呼伦贝尔市成人碘营养状况及其与甲状腺疾病关系的流行病学调查

Epidemiological survey of adult iodine nutritional status and its relationship with thyroid disease in Hulunbeir city

目的调查呼伦贝尔市成人的碘营养状况及其与甲状腺疾病之间的关系。方法于2017年11月~2018年11月随机选取呼伦贝尔市海拉尔区城区及周围地区的成年人861例作为研究对象,调查采集其年龄、民族以及生活地区,并检测其尿碘、促甲状腺素(TSH)、甲状腺素(FT4)、三碘甲状原氨酸(FT3)、甲状腺过氧化物酶抗体(TPOAb)以及甲状腺球蛋白抗体(TGAb)水平。比较不同年龄、民族以及生活地区人群的尿碘水平,并分析不同碘营养状况人群的甲状腺疾病检出率。结果呼伦贝尔市成人的碘营养状况整体呈碘适量状态。蒙古族与汉族的碘营养状况比较,差异无统计学意义(P>0.05)。海拉尔城区与周边其他旗县的碘营养状况比较,差异无统计学意义(P>0.05)。≤60岁的成人碘营养状况与>60岁的老人人群比较,差异有统计学意义(P<0.05)。不同碘营养状况下,临床甲亢、亚临床甲亢、临床甲减、低T4血症、TPOAb抗体阳性检出率比较,差异无统计学有意义(P>0.05)。碘过量人群的亚临床甲减检出率高于其他碘营养状况者,碘缺乏人群的TGAb抗体阳性检出率高于其他碘营养状况者(P<0.05)。结论呼伦贝尔市的居民整体呈碘适量状态,不同民族和地区间的碘营养状况无明显差异,但老年人的碘缺乏比例更高;碘缺乏可能与TGAb抗体阳性有关,碘过量、碘超足量可能导致亚临床甲减。

Objective To investigate the iodine nutrition status of adults in Hulunbeir city and its relationship with thyroid diseases.Methods From November 2017 to November 2018,861 adults in Hailar district of Hulunbuir city and its surrounding areas were randomly selected as the study subjects.Their age,nationality and living area were investigated.The levels of urinary iodine,thyrotropin(TSH),thyroxine(FT4),triiodothyronine(FT3),thyroid peroxide antibody(TPOAb)and thyroglobulin antibody(TGAb)were measured.The urinary iodine levels of people of different ages,nationalities and living areas were compared,and the detection rate of thyroid diseases in people with different iodine nutrition status was analyzed.Results The overall iodine nutrition status of adults in Hulunbeir city was in an appropriate amount of iodine.There was no significant difference in iodine nutrition between Mongolian and Han nationality(P>0.05).There was no significant difference in iodine nutrition between Hailar city and other surrounding counties(P>0.05).The iodine nutritional status of adults aged≤60 years old was significantly different from that of>60 years old(P<0.05).Under different iodine nutrition conditions,there were no significant differences in the detection rates of clinical hyperthyroidism,subclinical hyperthyroidism,clinical hypothyroidism,hypo T4 emia and TPOAb antibody positive(P>0.05).The detection rate of subclinical hypothyroidism in iodine overdose group was higher than that in other iodine nutrition groups,and the positive detection rate of TGAb antibody in iodine deficiency group was higher than that in other iodine nutrition groups(P<0.05).Conclusion In Hulunbeir city,the residents as a whole showe an appropriate amount of iodine.There is no significant difference in iodine nutrition among different nationalities and regions,but the proportion of iodine deficiency in the elderly is higher.Iodine deficiency may be related to TGAb antibody positive,iodine excess and iodine super sufficient may lead to subclinical hypothyroidism.