分化型甲状腺癌患者^(131)I治疗前正常碘盐饮食对尿碘浓度和摄碘率的影响

Effect of normal iodized salt diet on urinary iodine concentration and iodine uptake rate in patients with differentiated thyroid cancer before^(131)I treatment

目的探讨正常碘盐饮食对分化型甲状腺癌(DTC)患者^(131)I治疗前尿碘浓度和摄碘率的影响。方法前瞻性研究2021年1月至2022年4月就诊于郑州大学第一附属医院,行甲状腺全切术后首次^(131)I治疗的DTC患者,其中男59例、女130例,年龄(43.7±12.2)岁。根据^(131)I治疗前4周是否行碘盐饮食将患者分为正常碘盐饮食组和限碘盐饮食组。采用两独立样本t检验或χ^(2)检验比较2组的年龄、性别、尿碘浓度、摄碘率和肿瘤危险度分层的差异。此外,根据尿碘浓度将患者分为2组:a1组,尿碘<200μg/L;a2组,尿碘≥200μg/L,采用logistic回归分析影响尿碘浓度的因素。结果正常碘盐饮食组和限碘盐饮食组患者尿碘浓度分别为(140.53±76.66)和(121.74±74.64)μg/L(t=1.67,P=0.489);2组摄碘率如下:(3.77±1.06)%和(3.42±0.97)%(2 h)、(3.33±1.07)%和(3.21±1.15)%(4 h)、(2.90±2.60)%和(3.23±2.94)%(24 h),差异均无统计学意义(t值:2.33、0.68、-0.81,均P>0.05);2组年龄(t=0.56,P=0.889)、性别(χ^(2)=1.33,P=0.250)、肿瘤危险度分层(χ^(2)=0.14,P=0.709)差异也无统计学意义。Logistic回归分析结果显示,肿瘤危险度分层与尿碘浓度有关[比值比(OR)=3.914(95%CI:1.505~10.176),P=0.005]。结论正常碘盐饮食对DTC患者^(131)I治疗前尿碘浓度和摄碘率或无影响。

Objective To investigate the effects of normal iodized salt diet on urinary iodine concentration and iodine uptake rate in patients with differentiated thyroid cancer(DTC)before^(131)I treatment.Methods A prospective study was conducted on patients with DTC(59 male patients and 130 female patients,age(43.7±12.2)years)who received^(131)I treatment for the first time after total thyroidectomy in the First Affiliated Hospital of Zhengzhou University between January 2021 and April 2022.Patients were divided into normal iodized salt diet group and limited iodized salt diet group according to whether iodized salt diet was administered 4 weeks before^(131)I treatment.The age,gender,urinary iodine concentration,iodine uptake rate and tumor risk stratification of the two groups were compared by independent-sample t test orχ^(2)test.In addition,according to the concentration of urinary iodine,patients were divided into group a1(urinary iodine<200μg/L)and group a2(urinary iodine≥200μg/L).Logistic regression analysis was used to analyze the factors affecting urinary iodine concentration.Results The urinary iodine concentration of normal iodized salt diet group was not significantly different from that of non-iodized salt diet group((140.53±76.66)vs(121.74±74.64)μg/L;t=1.67,P=0.489).The iodine uptake rates at 2 h,4 h and 24 h in the 2 groups were(3.77±1.06)%vs(3.42±0.97)%,(3.33±1.07)%vs(3.21±1.15)%,(2.90±2.60)%vs(3.23±2.94)%,respectively(t values:2.33,0.68,-0.81,all P>0.05).There were no significant differences in age(t=0.56,P=0.889),gender(χ^(2)=1.33,P=0.250)and tumor risk stratification(χ^(2)=0.14,P=0.709)between the two groups.Logistic regression analysis showed that tumor risk stratification was associated with urinary iodine concentration(odds ratio(OR)=3.914,95%CI:1.505-10.176;P=0.005).Conclusion Normal iodized salt diet may have no effect on urinary iodine concentration and iodine uptake rate of patients with DTC before^(131)I treatment.