甲状腺体积和结节与硒营养状况的相关性研究

Association of selenium with thyroid volume and thyroid nodules

目的探究本地区甲状腺体积与硒的相关性及硒营养水平是否是甲状腺肿大及甲状腺结节的危险因素。方法本文使用分层抽样的方法调查了年满18周岁且在山西太原居住5年以上的居民,共计1 470人参加了调查,内容包括问卷调查、体格检查、甲状腺功能、甲状腺超声、尿碘及血硒水平,其中1 339人满足条件。本文使用了参数及非参检验分析数据。结果调查人群中尿碘的中位数是:216.4μg/L(四分位数区间:139.9μg/L,303.6μg/L),表明碘的营养情况处于超足量状态;血硒的中位数:78.21μg/L(四分位数区间:58.46μg/L,128.77μg/L);甲状腺体积的中位数7.51 ml(四分位数区间5.90 ml,9.39 ml);血硒浓度与年龄呈负相关(r=-0.088,P=0.001),与BMI、TSH不相关(r=-0.007、P=0.801;r=-0.051、P=0.063);在线性回归分析中甲状腺体积与血硒无显著相关(β=-0.007,P=0.367);硒在有无甲状腺肿大中差异并不显著(P=0.278,OR=1.173);硒在有无甲状腺结节中差异也并不显著(P=0.399,OR=1.073)。结论硒不影响甲状腺肿大的发生,也不是甲状腺结节的影响因素。

Objective To investigate the relationship between thyroid volume and serum selenium, as well as the association between serum selenium concentration and risk for an enlarged thyroid gland and thyroid nodules in our area. Methods We selected residents of Taiyuan using a stratified cluster sampling technique, who were over 18 years old and living in the city for more than 5 years. 1 470 subjects were selected for the study, which involved a questionnaire survey, physical examination, serum thyroid function test, thyroid ultrasound, urinary iodine, and the serum selenium. Ultimately, 1 339 subjects were included in our study. We analyzed the data using appropriate parametric and nonparametric statistical tests. Results The median urinary iodine value was 216.4, interquartile range(IQR): 139.9, 303.6 μg/Lin 1 339 subjects, indicating iodine more than adequate. The median serum selenium level was 78.21(IQR: 58.46, 128.77) μg/L. The median thyroid volume was 7.51(IQR: 5.90, 9.39) ml; In the Spearman correlation, there were inverse correlation between serum selenium and age(r=-0.088, P=0.001). We found no association between serum selenium and body mass index, and thyroid-stimulating hormone(r=-0.007, P=0.801; r=-0.051, P=0.063). In the linear regression analyses, we found no association between thyroid volume and serum selenium(β=-0.007, P=0.367). There were no significant differences in serum selenium between persons with or without goiter or nodules(P=0.278, OR=1.173; P=0.399, OR=1.073). Serum selenium was not a risk factor for goiter or nodules. Conclusion The selenium nutrition in our study population is relative shortage, and serum selenium was neither associated with goiter nor with nodules.