文章摘要
王莹莹,徐芊,徐东丽,董晓莲,苏美芳,钱俊华,江峰,付朝伟,姜庆五,王娜.青春发育与女性甲状腺形态及功能状况的关联研究[J].中华流行病学杂志,2020,41(6):877-883
青春发育与女性甲状腺形态及功能状况的关联研究
Association between puberty with thyroid morphology and function in women
收稿日期:2019-06-26  出版日期:2020-06-16
DOI:10.3760/cma.j.cn112338-20190626-00470
中文关键词: 青春发育;甲状腺容积;甲状腺结节;甲状腺激素
英文关键词: Puberty;Thyroid volume;Thyroid nodules;Thyroid hormones
基金项目:上海市公共卫生三年行动计划慢病重点学科项目(15GWZK0801);国家自然科学基金(81602806)
作者单位E-mail
王莹莹 复旦大学公共卫生学院流行病学教研室 公共卫生安全教育部重点实验室, 上海 200032  
徐芊 复旦大学公共卫生学院流行病学教研室 公共卫生安全教育部重点实验室, 上海 200032  
徐东丽 上海市闵行区疾病预防控制中心 201100  
董晓莲 浙江省德清县疾病预防控制中心 313000  
苏美芳 浙江省玉环市疾病预防控制中心 317600  
钱俊华 江苏省海门市疾病预防控制中心 226100  
江峰 复旦大学公共卫生学院流行病学教研室 公共卫生安全教育部重点实验室, 上海 200032  
付朝伟 复旦大学公共卫生学院流行病学教研室 公共卫生安全教育部重点实验室, 上海 200032  
姜庆五 复旦大学公共卫生学院流行病学教研室 公共卫生安全教育部重点实验室, 上海 200032  
王娜 复旦大学公共卫生学院流行病学教研室 公共卫生安全教育部重点实验室, 上海 200032 na.wang@fudan.edu.cn 
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中文摘要:
      目的 探讨不同青春发育分期对女性甲状腺形态及功能状况的影响。方法 2017年10-11月,采用分阶段整群抽样的方法,分别在上海市闵行区、江苏省海门市、浙江省玉环市、浙江省德清县各选定1所初中,将4所初中所有初一年级女生共491名纳入研究。对研究对象进行甲状腺B超检查、体格检查以及尿碘、甲状腺激素水平检测;采用《青春发育事件自我评定量表》(PDS)评价青春发育分期;采用多重线性回归模型及多因素logistic回归模型分析不同青春发育分期对甲状腺容积及激素水平的影响。结果 不同青春发育阶段女性的甲状腺状况存在差异。甲状腺容积大小、结节检出率及FT4水平均表现为青春期前期 < 青春发动期 < 青春期后期(P<0.05);TT3及FT3水平表现为青春期前期 > 青春发动期 > 青春期后期(P<0.001);TSH及TT4水平不受青春发育分期的影响(P>0.05)。多重线性回归分析及多因素logistic回归分析结果一致,青春发育与TT3和FT3水平呈负相关。PDS总分每增加1分,TT3和FT3水平在模型1中分别减少0.067 nmol/L和0.170 nmol/L,在模型2中分别减少0.065 nmol/L和0.162 nmol/L;相较于青春期前期者,青春期后期者具有较低的TT3和FT3水平(模型1:OR=0.337,95% CI:0.173~0.658;OR=0.283,95% CI:0.144~0.557;模型2:OR=0.306,95% CI:0.155~0.605;OR=0.263,95% CI:0.132~0.524)。结论 青春发育与女性甲状腺形态及功能状况存在关联。青春发育越成熟,甲状腺容积越大,结节越易发生,TT3及FT3水平越低。
英文摘要:
      Objective To explore the effects of different puberty development stages on thyroid morphology and function in women. Methods From October to November 2017, a multi-stage cluster sampling method was used to select one junior high school in Minhang district of Shanghai, Haimen city of Jiangsu province, Yuhuan city of Zhejiang province and Deqing county of Zhejiang province respectively. A total of 491 girls in the first grade in 4 schools were included in the study. The subjects were examined with thyroid B-ultrasound and physical examination, and their morning random urine samples and fasting blood samples were collected to detect urinary iodine and thyroid function indexes. Puberty Development Self-rating Scale (PDS) was used to evaluate the stages of puberty; multiple linear regression models and logistic regression models were used to investigate the effects of different puberty stages on thyroid morphology and function. Results There were differences in thyroid status among women at different stages of puberty. Thyroid volume, the rate of nodules and the level of FT4 were lowest in prepubertal period, followed by pubertal period and postpubertal period (P<0.05). TT3 and FT3 levels were highest in prepubertal period, followed by pubertal period and postpubertal period (P<0.001), and there was an opposite trend on the abnormal rate. TSH and TT4 levels were not affected by the stage of puberty (P>0.05). Multiple linear regression analysis and multivariate logistic regression analysis showed consistent results. There was a negative correlation between puberty development and TT3 and FT3 levels. For each 1 point increase in PDS, TT3 and FT3 levels decreased by 0.067 nmol/L and 0.170 nmol/L in Model 1, respectively, and decreased by 0.065 nmol/L and 0.162 nmol/L in Model 2, respectively. Compared with the prepubertal period, the TT3 and FT3 levels were lower in postpubertal period (Model 1: OR=0.337, 95%CI: 0.173-0.658; OR=0.283, 95%CI: 0.144-0.557; Model 2: OR=0.306, 95%CI: 0.155- 0.605; OR=0.263, 95%CI: 0.132-0.524). Conclusions The process of puberty is related to the thyroid status in women. The better matured during the puberty, the larger volume the thyroid was, more likely the thyroid nodules appeared, and the levels of TT3 and FT3 was much lower.
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