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乌克兰切尔诺贝利核电站事故碘-131暴露队列中与血清甲状腺球蛋白相关的因素。

Factors associated with serum thyroglobulin in a Ukrainian cohort exposed to iodine-131 from the accident at the Chernobyl Nuclear Plant.

作者信息

Peters Kamau O, Tronko Mykola, Hatch Maureen, Oliynyk Valeriy, Terekhova Galyna, Pfeiffer Ruth M, Shpak Victor M, McConnell Robert J, Drozdovitch Vladimir, Little Mark P, Zablotska Lydia B, Mabuchi Kiyohiko, Brenner Alina V, Cahoon Elizabeth K

机构信息

Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States.

Department of Fundamental and Applied Problems of Endocrinology, State Institution 'V.P. Komisarenko Institute of Endocrinology and Metabolism of Academy of Medical Sciences of Ukraine', Kiev, Ukraine.

出版信息

Environ Res. 2017 Jul;156:801-809. doi: 10.1016/j.envres.2017.04.014. Epub 2017 May 12.

Abstract

BACKGROUND

Serum thyroglobulin (Tg) is associated with the presence of thyroid disease and has been proposed as a biomarker of iodine status. Few studies have examined factors related to serum Tg in populations environmentally exposed to ionizing radiation and living in regions with endemic mild-to-moderate iodine deficiency.

METHODS

We screened 10,430 individuals who were living in Ukraine and under 18 years of age at the time of the 1986 Chernobyl Nuclear Power Plant accident for thyroid disease from 2001 to 2003. We estimated the percent change (PC) in serum Tg associated with demographic factors, iodine-131 thyroid dose, and indicators of thyroid structure and function using linear regression. We also examined these relationships for individuals with and without indications of thyroid abnormality.

RESULTS

Mean and median serum Tg levels were higher among participants with abnormal thyroid structure/function. Percent change in serum Tg increased among females, smokers and with older age (p-values<0.001), and Tg increased with increasing thyroid volume, and serum thyrotropin (p-values for trend<0.001). We found no evidence of significant associations between iodine-131 thyroid dose and Tg. Serum Tg levels were inversely associated with iodized salt intake (PC=-7.90, 95% confidence interval: -12.08, -3.52), and over the range of urinary iodine concentration, the odds of having elevated serum Tg showed a U-shaped curve with elevated Tg at low and high urinary iodine concentrations.

CONCLUSION

Serum Tg may be a useful indicator of population iodine status and a non-specific biomarker of structural and functional thyroid abnormalities in epidemiological studies.

摘要

背景

血清甲状腺球蛋白(Tg)与甲状腺疾病的存在相关,并已被提议作为碘状态的生物标志物。很少有研究探讨在环境中暴露于电离辐射且生活在地方性轻度至中度碘缺乏地区的人群中与血清Tg相关的因素。

方法

我们在2001年至2003年期间,对1986年切尔诺贝利核电站事故发生时居住在乌克兰且年龄在18岁以下的10430人进行甲状腺疾病筛查。我们使用线性回归估计与人口统计学因素、碘-131甲状腺剂量以及甲状腺结构和功能指标相关的血清Tg的百分比变化(PC)。我们还对有和没有甲状腺异常迹象的个体研究了这些关系。

结果

甲状腺结构/功能异常的参与者中血清Tg的均值和中位数较高。血清Tg的百分比变化在女性、吸烟者和年龄较大者中增加(p值<0.001),并且Tg随着甲状腺体积和血清促甲状腺激素的增加而增加(趋势p值<0.001)。我们没有发现碘-131甲状腺剂量与Tg之间存在显著关联的证据。血清Tg水平与碘盐摄入量呈负相关(PC = -7.90,95%置信区间:-12.08,-3.52),并且在尿碘浓度范围内,血清Tg升高的几率呈U形曲线,在低尿碘浓度和高尿碘浓度时Tg升高。

结论

在流行病学研究中,血清Tg可能是人群碘状态的有用指标以及甲状腺结构和功能异常的非特异性生物标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6890/10693440/36d38975ba9b/nihms-876458-f0001.jpg

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