尿碘浓度与高尿酸血症和痛风患病率之间的负相关关系：中国大陆的一项横断面和基于人群的研究。

A negative association between urinary iodine concentration and the prevalence of hyperuricemia and gout: a cross-sectional and population-based study in Mainland China.

机构信息

The Institute of Endocrinology, The First Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, 110001, Liaoning, People's Republic of China.

Department of Endocrinology, Cardiovascular and Cerebrovascular Disease Hospital, Ningxia Medical University General Hospital, Yinchuan, 750004, Ningxia, People's Republic of China.

出版信息

Eur J Nutr. 2020 Dec;59(8):3659-3668. doi: 10.1007/s00394-020-02199-z. Epub 2020 Feb 20.

DOI:10.1007/s00394-020-02199-z

PMID:32078063

Abstract

BACKGROUND AND AIMS

Iodine is one of the most important trace elements in the human body. It is not only the main component of thyroid hormones but also has extrathyroid biological functions. To date, there have been no large-scale epidemiological studies on the relationship between hyperuricemia and iodine intake, although both are closely related to health. A population-based epidemiological survey in China offers such an opportunity.

METHODS

This population-based cross-sectional study recruited 75,653 adults aged ≥ 18 years from 2015 to 2017 with a randomized, multistage, stratified sampling strategy. Serum uric acid levels and urinary iodine concentrations (UICs) were measured.

RESULTS

Stratified by UIC, the prevalence of hyperuricemia was 17.8%, 18.8%, 16.0% and 13.7% in the UIC < 100, 100-199, 200-299, and ≥ 300 μg/L groups, respectively; the prevalence of gout was 4.0%, 3.4%, 2.4% and 1.7%, respectively. The prevalence of gout decreased significantly as the UIC increased. The prevalence of hyperuricemia and gout were markedly higher in postmenopausal females than in the premenopausal population (hyperuricemia: 15.9% vs. 8.3%, X = 520.072, p < 0.001; gout: 3.6% vs. 1.3%, X = 219.889, p < 0.001), and the prevalence decreased as the UIC increased. Subjects in the more than adequate and excessive iodine groups had lower likelihoods of having hyperuricemia [aOR = 0.81 (95% CI 0.77-0.85), aOR = 0.68 (95% CI 0.64-0.72)] and lower odds of having gout than subjects in the adequate iodine (AI) group [aOR = 0.77 (95% CI 0.68-0.86), aOR = 0.59 (95% CI 0.51-0.68)].

CONCLUSIONS

UIC was inversely associated with the occurrence of hyperuricemia and gout. More in-depth research and prospective studies are needed to explore the molecular mechanisms and confirm the observed association.

摘要

背景与目的

碘是人体最重要的微量元素之一。它不仅是甲状腺激素的主要成分，而且具有甲状腺外的生物学功能。迄今为止，尽管高尿酸血症和碘摄入都与健康密切相关，但尚未有关于两者之间关系的大规模流行病学研究。中国的一项基于人群的流行病学调查为此提供了机会。

方法

本项基于人群的横断面研究采用随机、多阶段、分层抽样策略，于 2015 年至 2017 年招募了 75653 名年龄≥18 岁的成年人。测量了血清尿酸水平和尿碘浓度（UIC）。

结果

按 UIC 分层，UIC<100μg/L、100-199μg/L、200-299μg/L 和≥300μg/L 组的高尿酸血症患病率分别为 17.8%、18.8%、16.0%和 13.7%；痛风的患病率分别为 4.0%、3.4%、2.4%和 1.7%。随着 UIC 的增加，痛风的患病率显著下降。与绝经前人群相比，绝经后女性的高尿酸血症和痛风患病率明显更高（高尿酸血症：15.9%比 8.3%，X2=520.072，p<0.001；痛风：3.6%比 1.3%，X2=219.889，p<0.001），且随着 UIC 的增加，患病率下降。碘摄入量充足和过量组发生高尿酸血症的可能性较低[比值比（OR）=0.81（95%置信区间 0.77-0.85），OR=0.68（95%置信区间 0.64-0.72）]，发生痛风的可能性也较低[OR=0.77（95%置信区间 0.68-0.86），OR=0.59（95%置信区间 0.51-0.68）]，与碘摄入量充足（AI）组相比。