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血清碘在评估个体碘营养状况中的应用。

The application of serum iodine in assessing individual iodine status.

机构信息

Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China.

Institute for Endemic Disease Prevention and Treatment of Shanxi Province, Linfen, Shanxi, China.

出版信息

Clin Endocrinol (Oxf). 2017 Dec;87(6):807-814. doi: 10.1111/cen.13421. Epub 2017 Aug 4.

Abstract

CONTEXT

The prevalence of thyroid disease in China is on the rise, and this could be partly associated with excessive iodine intake in some individuals; therefore, increased attention is being paid to individual iodine status. However, current indices are not appropriate for evaluating individual iodine status.

OBJECTIVE

To evaluate the association between serum iodine and urinary iodine (UI), as well as thyroid diseases, and provide an excellent base for future individual iodine status assessment.

DESIGN, SUBJECTS AND MEASUREMENTS: A total of 902 adults were enrolled in this study including 325, 286 and 291 subjects from regions in China where iodine is adequate, sufficient and in excess, respectively. Serum iodine, UI and thyroid function were assessed, and ultrasonography performed in all subjects.

RESULTS

The median serum iodine values of adults with subclinical hypothyroidism, high serum autoantibody and thyroid nodules were significantly higher than those of euthyroid adults (P<0.05). A serum iodine level higher than 100 μg/L was considered as a risk factor for thyroid diseases. Serum iodine had strong nonlinear correlations with UI and thyroid function. When thyroid function was taken as a gold standard, the area under the receiver operating characteristic (ROC) curve for serum iodine was 0.752 and UI was 0.507 for subjects with lower serum iodine and UI levels. The area for serum iodine was 0.773 and UI was 0.638 for subjects with higher serum iodine and UI levels. The areas under these curves were significantly different (P<0.001).

CONCLUSION

In adults, serum iodine had a strong nonlinear correlation with UI and a high level of serum iodine was a risk factor for thyroid diseases.

摘要

背景

中国甲状腺疾病的患病率呈上升趋势,这在一定程度上可能与某些个体碘摄入过量有关;因此,人们越来越关注个体碘状况。然而,目前的指标并不适合评估个体碘状况。

目的

评估血清碘与尿碘(UI)以及甲状腺疾病之间的关系,为未来个体碘状况评估提供良好的基础。

设计、对象和测量:本研究共纳入 902 名成年人,分别来自碘充足、适量和过量的地区,其中包括 325 名、286 名和 291 名受试者。所有受试者均进行了血清碘、UI 和甲状腺功能评估以及超声检查。

结果

亚临床甲状腺功能减退、高血清自身抗体和甲状腺结节患者的血清碘中位数明显高于甲状腺功能正常的成年人(P<0.05)。血清碘水平高于 100μg/L 被认为是甲状腺疾病的危险因素。血清碘与 UI 和甲状腺功能呈强非线性相关。当甲状腺功能作为金标准时,血清碘的受试者工作特征(ROC)曲线下面积为 0.752,UI 为 0.507,用于血清碘和 UI 水平较低的受试者。血清碘的面积为 0.773,UI 为 0.638,用于血清碘和 UI 水平较高的受试者。这些曲线下面积差异有统计学意义(P<0.001)。

结论

在成年人中,血清碘与 UI 呈强非线性相关,高血清碘水平是甲状腺疾病的危险因素。

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