Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, China.
Institute of Endemic Disease Control, Jinan, Shandong Province, China.
Biol Trace Elem Res. 2022 Mar;200(3):1020-1031. doi: 10.1007/s12011-021-02727-w. Epub 2021 Apr 30.
Currently, the removal of iodized salt is carried out in high water iodine regions. The present situation of iodine nutrition and the prevalence of thyroid diseases in such regions have not been clearly elucidated. This study aimed to figure out these problems to help render effective measures for cases of abnormal iodine nutrition status. A cross-sectional study was carried out in four areas of Jining and Heze, Shandong Province, China, with different water iodine concentrations (WIC). In total, 1344 adults were enrolled in this study, and data related to their iodine nutrition, thyroid function, and thyroid ultrasonography were collected. Subjects were grouped according to WIC, urine iodine concentration (UIC), serum iodine concentration (SIC), and combined UIC and SIC for analysis. Iodine levels were in excess in the 100 μg/L ≤ WIC < 300 μg/L and WIC ≥ 300 μg/L areas. Compared with the control WIC group (10-100 μg/L), the WIC ≥ 300 μg/L group had a higher prevalence of thyroid autoimmunity (TAI, 21.25% vs. 13.19%, P <0.05), subclinical hypothyroidism (SH, 20.20% vs. 11.96%, P < 0.05), thyroid nodules (TN, 31.75% vs. 18.71%, P < 0.05), and thyroid dysfunction (23.62% vs. 12.26%, P < 0.05). Compared with the UIC control group (100-300 μg/L), high UIC group (≥ 800 μg/L) had a higher prevalence of TN (33.75% vs. 21.14%, P < 0.05) and thyroid dysfunction (25% vs. 14.47%, P < 0.05). Next, compared with the control SIC group (50-110 μg/L), high SIC group (≥ 110 μg/L) had a higher prevalence of TAI (33.80% vs. 14.47%, P < 0.05), SH (23.94% vs. 14.30%, P < 0.05), and thyroid dysfunction (33.80% vs. 15.29%, P < 0.05). Finally, subjects with the highest UIC and the highest SIC also had a higher prevalence of TAI (25.92% vs. 10.97%, P < 0.05), SH (23.45% vs. 10.97%, P < 0.05), TN (34.56% vs. 15.85%, P < 0.05), and thyroid dysfunction (27.16% vs. 13.41%, P < 0.05) than subjects with middle iodine levels. The iodine nutrition of subjects in the WIC ≥ 300 μg/L areas was still in excess after removing iodized salt from their diets. High levels of iodine also increased the prevalence of TAI, SH, TN, and thyroid dysfunction in those areas. Simply removing iodized salt may not be sufficient for high water iodine regions.
目前，在高水碘地区已经停止供应碘盐。这些地区的碘营养状况和甲状腺疾病的流行情况尚未得到明确阐明。本研究旨在解决这些问题，为异常碘营养状况的病例提供有效的措施。在山东省济宁和菏泽的四个地区进行了一项横断面研究，这些地区的水碘浓度（WIC）不同。共纳入 1344 名成年人，收集了与他们的碘营养、甲状腺功能和甲状腺超声相关的数据。根据 WIC、尿碘浓度（UIC）、血清碘浓度（SIC）和 UIC 和 SIC 的组合对受试者进行分组进行分析。100μg/L≤WIC<300μg/L 和 WIC≥300μg/L 地区的碘含量过高。与对照 WIC 组（10-100μg/L）相比，WIC≥300μg/L 组的甲状腺自身免疫（TAI）患病率更高（21.25%比 13.19%，P<0.05）、亚临床甲状腺功能减退症（SH，20.20%比 11.96%，P<0.05）、甲状腺结节（TN，31.75%比 18.71%，P<0.05）和甲状腺功能障碍（23.62%比 12.26%，P<0.05）。与 UIC 对照组（100-300μg/L）相比，高 UIC 组（≥800μg/L）的甲状腺结节（TN，33.75%比 21.14%，P<0.05）和甲状腺功能障碍（25%比 14.47%，P<0.05）的患病率更高。接下来，与对照 SIC 组（50-110μg/L）相比，高 SIC 组（≥110μg/L）的 TAI 患病率更高（33.80%比 14.47%，P<0.05）、SH（23.94%比 14.30%，P<0.05）和甲状腺功能障碍（33.80%比 15.29%，P<0.05）更高。最后，UIC 和 SIC 最高的受试者的 TAI（25.92%比 10.97%，P<0.05）、SH（23.45%比 10.97%，P<0.05）、甲状腺结节（34.56%比 15.85%，P<0.05）和甲状腺功能障碍（27.16%比 13.41%，P<0.05）的患病率也高于碘水平中等的受试者。WIC≥300μg/L 地区的受试者在停止食用碘盐后，碘营养仍处于过剩状态。高碘水平也增加了这些地区 TAI、SH、TN 和甲状腺功能障碍的患病率。单纯去除碘盐可能不足以解决高水碘地区的问题。
