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成人甲状腺球蛋白作为碘状态的敏感生物标志物:不同碘摄入水平地区的5年随访人群研究

Tg in Adults as a Sensitive Biomarker of Iodine Status: A 5-Year Follow up Population Study in Different Levels of Iodine Intake Regions.

作者信息

Chong Wei, Shi Xiaoguang, Shan Zhongyan, Teng Xiaochun, Teng Di, Guan Haixia, Li Yushu, Jin Ying, Yu Xiaohui, Fan Chenling, Yang Fan, Dai Hong, Yu Yang, Li Jia, Chen Yanyan, Zhao Dong, Hu Fengnan, Mao Jinyuan, Gu Xiaolan, Yang Rong, Tong Yajie, Wang Weibo, Gao Tianshu, Li Chenyang, Teng Weiping

机构信息

Department of Emergency, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, People's Republic of China.

Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, People's Republic of China.

出版信息

PLoS One. 2015 Aug 12;10(8):e0135553. doi: 10.1371/journal.pone.0135553. eCollection 2015.

Abstract

This study was to evaluate the usefulness of serum thymoglobulin (Tg) in adults to assess iodine status through a 5-year cohort study which was conducted in three regions with different levels of iodine intake: mild deficiency, more than adequate, and excess, from 1999 to 2004 in China. A total of 3099 subjects over 14 years old with normal serum levels of Tg in 1999 were eligible, of whom 2448 were followed in 2004. Serum levels of thyroid hormones and thyroid autoantibodies as well as urine iodine were measured, and B-mode ultrasonography of the thyroid was performed. A general linear model was performed to determine the determinant factors of serum Tg. Among subjects with mildly deficient iodine intake, those with more than adequate intake, and those with excessive intake, the baseline levels of serum Tg were substantially different (7.5μg/L, 5.9μg/L, and 6.8μg/L respectively, P<0.01), which were associated with age, sex, the rate of positive TgAb, abnormal thyroid volume, abnormal TSH, and positive personal history of thyroid diseases. The data from 1856 subjects with normal range of thyroid parameters but no personal history of thyroid diseases were analyzed to clarify the effect of iodine intake on Tg. Among these three regions, the serum Tg levels were substantially different in both 1999 and 2004, with a similar pattern for increased Tg (ΔTg) (3.1μg/L, 2.5μg/L and 3.5μg/L respectively, P<0.01). The general linear model analysis revealed that age, Tg, and baseline TSH levels were the determinants of ΔTg besides iodine intake. In conclusion, serum Tg in adults, resulting from a time-accumulative effect of iodine exposure, is a useful biomarker of regional iodine intake.

摘要

本研究旨在通过一项为期5年的队列研究,评估成人血清胸腺球蛋白(Tg)在评估碘营养状况方面的效用。该研究于1999年至2004年在中国三个碘摄入量水平不同的地区进行,分别为轻度缺碘地区、碘摄入适宜地区和碘摄入过量地区。共有3099名14岁以上且1999年血清Tg水平正常的受试者符合条件,其中2448人在2004年接受了随访。检测了甲状腺激素、甲状腺自身抗体的血清水平以及尿碘,并对甲状腺进行了B超检查。采用一般线性模型确定血清Tg的决定因素。在碘摄入轻度不足、碘摄入适宜和碘摄入过量的受试者中,血清Tg的基线水平存在显著差异(分别为7.5μg/L、5.9μg/L和6.8μg/L,P<0.01),这些差异与年龄、性别、TgAb阳性率、甲状腺体积异常、TSH异常以及甲状腺疾病个人史有关。对1856名甲状腺参数在正常范围内且无甲状腺疾病个人史的受试者的数据进行分析,以阐明碘摄入对Tg的影响。在这三个地区中,1999年和2004年的血清Tg水平均存在显著差异,Tg升高(ΔTg)的模式相似(分别为3.1μg/L、2.5μg/L和3.5μg/L,P<0.01)。一般线性模型分析显示,除碘摄入外,年龄、Tg和基线TSH水平是ΔTg的决定因素。总之,成人血清Tg受碘暴露的时间累积效应影响,是区域碘摄入的有用生物标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ced2/4534098/424131293215/pone.0135553.g001.jpg

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