieheng district were selected as iodine survey area. The adjacent district Boluo with economic situation, cultural background, living environment, eating habits similar to the iodine area was selected as control area. 1 708 adults were investigated, including 594 males （34.8%） and 1 114 women （65.2%） aged 20 to 50 years old. 1 042 children were investigated, including 614 males （58.9%） , 428 women （41.1%） aged 6 to 13 years old. Fasting mid-morning urine, fasting venous blood samples, drinking water, and salt samples were collected. The results were compared and analyzed. Results The prevalence of thyroid disease in adults and children with iodine excess was higher than those people in normal iodine area （P〈0.05）. The prevalence of thyroid disease in adults in iodine excess area was higher than that of the corresponding children; the difference was statistically significant （P〈0.05）. The prevalence of subclinical hyperthyroidism, hypothyroidism and subclinical hypothyroidism in adults with iodine excess was higher than those people in normal iodine area （P〈0.05）.The prevalence of hyperthyroidism and subclinical hypothyroidism in children with iodine excess was higher than those people in normal iodine area （P〈0.05）.Aduhs and children with thyroid disease had higher sTSH levels than those normal children and aduhs. The levels of sTSH in adults and children in iodine excess areas were higher than those in normal iodine area. The difference was statistically significant （P〈0.05）. Conclusion The incidence of thyroid disease in iodine excess area was higher than that in normal iodine area. Thyroid function in adults and children with long-term high iodine intake may cause high level of sTSH.