社区居民高TSH水平下甲状腺结节与碘营养状况调查

Investigation of thyroid nodules and iodine nutritional status in community residents under the level of high TSH

目的调查兰州市社区居民高促甲状腺激素(TSH)水平下甲状腺结节患病率与碘营养状况。方法对兰州市社区常住居民整群分层抽样,按照高TSH组与正常TSH组进行甲状腺结节患病情况和碘营养状况调查。结果①男性甲状腺结节患病率为17.98%,男性高TSH率占16.85%。女性分别为23.43%和25.31%。甲状腺结节患病率、TSH水平具有性别差异(P<0.05)。②加碘盐政策施行后,相较于37岁以上人群,37岁以下人群的尿碘水平升高,TSH数值降低(P<0.05)。高TSH水平下甲状腺结节患病率与年龄,性别显著相关(P<0.05),但正常水平没有此相关性(P>0.05)。③年龄是发生甲状腺结节的危险因素。TSH水平与收缩压、低密度脂蛋白、空腹血糖、总胆固醇、年龄相关。④尿碘中位数为197.00μg/L,高于其他地区,施行加碘盐政策后尿碘水平显著升高(P<0.05)。尿碘水平与TSH、甲状腺结节的患病率没有相关性;高TSH下单发结节与多发结节患病率不受尿碘影响。结论高TSH可增加甲状腺结节的患病率,同时年龄、性别影响甲状腺结节患病率。目前状态下,居民尿碘和TSH、甲状腺结节患病率均没有相关性。

Objective To investigate the prevalence of thyroid nodules and the iodine nutritional status of community residents in Lanzhou under the high level of TSH.Methods Cluster stratified sampling was conducted among the permanent residents in Lanzhou City,and the investigation of thyroid nodules and iodine nutritional status was divided into two groups-a high TSH group and a normal TSH group.Results(1)The prevalence of male thyroid nodules was 17.98%,and the high TSH rate was 16.85%.For women,they were 23.43% and 25.31%.The prevalence of thyroid nodules and high TSH level showed gender differences(P<0.05).(2) After the iodized salt policy,compared with peoples under 37 years old,the urine iodine content increased and the TSH levels dropped among people over the age of 37(P<0.05).In the high TSH levels,thyroid nodules are significantly correlated with age and gender(P<0.05),but there’s no correlation in normal levels(P>0.05).(3)Age is a risk factor for thyroid nodules.And the TSH level was associated with systolic blood pressure,LDL,fasting blood glucose,total cholesterol,and age.(4) The urinary iodine median was 197.00 μg/L,higher than other regions,and it was significantly increased after the iodized salt policy(P<0.05).There was no correlation between urinary iodine level and the occurrence of TSH,also there’s no correlation between urinary iodine level and thyroid nodules.The prevalence of single and multiple nodules under high TSH was not affected by urinary iodine.Conclusion High TSH can increase the prevalence of thyroid nodules,in the meanwhile,age and gender influence the prevalence of thyroid nodules.At present,however,there is no correlation between urine iodine and TSH,urine iodine and thyroid nodules.