不同碘摄入量对甲状腺肿和甲状腺结节影响的前瞻性研究
불동전섭입량대갑상선종화갑상선결절영향적전첨성연구
Prospective study on the effect of different iodine intakes on goiter and thyroid nodules
  • 万方数据
    中华内分泌代谢杂志 중화내분비대사잡지
    CHINESE JOURNAL OF ENDOCRINOLOGY AND METABOLISM
    2009年 3期 255-259 ,共5页

    于晓会%范晨玲%单忠艳%滕晓春%滕笛%关海霞%李玉姝%崇巍%杨帆%戴红%何力%高庆军%于扬%李佳%陈彦彦%赵冬%毛金媛%谷晓岚%杨榕%姜雅秋%李晨阳%滕卫平

    우효회%범신령%단충염%등효춘%등적%관해하%리옥주%숭외%양범%대홍%하력%고경군%우양%리가%진언언%조동%모금원%곡효람%양용%강아추%리신양%등위평

    碘%甲状腺肿%甲状腺结节%流行病学研究%前瞻性研究 碘%甲狀腺腫%甲狀腺結節%流行病學研究%前瞻性研究
    전%갑상선종%갑상선결절%류행병학연구%전첨성연구
    Iodine%Goiter%Thyroid nodules%Epidemiological study%Prospective study
    目的 研究不同碘摄入量人群非毒性甲状腺肿(甲肿)和非毒性甲状腺结节的流行病学特点及影响其发生、发展和转归的因素.方法 2004年对盘山(长期轻度碘缺乏)、彰武(碘缺乏基础上补碘至碘超足量)和黄骅(长期碘过量)社区于1999年参加本课题组流行病学研究并进行甲状腺B超检查的人群(3 385人)进行甲状腺疾病的随访调查.结果 (1)盘山、彰武和黄骅社区弥漫型甲肿的累积发病率分别为7.1%、4.4%和6.9%,盘山和黄骅均显著高于彰武(均P<0.01);结节型甲肿的累积发病率分别为5,0%、2.4%和0.8%,盘山的发病率最高(P<0.01).(2)三社区甲状腺单发结节的累积发病率分别为4.0%、5.7%和5.6%,多发结节的累积发病率分别为0.4%、1.2%和1.0%.(3)基础碘缺乏、碘过量、甲状腺自身抗体(thyroid autoantibody,TAA)阳性是甲肿发生的独立危险因素.(4)彰武初访时TAA阳性人群非毒性甲肿的发生率显著高于TAA阴性人群(P<0.01),盘山和黄骅无显著差异.(5)三社区非毒性弥漫型甲肿维持人群和黄骅非毒性结节型甲肿维持人群随访前后TAA阳性率均高于同社区正常人群(P<0.05).结论 碘缺乏和碘过量均有可能使甲肿的发病率增加.碘缺乏社区结节型甲肿高发,弥漫型甲肿是碘过量社区甲肿发牛的主要形式.甲状腺自身免疫与甲肿的发生和维持相关,这种相关性在历史上为碘缺乏而后过度补碘的社区更明显.
    목적 연구불동전섭입량인군비독성갑상선종(갑종)화비독성갑상선결절적류행병학특점급영향기발생、발전화전귀적인소.방법 2004년대반산(장기경도전결핍)、창무(전결핍기출상보전지전초족량)화황화(장기전과량)사구우1999년삼가본과제조류행병학연구병진행갑상선B초검사적인군(3 385인)진행갑상선질병적수방조사.결과 (1)반산、창무화황화사구미만형갑종적루적발병솔분별위7.1%、4.4%화6.9%,반산화황화균현저고우창무(균P<0.01);결절형갑종적루적발병솔분별위5,0%、2.4%화0.8%,반산적발병솔최고(P<0.01).(2)삼사구갑상선단발결절적루적발병솔분별위4.0%、5.7%화5.6%,다발결절적루적발병솔분별위0.4%、1.2%화1.0%.(3)기출전결핍、전과량、갑상선자신항체(thyroid autoantibody,TAA)양성시갑종발생적독립위험인소.(4)창무초방시TAA양성인군비독성갑종적발생솔현저고우TAA음성인군(P<0.01),반산화황화무현저차이.(5)삼사구비독성미만형갑종유지인군화황화비독성결절형갑종유지인군수방전후TAA양성솔균고우동사구정상인군(P<0.05).결론 전결핍화전과량균유가능사갑종적발병솔증가.전결핍사구결절형갑종고발,미만형갑종시전과량사구갑종발우적주요형식.갑상선자신면역여갑종적발생화유지상관,저충상관성재역사상위전결핍이후과도보전적사구경명현.
    Objective To investigate the epidemiological characteristics of non-toxic goiter and non-toxic thyroid nodules in the regions with different iodine intakes and the factors influencing the occurrence, development and outcome of goiter and thyroid nodules. Methods 3 385 subjects, who had taken part in the previous survey in 1999 with the ultrasonic examination of thyroid, were composed of individuals in Panshan with chronic mild iodine deficiency,in Zhangwu with more than adequate iodine "after iodine supplementation and in Huanghua with excessive iodine. These 3 groups of subjects were followed up in 2004. Results (1) The cumulative incidences of diffuse goiter in Panshan ,Zhangwu and Huanghua were 7.1% ,4.4% and 6.9% ,respectively ,being the lowest in Zhangwu (P<0.01) and those of nodular goiter were 5.0% ,2. 4% and 0.8%, respectively, being the highest in Panshan (P<0.01). (2) The incidences of single nodule were 4.0% ,5.7% and 5.6%, respectively, and those of multiple nodules 0.4%, 1.2% and 1.0%, respectively. (3)The result of logistic analysis showed that iodine deficiency,iodine excess and positive thyroid autoantibodies (TAA) were the independent risk factors for the occurrence of goiter. (4)In Zhangwu ,the incidence of non-toxic goiter in the group with positive TAA was higher than that in the group with negative TAA(P<0.01) ,while there were no such differences in Panshan and Huanghua. (5)In these three regions, the rates of positive TAA in the individuals with diffuse non-toxic goiter were higher than those in the healthy subjects (P<0.05). And in Huanghua,the rate of positive TAA in subjects with non-toxic nodular goiter was also higher than that in the healthy individuals (P<0.05). Conclusion Iodine deficiency and iodine excess may both induce the raising incidence of goiter. Nodular goiter is prevalent in iodine deficient district and diffuse goiter is the predominant form in places with iodine excess. Thyroid autoimmunity is associated with occurrence and maintenance of goiter, and this phenomenon is more obvious in the community with previous iodine deficiency followed then by treatment with more than adequate iodine.
    원문보기 원문다운로드 사이트로이동
저자의 최근 논문