甘肃省成人甲状腺功能减退症患病率调查及相关因素分析

Prevalence and related risk factors of hypothyroidism in adults of Gansu province

目的 了解甘肃省成人甲状腺功能减退症（甲减）患病率及流行病学特点,分析影响甲减的相关生活方式及代谢影响因素,为甲减的预防提供科学依据.方法 采用多阶段分层与人口成比例的整群随机抽样方法抽取甘肃省10071名年龄在18～79岁的常住居民（居住时间≥5年）进行流行病学调查,每位被调查者都被要求填写调查问卷,并进行体格检查、静脉血采集.采用χ2检验和多因素Logistic回归分析进行甲减影响因素的分析.结果 甘肃省甲减的患病率为10.1％,其中1.5％为临床甲状腺功能减退症,8.7％为亚临床甲状腺功能减退症.女性甲减患病率高于男性（12.1％比7.5％）.多因素Logistic回归分析结果提示除了女性、年龄的增长是甲减的危险因素,吸烟史（OR：0.467,95％CI：0.289～0.754,P=0.002）、饮食口味偏咸（OR：0.355,95％CI：0.162～0.776,P=0.022）、经常进食海产品（OR：0.148,95％CI：0.057～0.385,P〈0.001）可能对甲减的发生发展起到保护性作用,而甲状腺过氧化物酶抗体阳性（OR：2.419,95％CI：1.160～5.043,P=0.018）、甲状腺球蛋白抗体阳性（OR：1.976,95％CI：1.037～3.768,P=0.039）或三酰甘油增高（OR：1.241,95％CI：1.044～1.474,P=0.014）对甲减的发生起促进作用.结论 甘肃省成人甲减患病率较高,约占全部人口的十分之一,相关生活方式和代谢因素对甲减的发生发展有一定影响,养成健康的工作和生活方式,关注血脂的控制或许有利于预防甲减的发生.

Objective To investigate the prevalence and epidemiological characteristics of hypothyroidism, possible related lifestyle and metabolic risk factors of hypothyroidism in adults of Gansu province, and to provide scientific evidence for the prevention of hypothyroidism. Methods Stratified multi-stage cluster sampling with probability proportionate to size method was used to collect data from 10071 residents aged 18 to 79 years and who had lived in the local area for more than 5 years. All participants were asked to fill in the questionnaire, and to take physical examination including anthropometric measurements and venous blood samples. Risk factors of hypothyroidism were analyzed by Chi-square test and multivariate logistic regression analysis. Result The prevalence of hypothyroidism was 10.1% （overt hypothyroidism： 1.5%, subclinical hypothyroidism： 8.7%）. Female （12.1%） had a higher percentage when compared to male （7.5%）. In addition to the increased odds with older age and female gender, current or previous smoking history （OR： 0.467, 95%CI： 0.289-0.754, P=0.002）, salty taste preference （OR：0.355, 95%CI：0.162-0.776, P=0.022） and a frequent seafood intake （OR：0.148, 95%CI：0.057-0.385, P〈0.001） were tended to be associated with reduced risk of hypothyroidism. Logistic regression analysis showed that positive thyroid peroxidase antibodies （OR：1.976, 95%CI：1.037-3.768, P=0.039）, positive thyroglobulin antibodies （OR：2.419, 95%CI：1.160-5.043, P=0.018） and triglycerides （OR：1.241, 95%CI：1.044-1.474, P=0.014） were associated with increased risk of hypothyroidism. Conclusion The prevalence of hypothyroidism in Gansu province was high, affecting approximately one in ten adults, and majority of which were SCH. Both lifestyle factors and metabolic factor were associated with hypothyroidism. Developing a healthy lifestyle at work and home, and paying attention to the control of blood lipids are conducive to the prevention of hypothyroidism.