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,P<0.01);不同年龄组尿碘频数分布比较差异无统计学意义(P>0.05)。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,P<0.01)。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,P<0.01),且检出率随年龄增大而增高(χ~2=492.50,P<0.01)。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。

Analysis of iodine nutrition level and prevalence of thyroid nodules in 10166 residents of Meishan community in Nanjing

Objective To understand the iodine nutrition status and the detection rate of thyroid nodules of residents in Meishan community,Nanjing City.Methods In Nanjing,10 166 residents in Meishan community who had physical examination in Meishan Hospital from January to December 2019 were selected.The urinary iodine concentration(UIC) was detected by arsenic cerium catalytic spectrophotometry,and the thyroid nodule was examined by B ultrasound.The UIC and the prevalence of thyroid nodules were analyzed.Results The proportion of 10 166 residents with insufficient iodine intake(urinary iodine 0~100 μg/L) was 15.83%,while those of the enough(urinary iodine 100~199 μg/L),the adequate(urinary iodine 200~299 μg/L),and the excessive groups(urinary iodine ≥300 μg/L) were 39.03%,31.09%,and 14.05%,respectively.The median UIC in all the residents was 181.5 μg/L,in male was 193.2 μg/L,and in female was 128.7 μg/L.The median UIC in male were significantly higher than that in female(Z=17.39,P<0.01).There was no significant difference in urinary iodine frequency distribution among age groups(P>0.05).A total of 3 926 persons in all participants with thyroid nodules were detected,with a detection rate of 38.62%.Among them,2 709 were males with a detection rate of 35.47%(2 709/7 637) and 1 217 were females with a detection rate of 48.12%(1 217/2 529).The detection rate of thyroid nodules in males was lower than that in female,and the difference was statistically significant(χ~2=128.25,P<0.01).The detection rate of thyroid nodules in the iodine deficiency group was 48.42%(779/1 609),in the iodine excessive group was 45.66%(652/1 428),in the iodine enough group was 34.45%(1 369/3 974),and in the iodine adequate group was 35.69%(1 126/3 155).The detection rate of the former two groups was significantly higher than that of the latter two groups(P<0.01).Furthermore,significant difference in the detection rate of thyroid nodules was observed among age groups(χ~2=518.05,P<0.01),and there was a positive and significant correlation between the detection rate of thyroid nodules and increasing age(χ~2=492.50,P<0.01).Conclusion The overall iodine nutritional status of residents of Meishan community in Nanjing City is ideal.The detection rate of thyroid nodules in men is lower than that in women and it is increased with age.The detection rate of thyroid nodules is high in the deficient iodine and excessive iodine residents.The iodine nutrition should be adjusted according to the level of urinary iodine.