甲状腺功能减退症和亚临床甲状腺功能减退症对妊娠结局的影响

文章分析妊娠合并甲状腺功能减退症(甲减)、合并亚临床甲减及正常孕产妇的临床资料,探讨妊娠合并甲减和亚临床甲减对孕婴及妊娠结局的影响.妊娠合并甲减和亚临床甲减严重影响着孕产妇和胎儿的健康,应加强妊娠期间甲状腺激素水平的监测与治疗,以减少不良妊娠结局的发生.     

亚临床甲状腺功能减退症4例分析

目的 总结亚临床甲状腺功能减退发病情况.方法 随访4例患者的临床资料,进行分析.结果 患者存在高体脂含量、高脂血症、动脉硬化、高血压病、脂肪肝.结论 血液粘稠可能是导致亚临床甲状腺功能减退的因素.     

糖尿病合并亚临床甲状腺功能减退症的研究进展

本文从亚临床甲状腺功能减退症的定义、病因及发病机制和流行病学、亚临床甲减对糖尿病患者糖代谢的影响、亚临床甲减对糖尿病患者脂代谢的影响以及亚临床甲减对糖尿病患者血管并发症的影响4个方面进行糖尿病合并亚临床甲状腺功能减退症的综述。     

亚临床甲状腺功能减退症患者血脂水平临床分析

目的分析亚临床甲状腺功能减退症（亚甲减）患者的血清总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白（LDLC）、高密度脂蛋白（HDL-C）、脂蛋白a（LP-a）水平与促甲状腺素（TSH）之间的关系。方法选取2012年3月~2013年4月期间我院收治的亚临床甲状腺功能减退症30例作为观察组,同时选取此期间在我院自愿进行健康体检的健康人员30例作为对照组,分别对两组人员的TC、TG、LDL-C、HDL-C、及LP-a进行测定,并比较两组之间的差异。结果观察组患者TC、TG及LDL-C水平显著高于对照组,差异具有统计学意义（P〈0.05）,两组的HDL-C与LP-a水平之间无明显差异,无统计学意义（P〉0.05）,TSH与TC、TG、LDL-C之间呈正相关。结论 TSH对甲状腺功能状态具有极高的敏感性,其水平变化与患者体内的TC、TG、LDL-C水平呈正相关,TSH对亚临床甲状腺功能减退症的诊断与治疗情况判定具有指导意义。     

长春地区女性亚临床甲状腺功能减退症与血脂异常的相关性分析

目的探讨女性亚临床甲状腺功能减退症(简称亚临床甲减)与血脂异常的相关性,为女性亚临床甲减人群调节脂质紊乱提供参考依据。方法选取2014年9-12月在吉林大学第一医院就诊的长春地区女性为研究对象,对其进行甲状腺疾病的流行病学调查,包括一般资料问卷调查、相关体格检查、甲状腺功能和血脂代谢等实验室指标检查。结果长春地区女性亚临床甲减发生率为12.59%。女性亚临床甲减患者三酰甘油(TG)及低密度脂蛋白胆固醇(LDL-C)水平显著高于正常人群,升高风险分别是甲功正常人群的2.49倍和1.82倍,差异有统计学意义(P<0.05)。促甲状腺激素(TSH)>10mIU/L时,其TG升高风险是正常人群的4.96倍,差异有统计学意义(P<0.05)。结论女性亚临床甲减人群的血脂异常与TSH存在直接相关性,TSH>10mIU/L可明显增加TG水平升高的风险。     

环境中碘过量育龄妇女甲状腺功能研究

目的了解环境中碘过量对育龄妇女甲状腺功能的影响。方法对碘过量和碘正常地区育龄妇女的血样进行甲状腺激素包括TSH、FT4和FT3测定分析。结果碘过量地区育龄妇女TSH水平、甲减和亚甲减检出率显著高于碘正常地区,其甲状腺肿大者TSH水平及甲减和亚甲减检出率也显著高于甲状腺正常者。结论重度碘过量会引起育龄妇女甲状腺功能异常,其甲状腺肿大者有甲状腺功能减退趋势。     

杭州地区个体从业人员亚临床甲状腺功能减退症的调查分析

目的:了解个体从业健康体检人员亚临床甲状腺功能减退症(SCH)的检出率,并观察SCH血清促甲状腺激素(TSH)与血脂的关系。方法:选取2007年个体从业健康体检人员血清2958份,采用化学免疫分析法测定TSH、游离三碘甲状腺原氨酸(FT3)和游离四碘甲状腺原氨酸(FT4)。血生化指标采用全自动生化检测仪测定。结果:2958例SCH总检出率7.03%。其中女性检出率8.95%,男性检出率4.79%,女性检出率高于男性(P<0.01)。从年龄结构看:50岁~59岁组检出率最高11.73%,其次是18岁~29岁组和60C以上岁组。TSH与血脂相关因素中,男性TSH与尿酸(UA)呈正相关,与载酯蛋白A(APOA)呈负相关。结论:我科个体从业健康体检人员SCH总检出率较上海(6.1%)、南昌地区(6.1%)高;SCH的发生与年龄和性别相关;TSH血浓度对血脂的影响因性别不同而不同。     

基于实验室指征的系统性红斑狼疮患者并发亚临床甲状腺功能减退症/临床甲状腺功能减退症的风险预警模型的建立

目的 收集本地区系统性红斑狼疮(SLE)患者的实验室指征,建立起SLE患者并发亚临床甲状腺功能减退症(SCH)/临床甲状腺功能减退症(CH)的列线图风险预警模型。方法 选取2021年1月—12月在本地三级医院确诊为SLE的患者92例,其中男性6例,女性86例,平均年龄为(44.64±13.42)岁,其中合并SCH/CH 23例。采用间接免疫荧光法检测抗核抗体(ANA)滴度和抗可溶性抗原(ENA)谱的各项染色强度,全自动生化仪检测各项生化和免疫指标,通过logistic回归从各项实验室指征中筛选独立风险因子,通过R程序输出Nomogram风险预测模型。结果 多因素logistic回归结果显示：双链DNA(dsDNA)、促甲状腺素(TSH)、游离三碘甲状腺原氨酸(FT₃)、尿24 h蛋白、肌酐(Cr)、肾小球滤过率(GFR)是SLE患者并发SCH/CH的6项独立风险因子,生成得到的列线图C-index为0.948。结论 建立了一种能预测SLE患者并发SCH/CH风险的Nomogram风险模型,有助于临床对SLE患者甲状腺疾病的早期评估。     

左旋甲状腺素治疗妊娠期亚临床甲状腺功能减退症疗效分析

目的探讨左旋甲状腺素治疗妊娠期亚临床甲状腺功能减退症(Subclinical hypothyroidism,SCH)的疗效。方法选取2010年2月至2012年1月江苏盛泽医院产科诊断为妊娠期SCH患者54例为SCH组,妊娠期甲状腺功能正常孕妇54例为正常组,同期经我院体检中心检测的育龄期甲状腺功能正常的女性54例为对照组。SCH组患者予以左旋甲状腺素,其他各组不做处理。观察SCH组治疗前与治疗后2个月、3组的叶酸水平及甲状腺功能,并加以对比;比较SCH组和正常组的妊娠结局情况、新生儿情况以及子女随访至3岁时的智力发育情况。结果治疗后SCH组患者的叶酸水平高于治疗前,血清促甲状腺激素(thyroid stimulating hormone,TSH)降低(P均0.05),血清游离三碘甲状腺原氨酸(free triiodothyronine,FT3)、游离甲状腺素(free thyroxine,FT4)水平较治疗前无变化(P0.05);SCH组剖宫产率高于正常组(P0.05),而分娩周数和产后出血量两组比较差异无统计学意义(P0.05);两组新生儿中神经管畸形差异有统计学意义(P0.05),其他新生儿情况比较,差异均无统计学意义(P0.05);SCH组子女3岁时的智力发育与正常组比较差异无统计学意义(P0.05)。结论左旋甲状腺激素治疗SCH,可有效增加叶酸水平,降低TSH含量,对妊娠结局产生积极影响,并可改善后代子女的生长发育情况。     

天津市妊娠期亚临床甲状腺功能减退症妇女硒碘营养状况调查

目的调查天津市239例孕妇的硒碘营养状况,分析硒碘营养对妊娠期亚临床甲状腺功能减退症(甲减)的影响。方法招募天津市7～20孕周单胎妊娠(年龄20～45岁)孕妇共239例,其中亚临床甲减组117例,甲状腺功能正常组122例,进行问卷调查并检测血清TSH、FT4、TPOAb、TgAb、血硒和尿碘水平。结果 239例孕妇的尿碘中位数为156.96μg/L,碘缺乏占43.9%,碘适量占38.9%,碘超足量/碘过量占17.2%。亚临床甲减组孕妇中碘超足量/碘过量占24.8%显著高于甲状腺功能正常组孕妇的9.80%。碘缺乏比率和碘超足量/碘过量比率在中心城区组、涉农非高碘区组、涉农高碘区组孕妇中分别为46.7%、46.5%、15.0%和16.2%、13.2%、45.0%。亚临床甲减组孕妇的血硒水平为(94.92±19.04)μg/L与甲功正常组的(98.05±17.15)μg/L,差异无统计学意义(P0.05),并且不同区域组的血硒水平差异亦无统计学意义(P0.05)。多因素Logistic回归分析显示,相比较于受教育程度≥12年的孕妇,受教育程度较低(12年)的孕妇在妊娠前半期发现亚临床甲减的风险较高(OR=1.804,95%CI为1.013～3.212);相比较于碘适量,碘超足量/碘过量会增加发生妊娠期亚临床甲减的风险(OR=3.461,95%CI为1.524～7.860)。结论天津市妊娠期妇女的硒碘营养状况应予以重视,需加强碘营养知识健康宣教,并在完善孕妇甲状腺功能筛查的同时进行个体化膳食指导,动态监测尿碘水平,实现精确补碘,降低妊娠期亚临床甲减的发病风险。     

左旋甲状腺素片治疗妊娠合并亚临床甲状腺功能减退的效果

目的 对于妊娠合并亚临床甲状腺功能减退孕妇开展左旋甲状腺素片进行治疗的具体方法以及对孕妇妊娠结局所产生的影响情况加以探讨.方法 选取2019年1—12月接诊的妊娠合并亚临床甲状腺功能减退孕妇80例作为文章观察对象,利用随机数字表法将所选孕妇加以分组,给予其中40例妊娠合并亚临床甲状腺功能减退孕妇左旋甲状腺素片进行治疗,...     

Sodium,Potassium and Iodine Intake in an Adult Population of Lithuania

Hypertension is a leading risk factor for cardiovascular events and death. A reduction in salt intake is among the most cost-effective strategies to reduce blood pressure and the risk of cardiovascular diseases. Increasing potassium lowers blood pressure and is associated with lower cardiovascular risk. Adequate iodine intake is important to prevent iodine deficiency disorders. Salt iodization is a key strategy to prevent such deficiency. In Lithuania, no surveys have been performed to directly assess sodium, potassium and iodine consumption. The aim of the present study was to measure sodium, potassium and iodine intake in a randomly selected adult Lithuanian adult population using 24 h urine collections, and to assess knowledge, attitudes and behavior towards salt consumption. Salt and potassium intakes were estimated in 888 randomly selected participants by 24 h urine sodium and potassium excretion and 679 individuals provided suitable 24 h urine samples for the analysis of iodine excretion. Average salt intake was 10.0 (SD 5.3) g/24 h and average potassium intake was 3.3 (SD 1.3) g/24 h. Only 12.5% of participants consumed less than 5 g/24 h of salt. The median value of urinary iodine concentration (UIC) was 95.5 μg/L. Our study showed that average salt intake is twice as high as the maximum level recommended by the World Health Organization while potassium and iodine intakes in Lithuania are below the recommended levels.     

Iodine Intake Estimated by 24 h Urine Collection in the Italian Adult Population: 2008–2012 Survey

Monitoring the population iodine status is essential for iodine deficiency eradication. This study assessed the average dietary iodine intake and the iodine status of a random sample of the Italian general adult population. The study population included 2378 adults aged 35–79 years (1229 men and 1149 women) from all 20 Italian regions, participating in the Osservatorio Epidemiologico Cardiovascolare/Health Examination Survey 2008–2012 (OEC/HES), and were examined for iodine intake in the framework of the MINISAL-GIRCSI Programme. Dietary iodine intake was assessed by the measurement of 24 h urinary iodine excretion. The median daily iodine intake of the whole population was lower (96 µg/d, interquartile range 51–165) than the daily adequate iodine intake according to both EFSA and WHO recommendation (150 µg/d), with a significantly lower value among women (85 µg/d) compared with men (111 µg/d). Iodine intake diminished with age and increased with BMI (body mass index) in male but not in female participants, without achieving the adequate intake in any sex, age, or BMI category. In this random sample of Italian general adult population examined in 2008–2012, iodine intake still remained lower than the recommended values despite the implementation of a strategy of iodoprophylaxis based on salt iodization in 2005. These data represent a valuable reference for future monitoring of iodine status in our country.     

Iodine Intake from Food and Iodized Salt as Related to Dietary Salt Consumption in the Italian Adult General Population

Since the Italian iodoprophylaxis strategy is based on the use of iodized salt, we assessed the relationship between dietary salt consumption and iodine intake in the Italian adult population. We estimated the relative contribution given by the use of iodized salt and by the iodine introduced by foods to the total iodine intake. The study population included 2219 adults aged 25–79 years (1138 men and 1081 women) from all Italian regions, participating to the Osservatorio Epidemiologico Cardiovascolare/Health Examination Survey 2008–2012 (OEC/HES), and examined for sodium and iodine intake in the framework of the MINISAL-GIRCSI Programme. Dietary sodium and total iodine intake were assessed by the measurement of 24 h urinary excretion, while the EPIC questionnaire was used to evaluate the iodine intake from food. Sodium and iodine intake were significantly and directly associated, upon accounting for age, sex, and BMI (Spearman rho = 0.298; p < 0.001). The iodine intake increased gradually across quintiles of salt consumption in both men and women (p < 0.001). The European Food Safety Authority (EFSA) adequacy level for iodine intake was met by men, but not women, only in the highest quintile of salt consumption. We estimated that approximately 57% of the iodine intake is derived from food and 43% from salt. Iodized salt contributed 24% of the total salt intake, including both discretionary and non-discretionary salt consumption. In conclusion, in this random sample of the Italian general adult population examined in 2008–2012, the total iodine intake secured by iodized salt and the iodine provision by food was insufficient to meet the EFSA adequate iodine intake.     

河北省沧州市高碘水源地理分布调查

[目的]了解沧州市高碘水源的地理分布特征。[方法]依据历史资料,选取沧州市中东部63个乡镇,每个乡镇按东、南、西、北、中不同方位随机抽取5个自然村,采集水样、了解水源类型及水井深度等信息资料。[结果]本次调查共采集水样计315份,水碘中位数为359.72μg/L（6.76-1457.50μg/L）,浅井水和深井水的碘含量分布不同（u=2099,P〈0.001）,深井水碘含量与井深之间存在正相关关系（rs=0.414,P〈0.001）。不同地貌特征和地层条件下的饮用水碘含量差异均有统计学意义（P〈0.001）。[结论]建议在沧州市中东部地区同时供应含碘盐和不含碘盐,开展健康教育和实施改水措施。     

Diets with Higher Vegetable Intake and Lower Environmental Impact: Evidence from a Large Australian Population Health Survey

Increasing the consumption of vegetables is a public health nutrition priority in Australia. This must be achieved in the context of lowering dietary environmental impacts. In this study, a subgroup of 1700 Australian adult daily diets having a higher diet-quality score and a lower environmental impact score was isolated from Australian Health Survey data. These diets were primarily distinguished by their lower content of energy-dense/nutrient-poor discretionary foods. Among these diets, those with higher levels of vegetable intake were characterized by greater variety of vegetables eaten, lower intake of bread and cereal foods, and higher intake of red meat. These diets also had a greater likelihood of achieving recommended intakes for a range of vitamins and minerals. These findings highlighted the importance of considering the total diet in developing strategies to promote healthy and sustainable food consumption, as well as the need to understand the interrelationships between foods that exist in a local cultural context. As vegetables are usually eaten with other foods, higher vegetable consumption in Australia could be supported by encouraging more regular consumption of the types of meals that include larger quantities of vegetables. Our results showed that this was possible while also substantially lowering total dietary environmental impacts.     

Dietary Intake according to Gender and Education: A Twenty-Year Trend in a Swiss Adult Population

We assessed trends in dietary intake according to gender and education using repeated cross-sectional, population-based surveys conducted between 1993 and 2012 in Geneva, Switzerland (17,263 participants, 52.0 ± 10.6 years, 48% male). In 1993–1999, higher educated men had higher monounsaturated fatty acids (MUFA), carotene and vitamin D intakes than lower educated men, and the differences decreased in 2006–2012. In 1993–1999, higher educated women had higher fiber, iron, carotene, vitamin D and alcohol intakes than lower educated women, and the differences decreased in 2006–2012. Total energy, polyunsaturated fatty acids, retinol and alcohol intakes decreased, while mono/disaccharides, MUFA and carotene intake increased in both genders. Lower educated men had stronger decreases in saturated fatty acid (SFA) and calcium intakes than higher educated men: multivariate-adjusted slope and 95% confidence interval −0.11 (−0.15; −0.06) vs. −0.03 (−0.08; 0.02) g/day/year for SFA and −5.2 (−7.8; −2.7) vs. −1.03 (−3.8; 1.8) mg/day/year for calcium, p for interaction <0.05. Higher educated women had a greater decrease in iron intake than lower educated women: −0.03 (−0.04; −0.02) vs. −0.01 (−0.02; 0.00) mg/day/year, p for interaction = 0.002. We conclude that, in Switzerland, dietary intake evolved similarly between 1993 and 2012 in both educational groups. Educational differences present in 1993 persisted in 2012.     

某铅锌矿及周围镉污染区镉接触者健康状况调查

目的：了解某铅锌矿及周围镉污染区镉接触者的健康状况,为镉污染所致慢性镉中毒症的判定提供依据。方法：对骨密度测定值低于X^-S的84例研究对象进行尿样检测和分析,并对其中骨密度测定值低于X^-S的84例研究对象分别进行骨骼X线检查。结果：尿镉、尿NAG、尿β2－MG分别为14．48μg/g.cr、14．46U／g.cr、404．59μg/g.cr;尿镉≥15μg/g.cr时,尿NAG和尿β2－MG出现显著升高,且超过正常人群中的参考值;22例研究对象的X线拍片结果显示,有19例有不同程度的骨质疏松或骨质软化。结论：用尿镉≥ 15μg/g.cr作为环境镉污染致慢性镉中毒中晚期病例的判定条件之一是可行的。     

Baseline Levels of Vitamin D in a Healthy Population from a Region with High Solar Irradiation

The use of vitamin D (VitD) supplements has become widespread in the last decade due not only to the dissociation between the blood levels recommended as “optimal” and those shown by the healthy population but also to its presumed beneficial effects on multiple disorders. This work evaluated the levels of 25-hydroxyvitamin D (25(OH)D) in a healthy population of European origin living in a region with high solar irradiation. In serum samples from a population-based study conducted in the Canary Islands, levels of 25(OH)D were analyzed. In 876 individuals who had no history of kidney or malabsorption disorders and, who had not been treated with calcium and/or VitD supplementation, the median 25(OH)D level was 26.3 (5th; 95th percentile, 14.3; 45.8) ng/mL. Notably, 65.4% of the population had 25(OH)D blood levels below 30 ng/mL, 23.4% below 20 ng/mL and 6.4% below 15 ng/mL. Based on the lack of evidence supporting causality between 25(OH)D levels below what is recommended as optimal (≥20 ng/mL, or even ≥30 ng/mL) and major skeletal and non-skeletal diseases, and in light of the distribution of the concentration of this vitamin in healthy adults living under optimal conditions of solar irradiation, it seems reasonable to consider 25(OH)D levels below 20 ng/mL and close to 15 ng/mL as adequate for the general population.     

Increased Omega-3 Fatty Acid Intake Is Inversely Associated with Subclinical Inflammation in Healthy Elderly Men,Based on the 2015–2018 Korean National Health and Nutrition Examination Survey

(1) Background: Subclinical inflammation as a risk factor of cardiovascular diseases was clinically measured using C-reactive protein (CRP) level. (2) Methods: This study was cross-sectionally designed based the 2015–2018 Korean National Health and Nutrition Examination Survey (KNHANES). The ratio of daily omega-3 fatty acids to energy intake (ω3FA ratio) was classified into four quartile groups (Q1, <0.3%; Q2, 0.3%–<0.6%; Q3, 0.6%–<1.0%; and Q4, ≥1.0% in both sexes). Logistic regression analysis was conducted to investigate the association between the ω3FA ratio and subclinical inflammation defined as CRP levels ≥3 mg/dL. (3) Results: The ω3FA ratio in subjects without and with subclinical inflammation was 0.8% and 0.7% in men (p-value = 0.001), and 0.8% and 0.8% in women (p-value = 0.491), respectively. The prevalence of subclinical inflammation in males decreased with increasing quartile of ω3FA ratio (12.9%, 9.6%, 7.4%, and 7.7%, p-value = 0.033), while female prevalence was not significant among quartile groups. Compared to Q1, odds ratios (95% confidence intervals) for subclinical inflammation of Q2, Q3, and Q4 were 0.740 (0.465–1.177), 0.564 (0.341–0.930), and 0.549 (0.317–0.953) in males, and 1.066 (0.653–1.741), 1.105 (0.600–1.718), and 0.934 (0.556–1.571) in females after full adjustment. (4) Conclusion: The ω3FA ratio is associated with subclinical inflammation in men.