Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China.
Hangzhou Institute for Food and Drug Control, Hangzhou 310051, China.
Nutrients. 2024 Oct 30;16(21):3720. doi: 10.3390/nu16213720.
Thyroid autoimmunity (TAI), marked by thyroid peroxidase antibodies (TPOAb) and thyroglobulin antibodies (TgAb), affects over 10% of the general population, with children and adolescents experiencing significant impacts on growth and quality of life despite lower prevalence rates compared to adults. In the context of over 20 years of universal salt iodization (USI) in China, this study investigated the relationship between iodine nutritional status and TAI in children and adolescents aged 6-17. Our findings suggest that while iodine levels are generally sufficient (median urinary iodine concentration [UIC] was 205.2 µg/L), TAI remains a significant concern due to its potential impact on growth and development. TAI was significantly associated with age, sex, and urban-rural residency ( < 0.05). Positive TPOAb and TgAb were identified as risk factors for subclinical hypothyroidism (OR = 2.274, 95% CI: 1.171-1.916). Although some literature suggests that excessive iodine may exacerbate TAI and others propose iodine deficiency as a risk factor, this study did not find a significant overall association between iodine status and TAI. Notably, a low urinary iodine-to-creatinine ratio (UI/Cr) level was linked to an increased risk of TgAb positivity in males (OR = 3.470, 95% CI: 1.200-10.036). In individuals with negative thyroid antibodies, increased BMI (OR = 1.062, 95% CI: 1.032-1.093) and high UI/Cr levels (OR = 1.510, 95% CI: 1.175-1.941) were risk factors for subclinical hypothyroidism, whereas older age (OR = 0.710, 95% CI: 0.555-0.908 for the age 9-11 group; OR = 0.681, 95% CI = 0.484-0.959 for the age 12-17 group) and high UIC levels (OR = 0.739, 95% CI: 0.554-0.985) were associated with reduced risk. No significant associations were observed in the thyroid antibody-positive group. These results highlight the importance of considering individual TAI status when devising iodine supplementation policies.
甲状腺自身免疫性疾病（TAI），以甲状腺过氧化物酶抗体（TPOAb）和甲状腺球蛋白抗体（TgAb）为标志，影响超过 10%的普通人群，儿童和青少年尽管患病率低于成年人，但对生长和生活质量的影响较大。在中国实行了 20 多年的全民食盐碘化（USI）之后，本研究调查了儿童和青少年（6-17 岁）碘营养状况与 TAI 之间的关系。我们的研究结果表明，尽管碘水平普遍充足（中位数尿碘浓度[UIC]为 205.2μg/L），但 TAI 仍然是一个重要的问题，因为它可能会影响生长和发育。TAI 与年龄、性别和城乡居住情况显著相关（<0.05）。阳性 TPOAb 和 TgAb 被确定为亚临床甲状腺功能减退的危险因素（OR=2.274，95%CI：1.171-1.916）。尽管一些文献表明过量碘可能会加重 TAI，而另一些文献则认为碘缺乏是一个危险因素，但本研究并未发现碘状况与 TAI 之间存在显著的总体关联。值得注意的是，尿碘/肌酐比值（UI/Cr）水平较低与男性 TgAb 阳性风险增加相关（OR=3.470，95%CI：1.200-10.036）。在甲状腺抗体阴性的个体中，较高的 BMI（OR=1.062，95%CI：1.032-1.093）和较高的 UI/Cr 水平（OR=1.510，95%CI：1.175-1.941）是亚临床甲状腺功能减退的危险因素，而年龄较大（OR=0.710，95%CI：9-11 岁组为 0.555-0.908；OR=0.681，95%CI=0.484-0.959 岁）和较高的 UIC 水平（OR=0.739，95%CI：0.554-0.985）与降低风险相关。甲状腺抗体阳性组未观察到显著相关性。这些结果强调了在制定碘补充政策时考虑个体 TAI 状态的重要性。
