Xia Yuting, Ye Yunjie, Liu Mao, Wang Yang, Shang Li, Wang Peihua, Xu Yan
Department for Environmental Health (Endemic Disease Control and Prevention), Jiangsu Provincial Center for Disease Control and Prevention, Jiangsu Road 172, 210009 Nanjing, PR China.
Heliyon. 2024 Nov 1;10(21):e40082. doi: 10.1016/j.heliyon.2024.e40082. eCollection 2024 Nov 15.
With advancements in detection equipment and an increase in the frequency of examinations, thyroid nodules and goiter in children have garnered attention.
This study aims to determine the effects of high iodine and fluoride exposure on thyroid nodules and goiter in school-aged children.
We recruited children aged 8 to 12 from rural Jiangsu, China, based on the concentrations of iodine and fluoride in local drinking water and urine. Participants were divided into four groups: a group with high fluoride and iodine (HFHI), a group with high fluoride (HF), a group with high iodine (HI), and a control group (CONTROL). Fluoride levels in both drinking water and urine samples were measured using the ion-selective electrode method. Urinary iodine (UI) was assessed using inductively coupled plasma mass spectrometry, and children's thyroids were examined with portable ultrasound equipment equipped with a linear 7.5-MHz probe.
The detection rates of thyroid nodules in the HFHI, HF, HI, and CONTROL groups were 10.4 %, 6.5 %, 7.7 %, and 2.8 %, respectively. The goiter detection rates were 3.8 %, 2.9 %, 3.8 %, and 1.1 %, respectively. In the HFHI group, statistically significant correlations were found between urinary fluoride (UF) and thyroid nodules ( = 0.011, adjusted OR and 95 % CIs were 2.29 [1.21, 4.32]), as well as between UI and thyroid nodules ( = 0.038, adjusted OR and 95 % CIs were 1.58 [1.04, 2.40]), and between UI and goiter ( = 0.014, adjusted OR and 95 % CI were 2.31 [1.19, 4.48]). In the HI group, there was a statistically significant link between UI and goiter ( = 0.005, adjusted OR and 95 % CI were 2.45 [1.31, 4.58]).
Combined high iodine and fluoride exposure may have an adverse effect on thyroid nodules in school-age children.
随着检测设备的进步以及检查频率的增加，儿童甲状腺结节和甲状腺肿已受到关注。
本研究旨在确定高碘和高氟暴露对学龄儿童甲状腺结节和甲状腺肿的影响。
我们根据中国江苏农村地区当地饮用水和尿液中的碘和氟浓度，招募了8至12岁的儿童。参与者被分为四组：高氟高碘组（HFHI）、高氟组（HF）、高碘组（HI）和对照组（CONTROL）。使用离子选择电极法测量饮用水和尿液样本中的氟含量。采用电感耦合等离子体质谱法评估尿碘（UI），并使用配备7.5MHz线性探头的便携式超声设备对儿童甲状腺进行检查。
HFHI组、HF组、HI组和对照组的甲状腺结节检出率分别为10.4%、6.5%、7.7%和2.8%。甲状腺肿检出率分别为3.8%、2.9%、3.8%和1.1%。在HFHI组中，尿氟（UF）与甲状腺结节之间存在统计学显著相关性（P = 0.011，调整后的OR和95%CI为2.29 [1.21, 4.32]），尿碘与甲状腺结节之间也存在相关性（P = 0.038，调整后的OR和95%CI为1.58 [1.04, 2.40]），尿碘与甲状腺肿之间同样存在相关性（P = 0.014，调整后的OR和95%CI为2.31 [1.19, 4.48]）。在HI组中，尿碘与甲状腺肿之间存在统计学显著关联（P = 0.005，调整后的OR和95%CI为2.45 [1.31, 4.58]）。
高碘和高氟联合暴露可能对学龄儿童的甲状腺结节产生不利影响。
