Current investigation of thyroid diseases in residents of different degree of high iodine and high fluorine area
Objective To investigate the status of thyroid diseases in different iodine and fluoride areas in Anhui Province,so as to explore the effect of high iodine and fluoride on thyroid diseases.Methods According to the historical water iodine and water fluorine value,Huangkou Town(high iodine and high fluorine)and Qinglong Town(suitable iodine and normal fluorine)of Xiao County were selected as the investigation sites.The status of dietary salt,urinary iodine,urinary fluorine and thyroid diseases were investigated.Results A total of 876 residents were investigated,including 435 in the area of high iodine and high fluorine,441 in the area of normal iodine and fluorine,247 males(28.2％)and 629 females(71.8％).A total of 872 salts were collected.The percentage of uniodized salt was 93.2％,and the median salt iodine was 0.0 mg/kg.The proportion of uniodized salt in high iodine and high fluorine area was 96.3％,and the proportion of uniodized salt in normal fluorine area was 90.2％.There was significant difference in the rate of uniodized salt between the two areas(x2=13.120,P＜0.001).Urine fluoride was detected in 851 samples.The median urine fluoride was 2.3 mg/L,and the median urine fluoride was 3.2 mg/L in the high iodine and high fluorine area and 1.5 mg/L in the normal iodine fluorine area,respectively.There was significant difference in urine fluorine concentration between the two areas(Z=-13.430,P＜0.001).The median urine iodine was 411.2 µg/L in 867 samples.The median urinary iodine in the areas with high iodine and high fluorine and the areas with normal iodine were 508.4 and 347.1 μg/L,respectively.There were significant differences in urinary iodine concentration among different regions(Z=-9.486,P＜0.001).A total of 865 blood samples were tested,137 with abnormal TSH(15.8％abnormality rate)and 55 with abnormal FT4(6.4％abnormality rate).There was a statistically significant difference in TSH level between the two areas(Z=-6.868,P＜0.001),and there was a statistically significant difference in FT4 level between the two areas(t=-4.507,P＜0.001).The abnormal rate of TSH was statistically significant(x2=22.334,P＜0.001).Among the 865 blood samples,163 patients had abnormal thyroid function,the abnormal rate was 18.8％,and the detection rates of hyperthyroidism,subthyroidism,hypothyroidism,subhypothyroidism and hypo FT4 were 1.0％,0.5％,2.4％,12.5％and 2.4％,respectively.There were significant differences in thyroid dysfunction and subhypothyroidism between the two regions(X2=19.722,16.405,P＜0.001).Thyroid nodules were detected by B-ultrasound in 157 patients,and the nodules rate was 17.9％(157/876).There were statistically significant di-fferences in thyroid nodule rates among different regions,genders and age groups(x2=11.162,12.792,10.555;P=0.001,P＜0.001,0.014).Conclusion The iodine nutrition of residents in areas with high iodine,high fluorine and normal iodine is at the iodine excess level.In addition to implementing the policy of uniodized salt,other feasible prevention and control measures should be explored.The abnormal thyroid function rate of residents in the area of high iodine and high fluorine is higher than that in the area of normal iodine and high fluorine.
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