合肥市包河区成年人群碘营养状况与甲状腺疾病调查分析

Investigation and analysis of iodine nutrient status and thyroid diseases among adults in Baohe district of Hefei city

目的了解合肥市包河区成年人碘营养状况和甲状腺疾病患病情况。方法选取2 628例18岁以上常住居民,采集一次性晨尿5 ml测定尿碘(UI),以UI水平将调查对象进行分组;空腹静脉血测定促甲状腺激素(TSH)、游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)、甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)水平。结果①总人群尿碘中位数(MUI)为209.67 μg/L,城区居民UI水平与农村比较差异无统计学意义,女性的UI水平低于男性,碘缺乏(ID)组291例(11.07%),碘足量组941例(35.81%),碘超足量组687例(26.14%),碘过量组709例(26.98%), ID组的女性占比高;②总人群TSH中位数为2.63 μIU/ml;调查人群中甲状腺功能亢进占0.53%,亚临床甲状腺功能亢进占0.38%,甲状腺功能减退占0.84%,亚临床甲状腺功能减退(亚甲减)占19.25%,甲状腺异常者以亚甲减多见;甲状腺功能亢进组UI水平高于其他组;③ TPOAb抗体阳性组及TGAb阳性组UI水平高于TPOAb抗体阴性组及TGAb阴性组,差异有统计学意义;单抗体阳性组UI水平高于双抗体阳性组,差异有统计学意义;④多因素Logistic回归分析结果显示TPOAb阳性是甲状腺疾病危险因素。结论合肥市包河区人群平均碘营养处于超足量水平,城乡居民碘营养状态基本相当,甲状腺功能异常以亚甲减多见。

Objective To understand the status of iodine nutrition and thyroid disease among adults in Baohe district of Hefei city. Methods A total of 2 628 permanent residents over 18 years old were selected, 5 ml of disposable morning urine was collected for urine iodine (UI) detection, All of participants were divide into different groups according to the level of UI;Blood samples were drown to examine thyroid stimulating hormone (TSH), free thyroxine(FT4), free triiodothyronine(FT3), thyroperoxidase antibody (TPOAb) and thyroglobulin antibody (TGAb). Results ① The median urinary iodine (MUI) was 209.67 μg/L,the level of UI between urban and rural area had no statistical significance,the median of UI concentration in female was lower than male. All of participants were divided into iodine deficiency group(291,11.07%),iodine adequate group(941,35.81%), iodine super adequate group(687,26.14%);The proportion of women in the iodine-deficient group were higher than other groups.② The median levels of TSH in total population were 2.63 μIU/ml;Hyperthyroidism that accounted for 0.53%,subclinical hyperthyroidism was accounted for 0.38%,hypothyroidism was accounted for 0.53%,subclinical hypothyroidism was accounted for 19.25%;Hypothyroidism was more common in participants with thyroid abnormalities,the UI level of euthyroidism group was significant higher than others groups.③ The UI level of TPOAb positive group and TGAb positive group were significantly higher than TPOAb negative group and TGAb negative group;The UI level of single antibody positive group were significantly higher than that of double antibody positive group.④ Multivariate Logistic regression analysis showed that TPOAb positive was important risk factors for thyroid disease. Conclusion The general level of iodine nutrition in the participants is super excessive in Baohe district of Hefei city;The resident's nutrition status of iodine in urban and rural are roughly equivalent. Subclinical hypothyroidism are common in population with thyroid dysfunction.