成年人尿碘浓度、硒摄入量和甲状腺抗体之间的关系，包括碘和硒之间的相互作用：2007-2012 年国家健康和营养调查。

The Relationships among the Urinary Iodine Concentration, Selenium Intake, and Thyroid Antibodies in Adults, Including the Interaction between Iodine and Selenium: National Health and Nutrition Examination Survey 2007-2012.

机构信息

Department of Endocrinology and Metabolism, Institute of Endocrinology, National Health Commission (NHC) Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, China Medical University, Shenyang 110001, China.

出版信息

Nutrients. 2024 Oct 11;16(20):3443. doi: 10.3390/nu16203443.

DOI:10.3390/nu16203443

PMID:39458439

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11509967/

Abstract

OBJECTIVES

The objective of this study was to examine the urinary iodine concentration (UIC)-thyroid autoimmunity (TAI) association and UIC-selenium intake interaction in U.S. adults.

METHODS

We analyzed 2007-2012 National Health and Nutrition Examination Survey (NHANES) data on ≥20-year-old adults ( = 6612). Their food and supplemental selenium intake was measured. The associations of the UIC and selenium intake with thyroid peroxidase antibody (TPOAb) positivity, thyroglobulin antibody (TgAb) positivity, and TAI were assessed via weighted multivariable logistic regression. Interaction and subgroup analyses were conducted. Nonlinear relationships were explored and visualized via restricted cubic splines (RCSs).

RESULTS

Compared with a UIC 100~~200 μg/L, a UIC 500~~800 μg/L was associated with a 57% increased TPOAb positivity risk (OR = 1.57 [CI = 1.07-2.30]; = 0.022), a one-fold greater TgAb positivity risk (OR = 2.00 [CI = 1.10-3.65]; = 0.025), and a 62% increased TAI risk (OR = 1.62 [CI = 1.07-2.45]; = 0.024). Nonlinear relationships between the UIC and thyroid antibody positivity were observed. According to the univariate models, each 1 μg increase in selenium intake was associated with a 0.049 IU/mL decrease in the TPOAb levels (β [95% CI] = -0.049 [-0.092--0.005]; = 0.028). In the low-selenium group, a UIC of 200~~300 μg/L was a risk factor for TPOAb positivity ( = 0.046). At a moderate level of selenium intake, a UIC of 300~~800 μg/L significantly increased the TPOAb positivity risk (all < 0.05). At a high level of selenium intake, the UIC and TPOAb positivity risks were not significantly associated (all > 0.05).

CONCLUSIONS

A UIC of 500~800 μg/L is an independent TAI risk factor. The selenium intake modifies the UIC-thyroid antibody positivity relationship, with the association disappearing at high selenium levels.

摘要

目的

本研究旨在探讨美国成年人尿碘浓度（UIC）-甲状腺自身免疫（TAI）的相关性以及 UIC-硒摄入的相互作用。

方法

我们分析了 2007-2012 年全国健康和营养调查（NHANES）≥20 岁成年人的数据（n=6612）。测量了他们的食物和补充硒的摄入量。通过加权多变量逻辑回归评估 UIC 和硒摄入与甲状腺过氧化物酶抗体（TPOAb）阳性、甲状腺球蛋白抗体（TgAb）阳性和 TAI 的关联。进行了交互作用和亚组分析。通过受限立方样条（RCS）探索和可视化非线性关系。

结果

与 UIC 100-200μg/L 相比，UIC 500-800μg/L 与 TPOAb 阳性风险增加 57%相关（OR=1.57[CI=1.07-2.30]；=0.022），TgAb 阳性风险增加 1 倍（OR=2.00[CI=1.10-3.65]；=0.025）和 TAI 风险增加 62%（OR=1.62[CI=1.07-2.45]；=0.024）。观察到 UIC 与甲状腺抗体阳性之间存在非线性关系。根据单变量模型，硒摄入量每增加 1μg，TPOAb 水平下降 0.049IU/mL（β[95%CI]=-0.049[-0.092--0.005]；=0.028）。在低硒组中，UIC 200-300μg/L 是 TPOAb 阳性的危险因素（=0.046）。在中等硒摄入量水平下，UIC 300-800μg/L 显著增加 TPOAb 阳性风险（均<0.05）。在高硒摄入量水平下，UIC 与 TPOAb 阳性风险无显著相关性（均>0.05）。