CAJ | 학술논문

目的了解甘肃省武威市城市和农村健康成人碘营养水平及甲状腺功能状态.方法 2009年4月至2010年1月,采用横断面调查方法,在甘肃省武威市城市(城市组)及农村(农村组)常住居民(居住并生活半年以上)中各抽取18～45岁成人约100人,采集1次随机尿样及空腹血样.砷铈催化分光光度法检测尿碘;化学发光免疫法检测血清促甲状腺激素(TSH)、游离甲状腺激素(FT4)、游离三碘腺原氨酸(FT3);放射免疫法检测血清甲状腺球蛋白抗体(TGAb)、甲状腺微粒体抗体(TMAb).结果分别检测城市组、农村组尿样99、98份,尿碘中位数分别为189.0、258.2μg/L,城市组低于农村组(Z=-4.020,P＜ 0.01).分别检测城市组、农村组血样104、95份,其中城市组FT4[(16.8±3.0)pmol/L]高于农村组[(15.4±2.4)pmol/L,t=3.539,P＜ 0.01].城市组、农村组TGAb阳性率分别为11.5％(12/104)、15.8％(15/95),TMAb阳性率分别为13.5％ (14/104)、14.7％(14/95);男、女TGAb阳性率分别为5.5％(6/109)、23.3％(21/90),TMAb阳性率分别为6.4％(7/109)、23.3％(21/90),其中TGAb、TMAb阳性率男性均低于女性(x2值分别为13.362、11.661,P均＜0.01).城市组和农村组甲状腺功能异常率分别为16.3％(17/104)、8.4％(8/95),其中亚临床型甲状腺功能减退(亚甲减)最常见,分别为14.4％(15/104)、7.4％(7/95);男、女甲状腺功能异常率分别为11.9％(13/109)、13.3％(12/90),其中亚甲减分别为11.0％(12/109)、11.1％(10/90).结论武威市城市成人碘营养处于适宜水平,但农村存在碘营养偏高或部分过量;甲状腺功能异常发生以亚甲减为主;应关注碘营养过量对患甲状腺疾病,尤其是女性患病的风险.
목적 료해감숙성무위시성시화농촌건강성인전영양수평급갑상선공능상태.방법 2009년4월지2010년1월,채용횡단면조사방법,재감숙성무위시성시(성시조)급농촌(농촌조)상주거민(거주병생활반년이상)중각추취18～45세성인약100인,채집1차수궤뇨양급공복혈양.신시최화분광광도법검측뇨전;화학발광면역법검측혈청촉갑상선격소(TSH)、유리갑상선격소(FT4)、유리삼전선원안산(FT3);방사면역법검측혈청갑상선구단백항체(TGAb)、갑상선미립체항체(TMAb).결과 분별검측성시조、농촌조뇨양99、98빈,뇨전중위수분별위189.0、258.2μg/L,성시조저우농촌조(Z=-4.020,P＜ 0.01).분별검측성시조、농촌조혈양104、95빈,기중성시조FT4[(16.8±3.0)pmol/L]고우농촌조[(15.4±2.4)pmol/L,t=3.539,P＜ 0.01].성시조、농촌조TGAb양성솔분별위11.5％(12/104)、15.8％(15/95),TMAb양성솔분별위13.5％ (14/104)、14.7％(14/95);남、녀TGAb양성솔분별위5.5％(6/109)、23.3％(21/90),TMAb양성솔분별위6.4％(7/109)、23.3％(21/90),기중TGAb、TMAb양성솔남성균저우녀성(x2치분별위13.362、11.661,P균＜0.01).성시조화농촌조갑상선공능이상솔분별위16.3％(17/104)、8.4％(8/95),기중아림상형갑상선공능감퇴(아갑감)최상견,분별위14.4％(15/104)、7.4％(7/95);남、녀갑상선공능이상솔분별위11.9％(13/109)、13.3％(12/90),기중아갑감분별위11.0％(12/109)、11.1％(10/90).결론 무위시성시성인전영양처우괄의수평,단농촌존재전영양편고혹부분과량;갑상선공능이상발생이아갑감위주;응관주전영양과량대환갑상선질병,우기시녀성환병적풍험.
Objective To study the iodine nutritional status and thyroid function of adults in urban and rural areas of Wuwei City Gansu Province.Methods A cross-sectional survey was performed in 200 adults aged 18-45 who had lived more than six months in Wuwei City from April 2009 to January 2010.A random urine and fasting blood samples were collected.Urinary iodine content was measured with arsenic cerium catalytic spectrophotometry.The thyroid-stimulating hormone (TSH),free thyroid hormone (FT4) and three free triiodothyronine (FT3) were quantified by direct chemiluminescence immunoassay.Thyroglobulin antibodies (TGAb) and thyroid microsomal antibodies (TMAb) were detected by radioimmunoassay.Results A total of 99 and 98 copies of urine samples of urban and rural groups were tested,respectively.The median of urinary iodine of urban and rural groups was 189.0 and 258.2 μg/L,respectively,and rural group was higher than urban group (Z =-4.020,P ＜ 0.01).A total of 104 and 95 copies of blood samples of urban and rural groups were detected; mean value of FT4 in urban group [(16.8 ± 3.0)pmol/L] was higher than that of rural group [(15.4 ± 2.4)pmol/L,t =3.539,P ＜ 0.01].The positive rates of TGAb of urban and rural groups were 11.5％ (12/104) and 15.8％ (15/95),respectively; the positive rates of TMAb of urban and rural groups were 13.5％ (14/104) and 14.7％ (14/95),respectively; the positive rates of TGAb of male and female were 5.5％ (6/109) and 23.3％ (21/90),respectively; the positive rates of TMAb of male and female were 6.4％ (7/109) and 23.3％ (21/90),respectively.The positive rates of TGAb and TMAb were lower in male than in female (x2 =13.362,11.661,all P ＜ 0.01).The rates of thyroid function disorders of urban and rural groups were 16.3％ (17/104) and 8.4％ (8/95),of male and female 11.9％ (13/109) and 13.3％ (12/90),respectively.Subclinical hypothyroidism in all thyroid function disorders was the most common,which was 14.4％ (15/104) and 7.4％ (7/95) in urban and rural groups,11.0％ (12/109) and 11.1％ (10/90) in male and female,respectively.Conclusions Iodine nutrition level is appropriate for adults in urban areas,but in rural areas iodine nutrition is high or excessive; subclinical hypothyroidism in all thyroid function disorders is the most common; we should be concerned about the risk of iodine overdose,especially the risk of illness in women.