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中国青海碘营养与甲状腺疾病的关系。

Relation between iodine nutrition and thyroid diseases in Qinghai, China.

机构信息

Department of Endocrinology, Qinghai Provincial People's Hospital, Xining, China.

Key Laboratory of Ministry of Education for High Altitude Medicine, Research Center for High Altitude Medicine, Xining, China.

出版信息

Front Endocrinol (Lausanne). 2023 Sep 8;14:1234482. doi: 10.3389/fendo.2023.1234482. eCollection 2023.

Abstract

OBJECTIVE

To investigate the adult iodine nutrition and the prevalence of thyroid diseases in Qinghai Province, and analyze the correlation between iodine and thyroid diseases, so as to provide a basis for adjusting the salt iodization plan in Qinghai Province.

METHODS

Using cluster and stratified sampling method to select 2628 permanent residents over 18 years old in Qinghai Province for questionnaire survey, physical examination, thyroid color ultrasound, and laboratory index detection.

RESULTS

  1. The coverage of iodized salt in adults is 99.71%. 2. The detection rates of thyroid disorders in adults were as follows: Clinical hyperthyroidism was 1.20%, subclinical hyperthyroidism was 0.20%, clinical hypothyroidism was 1.00%, subclinical hypothyroidism was 29.20%, and the goiter was 2.10%. The percentages positivity of TPO Ab, TG Ab, goiter was 9.80%, 9.20%, 2.10%, respectively. Among them single thyroid nodule was 6.40%, multi-nodule thyroid gland was 1.80%. 3. The percentages of mild iodine deficiency, moderate iodine deficiency, Severe iodine deficiency, adequate iodine intake (AI), more than adequate iodine intake (MAI)and excessive iodine intake (EI)were 8.41%, 2.17%, 0.26%, 33.22%, 28.35%, and 27.59%, respectively. The percentages of mild, moderate and severe iodine deficiency in urban populations (7.13%, 0.87%, 0.0%) were significantly lower than those in rural populations (9.81%, 3.59%, 0.56%) (P < 0.05), and the rates of adequate, more than adequate iodine intake in urban populations (36.03%, 30.93%) were significantly higher than that in rural populations (30.14%, 25.52%). The rate of excess iodine intake was higher in rural areas (30.38%) than in urban areas (25.04%). 4. The positive rates of subclinical hypothyroidism, goiter, TPO Ab and TG Ab in female adults (35.28%, 3.39%, 13.54%, 13.94%) were higher than those in male adults (23.58%, 0.96%, 6.266%, 4.79%). The detection rate of single thyroid nodules was higher in urban (8.01%) than rural populations (4.70%), while the detection rate of hypothyroidism, subclinical hypothyroidism, and goiter (0.58%, 25.84%, 1.38%) was lower than that in rural populations (1.52%, 32.96%, 2.96%) (P<0.05). 5. There was no statistical significance in the detection rates of clinical hyperthyroidism, subclinical hypothyroidism, subclinical hypothyroidism, goiter, thyroid nodules, TPO Ab and TG Ab positive rates in different iodine nutritional status (P>0.05). The positive rate of hypothyroidism in the iodine deficiency group is higher than in other iodine nutrition groups.

CONCLUSION

The nutritional status of iodine in Qinghai Province is iodine excess. Subclinical hypothyroidism was detected at a high rate. Subclinical hypothyroidism, goiter, TPO Ab, and TG Ab were more common in female than in male. The proportion of mild, moderate, and severe iodine deficiency was higher in urban areas than in rural areas. The detection rate of thyroid nodules was higher in urban than in rural areas, and that of hypothyroidism, subclinical hypothyroidism, and goiter was lower than that in rural populations. The detection rate of clinical hypothyroidism was statistically significant in different iodine nutritional states (P< 0.05).

摘要

目的

调查青海省成人碘营养及甲状腺疾病流行情况,分析碘与甲状腺疾病的相关性,为调整青海省食盐加碘方案提供依据。

方法

采用整群分层抽样方法,选取青海省 18 岁及以上常住居民 2628 人进行问卷调查、体格检查、甲状腺彩色超声及实验室指标检测。

结果

  1. 成人碘盐覆盖率为 99.71%。2. 成人甲状腺疾病检出率如下:临床甲亢 1.20%、亚临床甲亢 0.20%、临床甲减 1.00%、亚临床甲减 29.20%、甲状腺肿 2.10%。TPOAb、TGAb 阳性率、甲状腺肿检出率分别为 9.80%、9.20%、2.10%。其中单发甲状腺结节 6.40%,多发结节甲状腺 1.80%。3. 碘轻度缺乏、中度缺乏、重度缺乏、碘适宜摄入量(AI)、碘超适宜摄入量(MAI)、碘过量的比例分别为 8.41%、2.17%、0.26%、33.22%、28.35%、27.59%。城市人群碘轻度、中度、重度缺乏比例(7.13%、0.87%、0.0%)显著低于农村人群(9.81%、3.59%、0.56%)(P<0.05),城市人群碘适宜、碘超适宜摄入量比例(36.03%、30.93%)显著高于农村人群(30.14%、25.52%)。农村地区碘过量摄入比例(30.38%)高于城市地区(25.04%)。4. 女性成人亚临床甲减、甲状腺肿、TPOAb、TGAb 阳性率(35.28%、3.39%、13.54%、13.94%)高于男性(23.58%、0.96%、6.266%、4.79%)。城市人群甲状腺单发结节检出率(8.01%)高于农村人群(4.70%),而甲减、亚临床甲减、甲状腺肿检出率(0.58%、25.84%、1.38%)低于农村人群(1.52%、32.96%、2.96%)(P<0.05)。5. 不同碘营养状态下临床甲亢、亚临床甲减、亚临床甲减、甲状腺肿、甲状腺结节、TPOAb、TGAb 阳性率检出率差异均无统计学意义(P>0.05)。碘缺乏组甲减检出率高于其他碘营养组。

结论

青海省碘营养状况处于碘过量状态。亚临床甲减检出率较高。亚临床甲减、甲状腺肿、TPOAb、TGAb 在女性中较男性更为常见。城市人群碘轻度、中度、重度缺乏比例高于农村人群。城市人群甲状腺结节检出率高于农村人群,而甲减、亚临床甲减、甲状腺肿检出率低于农村人群。不同碘营养状态下临床甲减检出率差异有统计学意义(P<0.05)。

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