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早年经历中国大饥荒与成年后患甲状腺功能和疾病的关系:一项横断面研究。

Exposure to the Chinese Great Famine in Early Life and Thyroid Function and Disorders in Adulthood: A Cross-Sectional Study.

机构信息

Department of Endocrinology and Metabolism and the Institute of Endocrinology, The First Hospital of China Medical University, Shenyang, P.R. China.

Department of Endocrinology, Chinese PLA General Hospital, Beijing, P.R. China.

出版信息

Thyroid. 2021 Apr;31(4):563-571. doi: 10.1089/thy.2020.0325. Epub 2020 Dec 23.

DOI:10.1089/thy.2020.0325
PMID:33138723
Abstract

Malnutrition in early life may permanently change the structure and function of the body, which lead to a number of diseases in adulthood. The effect of famine exposure during the early life on thyroid function and disorders remains unclear. This study investigated the association between exposure to the Great Chinese Famine (1959-1961) in early life and thyroid function and disorders in adulthood. Nine thousand eight hundred eighty-one subjects with appropriate birth dates derived from the Thyroid disorders, Iodine status, and Diabetes Epidemiological survey were included. Thyroid function and disorders were defined by the test results of blood sample and ultrasonography of all participants. Associations between famine exposure in early life and thyroid function and disorders in adulthood were assessed with binary logistic regression and linear regression. Participants exposed to the Great Chinese Famine during the fetal stage was associated with a higher thyrotropin (TSH) level in adulthood ( = 0.024;  = 0.038), compared with the nonexposed participants. The association was significant among rural participants ( = 0.039;  = 0.02) but not in urban participants ( = 0.005;  = 0.77). Fetal-exposed group did not show a higher risk of thyroid disorders than the age-matched balanced control group, including overt hyperthyroidism, subclinical hyperthyroidism, overt hypothyroidism, subclinical hypothyroidism, autoimmune thyroiditis, and thyroid nodules ( > 0.05). Famine exposure during the fetal stage was associated with a higher TSH level in adulthood. The fetal stage could be the critical period for programming the pituitary-thyroid axis.

摘要

早期生活中的营养不良可能会永久性地改变身体的结构和功能,从而导致成年后出现多种疾病。在生命早期暴露于饥荒对甲状腺功能和疾病的影响仍不清楚。本研究调查了生命早期暴露于中国大饥荒(1959-1961 年)与成年后甲状腺功能和疾病之间的关系。

本研究从甲状腺疾病、碘状况和糖尿病流行病学调查中选取了 9881 名出生日期合适的受试者。甲状腺功能和疾病通过所有参与者的血液样本检测结果和超声检查来定义。采用二项逻辑回归和线性回归评估生命早期暴露于饥荒与成年后甲状腺功能和疾病之间的关联。

与未暴露于大饥荒的参与者相比,胎儿期暴露于大饥荒的参与者成年后的促甲状腺激素(TSH)水平更高( = 0.024;  = 0.038)。这种关联在农村参与者中更为显著( = 0.039;  = 0.02),但在城市参与者中并不显著( = 0.005;  = 0.77)。与年龄匹配的平衡对照组相比,胎儿期暴露组并没有表现出更高的甲状腺疾病风险,包括显性甲亢、亚临床甲亢、显性甲减、亚临床甲减、自身免疫性甲状腺炎和甲状腺结节( > 0.05)。

胎儿期暴露于饥荒与成年后较高的 TSH 水平相关。胎儿期可能是编程垂体-甲状腺轴的关键时期。

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