Renaguli Aikebaier, Luo Y Z, Wang X L, Dilidaer Yimamu, Muyeshsaer Wulamu, Guzailinuer Julaiti, Zhang Y Y, Xin Y Y, Guo Yanying
Department of Endocrinology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, China.
Zhonghua Fu Chan Ke Za Zhi. 2018 Sep 25;53(9):595-601. doi: 10.3760/cma.j.issn.0529-567x.2018.09.003.
To investigate the relationship between thyrotropin (TSH) and urine iodine in pregnant women of Han and Uygur ethnic groups in People's Hospital of Xinjiang Uygur Autonomous Region. A total of 1 568 pregnant who completed screening of TSH and urine iodine in People's Hospital of Xinjiang Uygur Autonomous Region hospital from August 2014 to December 2017 were included in the study, 956 cases were Han and the other 612 were Uygur. Basic clinical data, serum TSH, thyroid peroxidase autoantibody (TPOAb) , and urine iodine levels were retrospectively analyzed. (1) General results: The median urine iodine level was 162.6 μg/L (53.4-539.3 μg/L) , and the distribution of urine iodine classification was iodine deficiency 42.9% (672/1 568) , iodine appropriate 36.7% (576/1 568) , iodine slightly high 17.1% (268/1 568) and iodine excess 3.3% (52/1 568) respectively. (2) The median urine iodine levels of Han and Uygur pregnant women were 169.1 μg/L (54.6-583.4 μg/L) and 156.3 μg/L (53.1-539.3 μg/L) respectively, and the difference was statistically significant (<0.05) .The distribution of urine iodine status in pregnancy between Han and Uygur was significantly different, which were 40.9% (391/956) . 45.9% (281/612) in iodine deficiency, 35.4% (338/956) . 38.9% (238/612) in iodine appropriate, 20.2% (193/956) . 12.3% (75/612) in iodine slightly high and 3.6% (34/956) . 2.9% (18/612) in iodine excess. (3) High serum TSH level proportion was significantly higher in Uygur ethnic group, early pregnancy, thyroid peroxidase antibody positive and anti-thyroglobulin antibody positive group when compared with Han, late pregnancy, thyroid peroxidase antibody negative and anti-thyroglobulin antibody negative groups (all <0.05) . There were no significant differences in different age groups and iodine nutrition groups (>0.05) . (4) There was no correlation between urinary iodine and TSH levels in all pregnant women (>0.05) , neither in Han or Uygur group. When further stratified by gestational age, age, and antibody level, there was a positive correlation between urine iodine and serum TSH level in Han pregnant women >30 years old (<0.05) , and there was a negative correlation in the third trimester in Uygur (<0.05) . When serum antibody level, gestational week and age were controlled. There was no correlation between urine iodine and serum TSH level in neither group. (1) In Han and Uygur pregnant women, the median urine iodine level and the distribution of urine iodine classification between two ethnic groups are significantly different. (2) The correlation between urine iodine and serum TSH is not identified in Han or Uygur pregnant women.
为探讨新疆维吾尔自治区人民医院汉族和维吾尔族孕妇促甲状腺激素(TSH)与尿碘的关系。选取2014年8月至2017年12月在新疆维吾尔自治区人民医院完成TSH和尿碘筛查的1568例孕妇纳入研究,其中汉族956例,维吾尔族612例。回顾性分析其基本临床资料、血清TSH、甲状腺过氧化物酶自身抗体(TPOAb)及尿碘水平。(1)一般结果:尿碘中位数水平为162.6μg/L(53.4~539.3μg/L),尿碘分类分布为碘缺乏42.9%(672/1568)、碘适宜36.7%(576/1568)、碘轻度升高17.1%(268/1568)、碘过量3.3%(52/1568)。(2)汉族和维吾尔族孕妇尿碘中位数水平分别为169.1μg/L(54.6~583.4μg/L)和156.3μg/L(53.1~539.3μg/L),差异有统计学意义(<0.05)。汉族和维吾尔族孕期尿碘状态分布差异有统计学意义,碘缺乏分别为40.9%(391/956)、45.9%(281/612),碘适宜分别为35.4%(338/956)、38.9%(238/612),碘轻度升高分别为20.2%(193/956)、12.3%(75/612),碘过量分别为3.6%(34/956)、2.9%(18/612)。(3)维吾尔族、孕早期、甲状腺过氧化物酶抗体阳性及抗甲状腺球蛋白抗体阳性组血清TSH高水平比例显著高于汉族、孕晚期、甲状腺过氧化物酶抗体阴性及抗甲状腺球蛋白抗体阴性组(均<0.05)。不同年龄组及碘营养组差异无统计学意义(>0.05)。(4)所有孕妇尿碘与TSH水平均无相关性(>0.05),汉族和维吾尔族组均如此。进一步按孕周、年龄及抗体水平分层后,汉族>30岁孕妇尿碘与血清TSH水平呈正相关(<0.05),维吾尔族孕晚期呈负相关(<0.05)。控制血清抗体水平、孕周及年龄后,两组尿碘与血清TSH水平均无相关性。(1)汉族和维吾尔族孕妇尿碘中位数水平及两民族间尿碘分类分布差异有统计学意义。(2)汉族和维吾尔族孕妇尿碘与血清TSH无相关性。