甘肃省碘营养适宜农村地区成年男性碘营养状况及甲状腺功能调查

Iodine nutritional status and thyroid function of adult males in iodine nutrition appropriate rural areas of Gansu Province

目的了解甘肃省碘营养适宜农村地区成年男性碘营养状况及甲状腺功能状态。方法2017年,选择甘肃省儿童碘营养适宜地区凉州区和临泽县作为调查点,对当地农村地区常住20~49岁男性进行调查,各为52人。采集1次随机尿样测定尿碘;采集空腹血样测定血清促甲状腺激素(TSH),甲状腺激素[游离三碘甲腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))],甲状腺球蛋白抗体(TgAb)和甲状腺微粒体抗体(TMAb),同时进行甲状腺B超检查。结果凉州区、临泽县成年男性尿碘中位数分别为180.2、161.0μg/L,二者比较差异有统计学意义(P<0.05);两地成年男性均无甲状腺肿大;血清TSH中位数分别为1.85、1.61 mU/L,血清FT_(3)、FT_(4)均值分别为5.19、5.16,16.58、16.30 pmol/L,地区间比较差异均无统计学意义(P均>0.05)。两地总体甲状腺功能异常率为6.7%(7/104),以亚临床甲状腺功能减退症(亚甲减)为主(6/7)。其中凉州区、临泽县甲状腺功能异常率分别为5.8%(3/52)、7.7%(4/52),二者比较差异无统计学意义(P>0.05)。两地总的抗体阳性率为12.5%(13/104),其中凉州区、临泽县抗体阳性率分别为13.5%(7/52)、11.5%(6/52),二者比较差异无统计学意义(P>0.05)。总的TgAb、TMAb同时阳性人数占总的抗体阳性人数的9/13,其中凉州区、临泽县抗体同时阳性者的占比分别为7/7、2/6。单纯抗体阳性(不伴有甲状腺激素和TSH异常)人数占总的抗体阳性人数的11/13。结论甘肃省碘营养适宜农村地区成年男性碘营养适宜,但该人群甲状腺功能存在潜在患病风险,应加以关注,定期开展检查。

Objective To study the iodine nutritional status and thyroid function of adult males in iodine nutrition appropriate rural areas of Gansu Province.Methods In 2017,Liangzhou District and Linze County of Gansu Province with suitable children iodine nutrition were selected as the study areas and 52 males aged 20-49 years old were investigated in each study area.One random urine sample was collected to determine urinary iodine.Fasting blood samples were collected to determine serum thyroid-stimulating hormone(TSH),free triiodothyronine(FT_(3)),free thyroxin(FT_(4)),thyroglobulin antibody(TgAb)and thyroid microsomal antibody(TMAb).At the same time,thyroid examination was performed by B-ultrasound.Results The median urinary iodine of adult males in Liangzhou District and Linze County was 180.2 and 161.0μg/L,respectively,and the difference was statistically significant(P<0.05).There was no goiter in adult males in Liangzhou District and Linze County.The serum TSH(median),FT_(3)and FT_(4)(mean value)of adult males in Liangzhou District and Linze County were 1.85,1.61 mU/L,5.19,5.16 pmol/L and 16.58,16.30 pmol/L,respectively.There were no significant differences between the two areas(P>0.05).The overall abnormal rate of thyroid function in the two areas was 6.7%(7/104),mainly subclinical hypothyroidism(6/7).The incidences of thyroid dysfunction in Liangzhou District and Linze County were 5.8%(3/52)and 7.7%(4/52),respectively,with no statistical difference between the two areas(P>0.05).The total positive rate of antibody was 12.5%(13/104).The positive rates of antibody in Liangzhou District and Linze County were 13.5%(7/52)and 11.5%(6/52),respectively,with no statistical difference between the two areas(P>0.05).Both TgAb and TMAb were positive in 9/13 of antibody positive persons,of which the proportion of antibody positive persons in Liangzhou District and Linze County were 7/7 and 2/6,respectively.The 11/13 of the total antibody positive persons were simple antibody positive without thyroid hormone and TSH abnormalities.Conclusion The iodine nutrition of adult males in iodine nutrition appropriate rural areas of Gansu Province is suitable,but there is a potential risk of thyroid disease in this population,which should be paid attention to and checked regularly.