10166例南京市梅山社区居民尿碘水平与甲状腺结节患病情况分析

目的了解南京市梅山社区居民碘营养水平及甲状腺结节检出率。方法回顾性分析2019年1-12月在我院健康体检的10 166例南京市梅山社区居民资料,统计尿碘及甲状腺B超检查结果,分析尿碘水平与甲状腺结节检出情况。结果 10 166例南京梅山社区居民碘摄入不足(尿碘100μg/L)人群比为15.83%,碘适宜组(尿碘100～199μg/L)为39.03%,碘超过适宜组(尿碘200～299μg/L)为31.09%,碘过量组(尿碘≥300μg/L)为14.05%。社区居民尿碘中位数为181.5μg/L,男性尿碘中位数193.2μg/L,女性尿碘中位数128.7μg/L。男性尿碘中位数高于女性,差异有统计学意义(Z=17.39,P0.01);不同年龄组尿碘频数分布比较差异无统计学意义(P0.05)。10 166例居民检出甲状腺结节者3 926人,总检出率为38.62%。男、女性检出率分别为35.47%(2 709/7 637)、48.12%(1 217/2 529),男性低于女性(χ~2=128.25,P0.01)。碘不足和碘过量组甲状腺结节检出率[48.42%(779/1 609)、45.66%(652/1 428)]均高于碘适宜组和碘超过适宜组[34.45%(1 369/3 974)、35.69%(1 126/3 155),P均0.01]。不同年龄组甲状腺结节检出率比较差异有统计学意义(χ~2=518.05,P0.01),且检出率随年龄增大而增高(χ~2=492.50,P0.01)。结论南京市梅山社区居民总体碘营养状况理想,甲状腺结节检出率男性低于女性,随年龄增加检出率增高,碘不足和碘过量人群甲状腺结节检出率高,需根据尿碘结果调整碘营养水平。     

高碘地区儿童甲状腺结节的调查分析

目的了解高碘地区学龄儿童甲状腺结节的检出率,为高碘甲状腺肿的防治工作提供科学依据。方法对山东省巨野县6~13岁儿童226名和山西省平遥县6~15岁256名儿童进行甲状腺B超检查和尿碘检测。结果本次调查共发现患有甲状腺结节的儿童为6例,检出率1.2%,尿碘中位数为437.7μg/L。尿碘<100μg/L组学龄儿童的甲状腺结节检出率较高,为6.3%;100~199μg/L组学龄儿童甲状腺结节检出率为2.6%;200~299μg/L组的检出率最低,为0.0%;≥300μg/L组的检出率为1.3%,不同尿碘水平甲状腺结节检出率无统计学意义,χ2=3.387,P>0.05。不同年龄甲状腺结节检出率无差异,χ2=0.194,P>0.05。儿童的性别之间甲状腺结节检出率无差异,χ2=0.604,P>0.05。不同年龄组尿碘中位数无明显差异(H=0.281,P>0.05)。不同性别儿童尿碘中位数无明显差异(Z=-0.467,P>0.05)。检出有结节组与无结节组学龄儿童的尿碘中位数分别为324.2μg/L和440.9μg/L,两者之间无统计学意义(Z=-1.688,P>0.05)。结论高碘地区存在儿童甲状腺结节,儿童甲状腺结节的成因有待进一步研究。     

不同碘营养水平儿童甲状腺结节患病情况及结节类型的研究

目的了解不同碘营养水平儿童甲状腺结节患病情况,探讨碘过量对儿童甲状腺结节类型的影响。方法选择供碘盐地区的3个县调查,每个县随机抽取8-10岁学生(男、女各半)200人;在水源性高碘地区抽取水碘含量100-1 100μg/L的13村为调查点,每个调查点随机抽取学校8-10岁学生(男、女各半)100名。对抽取的学生随机采集1次性尿样检测尿碘,用B超法检测甲状腺结节情况,对学校所在的村随机采集2份末梢水样检测水碘。结果检查2 092名8-10岁儿童的甲状腺,检出甲状腺结节患者138例,甲状腺结节总检出率为6.6%。其中,实质性结节占82.6%(114/138),囊实性占16.7%(23/138),囊性占0.7%(1/138)。尿碘中位数100-299μg/L、300-699μg/L、700-1 163μg/L的儿童甲状腺结节检出率经统计有显著差异(χ~2=22.17,P0.01);甲状腺实质性结节所占比例无差异(χ~2=2.82,P0.05)。结论碘营养过量可能会造成儿童甲状腺结节患病增加,但对甲状腺结节的囊、实性患病可能无影响。     

太原地区健康体检人群甲状腺结节患病率及危险因素分析

目的探讨山西省太原地区健康体检人群甲状腺结节的患病情况,并分析其患病的相关危险因素。方法 2015年7~12月采用分层整群抽样的方法,按一定的排除标准收集太原12个地区的常住居民2 658名成年人,全部进行问卷调查、体格检查、甲状腺超声检查及实验室检查,通过统计学分析得出太原地区甲状腺结节的流行病学特点。结果太原地区2 658名健康体检人群中,甲状腺结节的患病率为11.47%;其中,城市和农村患病率分别为14.54%和8.08%,城市患病率显著高于农村,差异有统计学意义(P0.05);男性和女性患病率分别为9.67%和13.16%,女性患病率显著高于男性,差异有统计学意义(P0.05);不同年龄组甲状腺结节患病率差异有统计学意义(P0.01),随着年龄增长患病率呈增高趋势;此次调查的人群尿碘中位数为212.3μg/L,甲状腺结节组和非甲状腺结节组尿碘中位数分别为181.9μg/L和214.7μg/L,差异有统计学意义(P0.05);多因素Logistic回归分析显示,年龄增长、高血糖、吸烟、城市均是甲状腺结节发生的危险因素。结论相对于大多数地区,太原地区人群甲状腺结节患病率较低,且处于适碘地区。     

辽宁省大连市健康体检人群甲状腺结节性疾病及其相关因素分析

Objective To investigate the characteristics about the prevalence of thyroid nodules detected on color Doppler uhrasonography(US) in people residing in Dalian City who undergo regular physical examinations, as well as its relative factors. Methods All thyroid sonographic and questionair procedures were performed in the 6020 people above 18-year-old living in the four districts of Dalian City for at least 5 years, who were examined at the department of health medical center of Dalian Municipal Central Hospital from May 2006 to March 2007. Urinary iodine concentration was measured in 2039 healthy adults selected by age layers in our study population. Moreover, urinary iodine concentrations were determined in 220 children aged 8-10 years old who were randomly chosen from four communities (55 children per elementary school from each community). The analysis of logistic regression was conducted for the risk factors linked to thyroid nodules. Results The prevalence of thyroid nodules in the 6020 adults was 38.5%(2319/6020), in which nodules sized between 0.3 and up to 0.5 cm were found in 17.1% (1030/6020), and those above 0.5 cm in 21.4% (1289/6020). Ultrsonography revealed solitary nodules in 17.2% (1036/6020), multinodular goiter in 21.3% (1283/6020). Fifty-four point nine percent (1272/2319) thyroid nodules showed solid internal echographic structures, 30.2%(701/2319) mixed and 14.9%(346/2319). The thyroid nodule detected rate in female individuals was 46.1% (1102/2393), among whom multinodular goiter [59.1% (651/1102)] was more than solitary nodules[40.9(451/1102)] in female; while only 33.6%(1217/3627) of male were detected to have thyroid nodule, there was a difference between the genders (χ2=95,079,P<0.01). The mediam urinary iodine concentration(MUI) was 184.32 μg/L in children and 216.75 μg/L in the health adults, moreover, it was 216.55 μg/L and 217.00 μg/L in the people with thyroid nodules and those without nodules without a significant difference (P>0.05). The rate of thyroid nodules gradually increased with age(χ2=344.998, P<0.01). The occurance of thyroid nodules was significant associated with gender and age(P<0.01). Conclusions The nutritional iodine intake in the four communities of Dalian City are adequate. The prevalence of thyroid incidentalomas is relatively high in this group of people receiving medical examination.     

山东省巨野县成人甲状腺结节的典型调查研究

目的研究不同碘氟摄入量人群甲状腺结节和TPOAb阳性的检出率。方法对山东巨野县的适碘低氟、高碘低氟和高碘高氟3个农村地区共396名23岁以上居民进行甲状腺B超检查、TPOAb和尿碘测定。结果适碘低氟组、高碘低氟组和高碘高氟组尿碘中位数（MUI）分别为207.1、383.9和461.7μg/L;甲状腺结节检出率16.5%、22.0%和11.5%,TPOAb阳性率25.9%、33.7%和12.4%。高碘高氟组人群甲状腺结节检出率明显低于高碘低氟组人群（P〈0.05）。各组人群随着年龄的增大,甲状腺结节检出率增高,60岁以上最高,分别为24.4%、29.2%和18.8%,经趋势性卡方检验有显著意义（P〈0.05）。高碘高氟组甲状腺B超正常人群TPOAb阳性率明显低于适碘低氟组和高碘低氟组。结论在水碘200~300μg/L范围内,若水氟自（0.99±0.29）mg/L升至（1.67±0.19）mg/L,无论是甲状腺结节检出率还是TPOAb阳性率均明显降低。     

基层医务人员甲状腺结节检出率及危险因素调查

目的掌握基层医务人员甲状腺结节患病现状及探究甲状腺结节患病的危险因素。方法于2019年6～7月抽取天津市某区医务工作者,对调查人员进行问卷调查以及健康体检,调查问卷内容包括性别、年龄、民族、学历、是否患有2型糖尿病、生活环境有无污染、头颈部是否接受过放射性检查与治疗、是否食用加碘食盐、氟斑牙患病情况、吸烟、饮酒及情绪是否良好等有关问题。体检包括身高、体重、腰围等常规指标测量,血液FT_3、FT_4、TSH、TgAb、TPOAb水平检测和尿液中尿碘的生化指标检测。结果调查共计286人,甲状腺结节检出率58.04%,其中男性49人,结节检出率为42.90%,女性237人,结节检出率为61.20%,单因素分析发现不同性别、不同年龄组和不同尿碘水平组组内存在统计学差异(P0.05),未发现放射科与非放射科之间的差异(P0.05)。多因素logistic分析发现,女性、高龄和尿碘水平缺乏和过量是甲状腺结节的危险因素[P=0.027,OR(95%CI)=2.113(1.090～4.095);P0.001,OR(95%CI)=1.643(1.276～2.115);P=0.041,OR(95%CI)=1.988(1.027～3.845);P=0.001,OR(95%CI)=3.196(1.563～6.535)]。结论天津市某区基层医务人员甲状腺结节检出率与一些内陆和沿海地区相比较高,女性、年龄大、尿碘缺乏和过量是甲状腺结节的危险因素。     

2008年浙江省舟山市海岛地区甲状腺疾病流行病学调查

目的 调查浙江省舟山市海岛地区食用非加碘盐的居民患甲状腺疾病状况及致甲状腺疾病的相关影响因素.方法 2008年在浙江省舟山市岱山县对737名食用非加碘盐的居民进行流行病学问卷调查、甲状腺B超检查、甲状腺功能及尿碘测定;同时抽查了183名8～10岁儿童(均为食用非加碘盐居民的子女)的尿碘.结果 舟山市岱山县食用非加碘盐的居民尿碘中位数(MUI)为122.2 μg/L,8～10岁儿童MUI为123.7μg/L;甲状腺肿、甲状腺癌、甲状腺功能亢进(简称甲亢)、亚临床甲状腺功能亢进(简称亚临床甲亢)和亚临床甲状腺功能减退(简称亚临床甲减)的患病率分别为39.9%、0.4%、0.4%、0.7%和0.8%.logistic回归分析显示,甲状腺肿患病率无性别差异(P>0.05),而年龄是甲状腺肿发生的危险因素(P<0.05);甲状腺肿、甲亢患病情况与饮食史、吸烟史、饮酒史、饮茶史、尿碘水平均无明显相关关系(P均>0.05).结论 舟山市海岛地区食用非碘盐居民碘摄入适量,但甲状腺肿和甲亢患病率较高.     

高碘地区儿童碘营养影响因素和甲状腺肿大及结节的流行特征

目的了解高碘地区停供碘盐前儿童碘营养的影响因素和甲状腺肿大和结节的状况。方法采用单纯随机法在河北省衡水市水碘中位数在200～300μg/L高碘乡(镇)中随机抽取3个进行调查。结果在3个乡(镇)共采集测定8～10岁儿童1次即时尿样326份,尿碘中位数在478.4～571.3μg/L之间,尿碘含量>300μg/L尿样所占比例在77.9%～86.6%之间。12个村儿童的尿碘中位数与其所在村的水碘中位数成正相关(Spearsman,R=0.79,P=0.002),而与盐碘中位数不相关(Spearsman,R=-0.17,P=0.6)。儿童尿碘中位数与水碘中位数成直线相关(R=0.83,F=22.0,P=0.001),直线回归方程为:尿碘=318.1+0.829*水碘。在3个乡(镇)共用B超检测8～10岁儿童452名,甲状腺肿大37例,肿大率为8.2%;不同性别和年龄组甲状腺肿大率无显著差异。在其中2个乡共发现甲状腺结节15例,平均检出率为5.6%,不同性别和年龄组甲状腺结节检出率无显著差异。结论高碘地区儿童碘营养过剩主要由高水碘造成,碘盐加重了这种状况;存在甲状腺肿大流行,甲状腺结节的检出率也较高。甲状腺结节的成因和发生强度有待于进一步研究。     

不同碘摄入量地区居民甲状腺肿和甲状腺结节的流行病学对比研究

目的 研究不同碘摄入量人群甲状腺肿(甲肿)和甲状腺结节的患病率。方法 对盘山县、彰武县和黄骅市的缺碘、碘充足和高碘3个农村地区3386名14岁居民进行甲状腺B超检查、甲状腺功能、甲状腺自身抗体(TAA)和尿碘测定。结果 缺碘、碘充足、高碘地区尿碘中位数(MUI)分别为103、374和615μg/L；弥漫型甲肿患病率分别为19．5％、13．6％和5．1％；结节型甲肿患病率分别为3．7％、3．5％和2．5％。甲状腺单发结节检出率分别为8．8％、8．3％和4．1％；多发结节检出率分别为3．8％、1．9％和6．7％。非毒性甲肿患者血清TSH水平盘山和彰武明显低于同地区无甲肿者(P＜0．01)；TAA阳性率高于正常人群(P＜0．05)，以黄骅为显著。结论 在MUI为100一600μg/L的碘摄入量范围内，随碘摄入量增加弥漫性甲肿患病率逐渐降低，结节性甲肿患病率无明显变化。缺碘地区甲状腺单发结节高发，高碘地区多发结节高发。缺碘和碘充足地区甲肿有自主性功能，高碘地区甲肿无自主功能。非毒性甲状腺肿、特别是高碘甲状腺肿存在自身免疫异常。     

海岛居民甲状腺疾病和碘营养状况的关系

目的 调查舟山海岛地区居民甲状腺疾病和碘营养状况,分析二者的相互关系.方法 通过整群随机抽样的方法选取了3284名舟山成年居民进行了尿碘检测,并进行流行病学问卷调查、甲状腺B超检查、甲状腺功能测定.结果 舟山海岛地区成年居民尿碘中位数为226.0μg/L,其中城镇居民320.7 μg/L、盐民122.2 μg/L、农民188.9 μg/L、渔民193.6 μg/L、僧侣271.7 μg/L.舟山地区3284名居民弥漫性甲状腺肿、结节性甲状腺肿、胶质性甲状腺肿、甲状腺腺瘤、甲状腺癌、甲状腺功能亢进(甲亢)、亚临床甲亢、甲状腺功能减退(甲减)、亚临床甲减的患病率分别为1.7%、25.3%、8.7%、0.2%、0.4%、0.5%、0.8%、0.03%和1.0%,甲状腺过氧化物酶抗体(TPOAb)阳性率为9.5%.甲状腺疾病患病率女性明显高于男性(P＜0.05),且随年龄的增长而增高(P＜0.05).经logistic回归模型分析甲状腺疾病患病率与年收入、食用海产品、吸烟史、饮酒史、饮茶史、尿碘值等均无明显相关性(P＞0.05).结论 舟山地区居民碘摄入充足,是否实施全民食盐加碘值得商榷;舟山海岛地区甲状腺疾病的患病率较高可能与碘过量有关.

Abstract：

Objective To investigate iodine nutrition and thyroid health status among residents in Zhoushan archipelago, and to analyse their relationship.Methods A total of 3 284 residents in Zhoushan archipelago were surveyed by questionnaire and their thyroids were examined by B-mode ultrasound.The levels of urinary iodine and thyroid function were detected.Results The median level of urinary iodine in 3 284 residents was 226.0 μg/L, being 320.7 μg/L in citizens, 188.9 μg/L in farmers, 122.2 μg/L in salt-makers, 193.6 μg/L in fishers, and 271.7 μg/L in buddhist.The prevalence of diffuse goiter, nodular goiter, colloid goiter, thyroid adenoma, thyroid carcinoma, hyperthyroidism, subclinical hyperthyroidism, hypothyroidism, subclinical hypothyroidism, and positve rate of TPOAb were 1.7% ,25.3% ,8.7% ,0.2% ,0.4% ,0.5% ,0.8% ,0.03%,1.0% ,and 9.5% repectively.The prevalence of thyroid diseases was increasing with aging, and higher in women than in men (P＜0.05).There was no significant relationship of the thyroid diseases with seafood, smoking,drinking, and tea (P＞0.05).Conclusions The citizens of Zhoushan archipelago have adequate iodine intake.It is pertinent to discuss Universal Salt Iodization.Excessive iodine intake may contribute to the high prevalence rate of thyroid diseases in Zhoushan.     

2009年西藏牧区人群碘营养及育龄妇女血清甲状腺激素水平分析

目的 了解西藏牧区人群碘营养水平、碘缺乏病病情和育龄妇女甲状腺功能。方法 2009年,在拉萨市当雄县牧区和曲水县农区各抽取30户家庭采集饮用水样和盐样检测含碘量;抽取8～ 10岁儿童、18～49岁育龄妇女和18 ～60岁成年男子3类人群,每类人群至少50人,检测尿碘,并对儿童和育龄妇女进行甲状腺触诊检查,检测育龄妇女血清甲状腺激素水平,并诊断个体甲状腺功能状态。盐碘测定用直接滴定法（GB/T 13025.7-1999）;水碘测定用砷铈氧化还原法(GB/T 5750.1-2006);尿碘测定用过硫酸铵消化——砷铈催化分光光度法(WS/T 107-2006);甲状腺检查按照《地方性甲状腺肿诊断标准》(WS 276-2007)执行。结果 牧区和农区水碘中位数分别为1.3、0.7μg/L,二者比较差异无统计学意义(Z=- 1.809,P＞ 0.05)。牧区居民全部食用非碘盐;农区居民碘盐覆盖率为90.0％ (27/30)。牧区人群尿碘中位数(50.2 μg/L)低于农区（193.2 μg/L,Z=- 10.48,P＜ 0.01）;牧区儿童和育龄妇女甲状腺肿大率[1.0％(1/100)]低于农区[18.0％ (18/100),x2=16.8,P＜ 0.01]。牧区育龄妇女血清FT4、TT4水平[(14.0±2.0)pmol/L、(85.6±17.5)nmol/L]显著低于农区[(16.2±6.3 )pmol/L、(95.4±21.1) nmol/L,t值分别为- 2.06、- 2.20,P均＜0.05];牧区育龄妇女甲状腺功能异常率[5.9％(2/34)]显著低于农区[25.5％( 12/47),x2=5.328,P＜ 0.05],亚临床甲状腺功能减退的发生率[2.9％(1/34)]显著低于农区[21.3％(10/47),x2=5.651,P＜ 0.05]。结论 牧区人群碘摄入量明显低于农区,尿碘水平反映牧区人群存在严重碘缺乏,但血液生化和甲状腺肿大率与尿碘不符,仅表现为隐性碘饥饿,未构成甲状腺肿大流行。     

舟山海岛成人碘营养状况调查与分析

目的了解舟山海岛成人碘营养状况,为制定和完善科学补碘策略提供依据。方法抽取舟山市2个县、区中6个居委会(村)3 098名当地18岁以上的常住居民,共采集1 683份碘盐、20份水样、2 872份尿样分别进行盐碘、水碘、尿碘浓度检测,并对调查对象开展甲状腺超声检查,采集血样进行甲状腺功能检测。结果盐碘浓度的中位数为0 mg/kg、均数5.63 mg/kg;有283份为合格碘盐,合格碘盐食用率为16.82%;水碘浓度均数为11.40μg/L;尿碘中位数为112.50μg/L;甲状腺超声检查总异常率30.63%;甲状腺功能总异常率为21.98%。结论舟山市成人居民的尿碘水平处于较适宜的水平;成人整体甲状腺超声检查异常率高于全省水平,18～65岁成人甲状腺超声检查异常率明显低于全省水平,成人女性甲状腺超声检查异常率明显高于男性,65岁以上老年人甲状腺结节发生率为38.49%,明显高于全省水平;甲状腺功能激素异常率低于全省水平。     

天津市食盐加碘后甲状腺肿大率与碘营养状况的调查

目的：调查和研究食盐加碘后天津市居民的甲状腺肿大率和碘营养状况,方法：在6个区共调查居民31530人,7－14岁在校儿童4415人,对调查对象进行甲状腺肿大率,尿碘浓度,食盐碘含量等项目的调查。结果：（1）食盐加碘后天津市居民的平均甲状腺肿大率为5．5％,8－10岁儿童平均甲状腺肿大率为19．7％,甲状腺肿大率较食盐加碘以前有了明显下降,但下降的速度较缓慢,（2）天津市食盐加碘以后各区居民的平均尿碘中位数为287．2ug/L,各区儿童尿碘中位数平均为271．6u/L,证明总体人群碘营养充足,（3）天津市居民总体盐碘含量超过20mg/kg水平,各区居民户盐含碘量有9．9％－41．1％超过60mg/kg,说明碘盐的含碘是偏高是一个新的现象。结论：经过3年左右的食盐加碘防治工作,天津市碘缺乏情况已得到控制。     

Iodine supplementation in Austria: methods and results.

Until 1963 Austria was an extremely iodine-deficient area with low iodine intake and high goiter prevalence. Therefore, for the first time in 1963, salt iodination with 10 mg of potassium iodide per kilogram of salt was introduced by federal law. Twenty years after this salt iodination, however, investigations in schoolchildren demonstrated iodine deficiency grade I to II according to the World Health Organization (WHO) (urinary iodine excretion, 42-75 microg/g Crea) and goiter prevalence of far more than 10%. In 1990, salt iodination was increased to 20 mg of potassium iodide per kilogram of salt. In 1994, further investigations in schoolchildren demonstrated an increase of urinary iodine excretion (121 microg/g Crea) and a reduction of goiter prevalence below 5%, with the exception of pupils ages 14-19 (12%). In the year 2000, 10 years after the increase of salt iodination in Austria, 430 nonselected adult inhabitants of three communities in Carinthia (a county of Austria) were investigated for iodine excretion, goiter prevalence, and prevalence of thyroid autoantibodies. This study demonstrated that although iodine supply is sufficient now in Austria (males, 163.7 microg of Crea; females, 183.3 microg of iodine per gram of Crea), goiter prevalence is still high in the elderly, who lived for a longer period of iodine deficiency (34.3% in women and 21.3% in men), whereas goiter prevalence in younger people up to age 40 years is below 5%. It could also be shown that the percentage of thyroid autoantibodies is now as high as in other countries with sufficient iodine supply (3.19% in males, 5.17% in females). In addition to the changes of urinary iodine excretion and goiter prevalence because of salt iodination, changes of incidence in hyperthyroidism and histologic types of thyroid cancer are discussed in this paper. In conclusion, the introduction of salt iodination led to an improvement in iodine supply with a marked reduction of goiter prevalence in people who were born after 1963, but also to an increase in hyperthyroidism and autoimmune thyroid diseases as well as changes in histologic types of thyroid cancer.     

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

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.     

福建省龙岩市碘缺乏病病情监测结果分析

目的 了解福建省龙岩市碘缺乏病病情现状,评价防治措施效果,为制订防治策略提供依据.方法 2006和2007年期间,在福建省龙岩市7个县(市、区),每个县(市、区)按容量比例概率抽样法(PPS)确定30所小学,每所小学抽取40名8～10岁学生,进行甲状腺触诊检查,同时抽取7名学生采集尿样和家中盐样,进行尿碘及盐碘测定,计算甲状腺肿大率、尿碘中位数、合格碘盐食用率、碘盐覆盖率、碘盐合格率和非碘盐率.结果龙岩市8～10岁儿童甲状腺肿大率为0.94%(79/8438),尿碘中位数为259.12μg/L,合格碘盐食用率为97.86%(1462/1494),碘盐覆盖率为99.46%(1486/1494),碘盐合格率为98.38%(1462/1486),非碘盐率为0.54%(8/1494).结论 龙岩市的碘缺乏病防治工作达到国家消除碘缺乏病标准.     

Iodine nutrition, nodular thyroid disease, and urinary iodine excretion in a German university study population.

We determined the influence of different nutritional factors on the urinary iodine excretion in an East German university population. First, we assessed iodine excretion in spot urine samples. Second, we measured iodine content in the university canteen meals, where approximately 20% of the probands had regular meals. Third, we used a special food questionnaire to assess for other sources of nutritional iodine intake, namely iodine tablets, fish consumption, etc. Fourth, we determined the actual prevalence of goiter and thyroid nodules in our probands by high-resolution ultrasonography. The mean urinary iodine excretion in our cohort was 109 +/- 81 microg/g level indicating a borderline adequate iodine intake (100-200). The frequency of thyroid nodules was 30% and the frequency of goiter 11%. Thyroid volumes greater than 18 mL and 25 mL were considered to be enlarged in adult women and men respectively. Urinary iodine excretion was not related to the presence of goiter or thyroid nodules. In addition urinary iodine excretion did not vary with regular consumption of canteen meals, which contained approximately 50% of the daily recommended iodine intake. In contrast probands with regular supplementary intake of iodine tablets had significantly higher values of urinary iodine excretion (169 +/- 130 microg/g) compared to participants without (103 +/- 87 microg/g). No other single nutritional factor (e.g., salt, milk, or bread) had a statistically significant impact on urinary iodine excretion or was able to raise the urinary iodine excretion above the level of marginal iodine deficiency. In summary, the nutritional iodine intake in a Saxonian study population was found to be close to the margin of iodine deficiency. This shows insufficient supplementation of iodine through iodized salt/industrialized food production.