A study of the correlation between urinary iodine and thyroid dysfunction in Kunming of Yunnan
谢亚娟 1牛奔 2邓真亭 1高洁 3苏恒 3薛元明3
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作者信息
1. 云南中医药大学第一临床医学院，昆明 650500
2. 云南省第一人民医院老年医学科，昆明理工大学附属医院，昆明 650032
3. 云南省第一人民医院内分泌代谢科，昆明理工大学附属医院，昆明 650032
折叠
摘要
目的 调查云南省昆明市碘营养状况及甲状腺功能异常的患病情况，研究甲状腺功能异常与尿碘的相关性及危险因素。 方法 本研究为横断面调查，按照多阶段、分层整群抽样方法，选取2014年1月至2016年7月符合纳入标准的云南省昆明市居民作为研究对象，共2 650人，通过问卷调查、身体测量、实验室检测获得受试者基本情况及相关数据。结合纳入排除标准并剔除缺失值数据，最终纳入1 463例受试者进行分组分析。采用SPSS 26.0软件进行统计学分析，使用R Studio描述尿碘与甲状腺功能异常发生风险的非线性关系。 结果 (1) 2 650名受试者中，甲状腺功能异常者共755例(28.5%)，临床甲状腺功能亢进症、亚临床甲状腺功能亢进症、临床甲状腺功能减退症、亚临床甲状腺功能减退症、单纯甲状腺抗体阳性的患病率分别为0.83%、0.38%、1.36%、17.66%、13.85%；总尿碘中位数为177.49(123.59，251.85)μg/L，人群总体碘营养状况处于碘适宜状态。(2)在符合纳入排除标准的1 463例受试者中，尿碘中位数在健康人群组与促甲状腺激素(TSH)异常组、TSH异常组与抗体阳性组中比较差异有统计学意义(H＝－83.437, P＝0.003；H＝107.489, P＝0.003)。Logistic回归分析结果显示，农村地区相比于城市地区患甲状腺功能异常的风险降低(OR＝0.429，95%CI 0.256～0.717, P＝0.001)；随着年龄的升高，患甲状腺疾病的风险随之升高；TSH、甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TgAb)、尿碘浓度是甲状腺功能异常发生的危险因素。甲状腺功能异常发生与尿碘浓度呈U型曲线关系。 结论 昆明市甲状腺功能异常患病率与全国水平相近，甲状腺功能异常的发病与尿碘浓度呈U型相关，地区、年龄、TSH、TPOAb、TgAb、尿碘浓度与甲状腺功能异常发病相关。 Objective To assess iodine nutritional status and the prevalence of thyroid dysfunction in Kunming, Yunnan Province, along with correlation and risk factors between thyroid dysfunction and urinary iodine levels. Methods This cross-sectional study was conducted from January 2014 to July 2016 using a multi-stage, stratified cluster sampling method. A total of 2 650 residents of Kunming, Yunnan Province, who met the inclusion criteria were selected. Data on participants′ demographics, physical measurements, and laboratory tests were collected through questionnaire and clinical assessments which led to 1 463 subjects in the final analysis considering missing data. Statistical analysis were performed using SPSS 26.0, while R Studio was used to model the nonlinear relationship between urinary iodine levels and the risk of thyroid dysfunction. Results (1) Among 2 650 subjects, 755(28.5%) were diagnosed with thyroid dysfunction, with incidence rates of clinical hyperthyroidism(0.83%), subclinical hyperthyroidism(0.38%), clinical hypothyroidism(1.36%), subclinical hypothyroidism(17.66%), and isolated thyroid antibody positive(13.85%). The median urinary iodine concentration was 177.49(123.59, 251.85) μg/L, indicating adequate iodine nutritional. (2)Among the 1 463 subjects analyzed, significant differences in urinary iodine were found between healthy individual group and abnormal TSH group or abnormal TSH group and thyroid antibody positive group( H=-83.437, P=0.003 H=107.489, P=0.003). Logistic regression revealed that rural residents had a lower risk of thyroid dysfunction than urban residents(OR=0.429, 95%CI 0.256-0.717, P=0.001). Risk of thyroid disease increased with age, and TSH, thyroid peroxidase antibody(TPOAb), thyroglobulin antibody(TgAb), and urinary iodine levels were identified as significant risk factors, with a U-shaped relationship between urinary iodine levels and thyroid dysfunction. Conclusions The prevalence of thyroid dysfunction in Kunming is comparable to the national average. The relationship between urinary iodine concentration and thyroid dysfunction follows a U-shaped curve. Factors including region, age, TSH, TPOAb, TgAb, and urinary iodine concentration are associated with thyroid dysfunction.
Abstract
Objective To assess iodine nutritional status and the prevalence of thyroid dysfunction in Kunming, Yunnan Province, along with correlation and risk factors between thyroid dysfunction and urinary iodine levels. Methods This cross-sectional study was conducted from January 2014 to July 2016 using a multi-stage, stratified cluster sampling method. A total of 2 650 residents of Kunming, Yunnan Province, who met the inclusion criteria were selected. Data on participants′ demographics, physical measurements, and laboratory tests were collected through questionnaire and clinical assessments which led to 1 463 subjects in the final analysis considering missing data. Statistical analysis were performed using SPSS 26.0, while R Studio was used to model the nonlinear relationship between urinary iodine levels and the risk of thyroid dysfunction. Results (1) Among 2 650 subjects, 755(28.5%) were diagnosed with thyroid dysfunction, with incidence rates of clinical hyperthyroidism(0.83%), subclinical hyperthyroidism(0.38%), clinical hypothyroidism(1.36%), subclinical hypothyroidism(17.66%), and isolated thyroid antibody positive(13.85%). The median urinary iodine concentration was 177.49(123.59, 251.85) μg/L, indicating adequate iodine nutritional. (2)Among the 1 463 subjects analyzed, significant differences in urinary iodine were found between healthy individual group and abnormal TSH group or abnormal TSH group and thyroid antibody positive group( H=-83.437, P=0.003 H=107.489, P=0.003). Logistic regression revealed that rural residents had a lower risk of thyroid dysfunction than urban residents(OR=0.429, 95%CI 0.256-0.717, P=0.001). Risk of thyroid disease increased with age, and TSH, thyroid peroxidase antibody(TPOAb), thyroglobulin antibody(TgAb), and urinary iodine levels were identified as significant risk factors, with a U-shaped relationship between urinary iodine levels and thyroid dysfunction. Conclusions The prevalence of thyroid dysfunction in Kunming is comparable to the national average. The relationship between urinary iodine concentration and thyroid dysfunction follows a U-shaped curve. Factors including region, age, TSH, TPOAb, TgAb, and urinary iodine concentration are associated with thyroid dysfunction.
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