碘适宜地区吸烟和甲状腺功能减退症的相关性研究

Study on the correlation between smoking and hypothyroidism in iodine-suitable areas

目的探讨中国6个碘适宜地区不同吸烟状态与甲状腺功能减退症(甲减)的关系。方法在6个城市中采取整群抽样的方法调查了常住居民8 187人,最终纳入7 448人,详细填写流行病学调查问卷,测量身高、体重、腰围及血压,采集血样检测促甲状腺激素(TSH)、甲状腺过氧化物酶抗体(TPOAb)和甲状腺球蛋白抗体(TgAb)。结果被动吸烟和主动吸烟组TSH均值、TPOAb阳性率、TgAb阳性率均低于从不吸烟组(均P<0.01)。主动吸烟组人群中,吸烟指数每增加1个单位,TSH值下降0.023个单位。被动吸烟和主动吸烟组对比不吸烟组,TgAb和TPOAb阳性率均降低(均P<0.01)。主动吸烟和被动吸烟者甲减的患病率降低(均P<0.01)。在女性人群中,主动吸烟组和被动吸烟组临床甲减和亚临床甲减患病的风险降低。在吸烟指数大于70的情况下,亚临床甲减患病的风险明显下降。在男性人群中,主动吸烟组和被动吸烟组亚临床甲减患病的风险降低,且在吸烟指数大于70的情况下,临床甲减、亚临床甲减的患病风险明显下降。结论碘适宜地区吸烟可能降低TSH水平及TPOAb、TgAb阳性率。

Objective To explore the relationship between different smoking status and hypothyroidism in six iodine-suitable areas of China. Methods A total of 8 187 residents were investigated by cluster sampling in six cities, and 7 448 residents were included in the survey. The height, weight, waist circumference, and blood pressure were measured by filling out epidemiological questionnaire. Blood samples were collected to detect thyroid stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), and thyroglobulin antibody (TgAb). Results The mean TSH, TPOAb, and TgAb positive rates in passive smoking and active smoking groups were all lower than those in non-smoking group (all P<0.01). In the active smoking group, the TSH value decreased by 0.023 units for every unit increase in smoking index. The positive rates of TgAb and TPOAb in both passive smoking and active smoking groups were lower than those in non-smoking group (all P<0.01). Active and passive smoking reduced the prevalence of hypothyroidism (both P<0.01). Among women, the risks of clinical hypothyroidism and subclinical hypothyroidism were reduced in both active and passive smoking groups. Besides, the risk of subclinical hypothyroidism decreased significantly when the smoking index was more than 70. In male population, the risk of subclinical hypothyroidism in active and passive smoking group decreased. Besides, the risk of clinical hypothyroidism and subclinical hypothyroidism decreased significantly when the smoking index was more than 70. Conclusion Smoking in iodine-suitable areas may reduce TSH level and the positive rates of TPOAb and TgAb.