文章摘要
王新玲,热孜万古丽·乌斯曼,马福慧,郭艳英,艾合买提江·吐呼提,赵红丽,木尼拉·阿不都乃依木,靳晓萍,王惠丽,邢淑清.新疆乌鲁木齐市常住居民甲状腺功能、甲状腺自身抗体与尿碘变化的分析[J].中华流行病学杂志,2015,36(8):811-814
新疆乌鲁木齐市常住居民甲状腺功能、甲状腺自身抗体与尿碘变化的分析
Changes of thyroid function, thyroid antibodies and urinary iodine among permanent residents of Urumqi in Xinjiang
收稿日期:2014-11-21  出版日期:2015-08-11
DOI:10.3760/cma.j.issn.0254-6450.2015.08.009
中文关键词: 尿碘;甲状腺功能异常;甲状腺自身抗体
英文关键词: Urinary iodine;Thyroid dysfunction;Thyroid antibodies
基金项目:国家自然科学基金(81260127);乌鲁木齐市天山区科学技术计划(20120101)
作者单位E-mail
王新玲 830001 乌鲁木齐, 新疆维吾尔自治区人民医院内分泌科  
热孜万古丽·乌斯曼 830001 乌鲁木齐, 新疆维吾尔自治区人民医院内分泌科  
马福慧 830001 乌鲁木齐, 新疆维吾尔自治区人民医院内分泌科  
郭艳英 830001 乌鲁木齐, 新疆维吾尔自治区人民医院内分泌科 guozeyang@126.com 
艾合买提江·吐呼提 830001 乌鲁木齐, 新疆维吾尔自治区人民医院内分泌科  
赵红丽 830001 乌鲁木齐, 新疆维吾尔自治区人民医院内分泌科  
木尼拉·阿不都乃依木 830001 乌鲁木齐, 新疆维吾尔自治区人民医院内分泌科  
靳晓萍 830001 乌鲁木齐, 新疆维吾尔自治区人民医院内分泌科  
王惠丽 830001 乌鲁木齐, 新疆维吾尔自治区人民医院内分泌科  
邢淑清 830001 乌鲁木齐, 新疆维吾尔自治区人民医院内分泌科  
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中文摘要:
      目的 了解新疆乌鲁木齐市居民甲状腺疾病知晓率及年龄分布的差异, 分析甲状腺功能、甲状腺自身抗体与尿碘相关性及其变化规律。方法 2013年5月采用横断面方法随机抽取乌鲁木齐市1 995名常住居民, 其中健康成年人1 906名, 年龄18~84岁, 平均(46.3±14.2)岁, 男性占30.4%, 女性占69.6%。采集一次性随机晨尿10 ml测定尿碘, 静脉血测定促甲状腺素(TSH)、血清游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)、甲状腺球蛋白抗体(TgAb)、甲状腺过氧化物酶抗体(TPOAb)。结果 (1)调查居民中新诊断甲状腺功能异常者213例(11.2%, 其中女性占78.4%), 甲状腺功能亢进(甲亢)者占2.7%, 甲状腺功能减低(甲减)者占8.5%;TgAb阳性率为23.2%, TPOAb阳性率为16.6%;人群尿碘M=134.5 μg/L, 人群中碘缺乏占32%, 碘适宜占58%, 碘过量占10%;甲状腺功能正常组和异常组比较、抗体阳性组与阴性组比较其尿碘水平的差异均无统计学意义。(2)将人群划分18~、45~和≥60岁3个年龄组, 则显示随年龄增长TSH水平有明显差异, 且女性高于男性(P<0.001);甲状腺功能正常人群中, TSH水平为抗体阳性组明显高于阴性组(P<0.000 1)。(3)≥60岁与<60岁人群比较, 甲减患病率显著增加(P=0.008), 但甲亢患病率无明显差别, 抗体阳性率亦无明显差异。结论 乌鲁木齐市社区居民甲状腺功能、自身抗体与尿碘水平无明显相关, 女性甲状腺功能异常、抗体阳性率均高于男性, 抗体阳性组TSH水平明显高于阴性组, 老年人群甲减患病率显著增高, 应对该人群定期监测。
英文摘要:
      Objective To understand the rates of diagnosis on thyroid disease and the differences in the distribution of age groups among those permanent residents, to analyze the relationships among thyroid function, thyroid antibodies and urinary iodine. Methods A cross-sectional survey was performed in 1 995 permanent residents in Urumqi, Xinjiang in May, 2013, Among them, 1 906 were healthy adults aged 18-84 age, with mean age as (46.3±14.2) years and 30.4% of them were men. One time 10 ml random urine and blood samples were drown to examine urinary iodine(UI) thyroid stimulating hormone(TSH), free thyroxine(FT4), free triiodothyronine(FT3), anti-thyroglobulin (TgAb) and anti-thyroid peroxidase (TPOAb). Results 1) 213 residents were newly diagnosed as having thyroid dysfunction (11.2%, including 78.4% women), hyperthyroidism(clinical and subclinical hyperthyroidism) that accounted for 2.7%, hypothyroidism (clinical and subclinical hypothyroidism) was accounted for 8.5%. Positive rates of TgAb (23.2%), TPOAb(16.6%) were noticed. The median urinary iodine was 134.5 μg/L, with 32% of the subjects were having iodine deficiency, 58% having adequate iodine and another 10% as under excessive iodine. No differences were observed on urine iodine between thyroid dysfunction and euthyroidism or between subjects with positive and negative antibodies. 2) TSH appeared different among age-groups of 18-, 45- and over 60. TSH showed higher in women than in men, with P value as <0.001. For people with euthyroidism, TSH level in the antibody positive group was significantly higher than the antibody negative group (P<0.000 1). 3) For people over 60 of age, morbidity of hypothyroidism was significantly higher than those under 60 but with no differences related to hyperthyroidism or the antibody positive rate. Conclusion UI levels were not significantly related with thyroid function and thyroid antibodies among residents of Urumqi, women showed higher on thyroid dysfunction or the rate of positive antibody. In the antibody positive group, TSH levels were significantly higher than in the antibody negative group. Hypothyroidism was seen higher in the over 60-years-of-age population. Monitoring programs on thyroid function, thyroid antibodies and urinary iodine among people over 60-years-of-age, should be strengthened.
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