Völzke Henry, Lüdemann Jan, Robinson Daniel M, Spieker Knut W, Schwahn Christian, Kramer Axel, John Ulrich, Meng Wieland
Department of Epidemiology and Social Medicine, Ernst Moritz Arndt University, Greifswald, Germany.
Thyroid. 2003 Aug;13(8):803-10. doi: 10.1089/105072503768499680.
The aim of the present study was to analyze the current status of morphologic and functional thyroid abnormalities in a previously iodine-deficient area.
The population based Study of Health in Pomerania (SHIP) comprised 4310 participants, aged 20-79 years. Thyroid function (thyrotropin [TSH] free triiodothyronine [FT(3)], and free thyroxine [FT(4)]) and serum autoantibodies to thyroperoxidase (TPOAb) were evaluated from blood samples. Thyroid structure and size were measured by ultrasound. Data from 3941 participants with no known thyroid disorders were analyzed.
The median iodine urine excretion was 12.4 microg/dL. The rate of decreased serum TSH levels (<0.3 mIU/L) was 11.3%; 2.2% of participants had suppressed serum TSH levels (<0.1 mIU/L). The prevalence of subclinical hyperthyroidism was 1.8%, the prevalence of overt hyperthyroidism 0.4%. Elevated TSH levels were found in 1.2% of individuals. Subclinical hypothyroidism was observed in 0.5%, overt hypothyroidism in 0.7% of the sample. Elevated TPOAb were detected in 7% of subjects, 4.1% of participants had TPOAb greater than 200 IU/mL. The prevalence of goiter was 35.9%. An inhomogeneous echo pattern was detected in 35.2% and nodules in 20.2% of participants. Diffuse autoimmune thyroiditis was diagnosed in 47 subjects (1.2%).
There are a number of thyroid disorders in this previously iodine-deficient region. Further studies are required to investigate the change of thyroid disorders during iodine supplementation programs.
本研究旨在分析一个既往碘缺乏地区甲状腺形态和功能异常的现状。
基于人群的波美拉尼亚健康研究（SHIP）包括4310名年龄在20 - 79岁的参与者。从血液样本中评估甲状腺功能（促甲状腺激素[TSH]、游离三碘甲状腺原氨酸[FT(3)]和游离甲状腺素[FT(4)]）以及抗甲状腺过氧化物酶血清自身抗体（TPOAb）。通过超声测量甲状腺结构和大小。对3941名无已知甲状腺疾病的参与者的数据进行分析。
尿碘排泄中位数为12.4微克/分升。血清TSH水平降低（<0.3 mIU/L）的比例为11.3%；2.2%的参与者血清TSH水平被抑制（<0.1 mIU/L）。亚临床甲状腺功能亢进的患病率为1.8%，显性甲状腺功能亢进的患病率为0.4%。1.2%的个体TSH水平升高。样本中0.5%观察到亚临床甲状腺功能减退，0.7%为显性甲状腺功能减退。7%的受试者检测到TPOAb升高，4.1%的参与者TPOAb大于200 IU/mL。甲状腺肿的患病率为35.9%。35.2%的参与者检测到不均匀回声模式，20.2%有结节。47名受试者（1.2%）被诊断为弥漫性自身免疫性甲状腺炎。
在这个既往碘缺乏地区存在多种甲状腺疾病。需要进一步研究来调查补碘计划期间甲状腺疾病的变化。
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