广州成人碘营养与甲状腺结节疾病临床特征分析

［摘要］ 目的 分析广州市居民碘营养状态与甲状腺结节疾病临床特征的关联。方法 收集自2018年1月1日至2019年2月1日在广州医科大学附属第二医院就诊的成人人群，且同期行甲状腺B超、尿碘以及甲状腺功能相关检查者；根据尿碘水平进行评判分组，尿碘<100 μg/L为碘营养不足组；尿碘100~199 μg/L为碘营养适宜组；尿碘200~299 μg/L为碘营养超适宜量组；尿碘>300 μg/L为碘营养过量组。观察尿碘与甲状腺疾病患病率和甲状腺功能的关系。结果 研究共入组观察1107例，尿碘中位数93.40 μg/L，其中甲状腺结节患者309例，与碘适量组甲状腺结节患病率比较，其他不同的碘营养组甲状腺结节患病率无显著性差异，碘营养水平对甲状腺结节合并甲亢或自身免疫性甲状腺炎的患病率亦无显著影响；与碘适量组人群相比，碘营养不足和碘过量组FT3和FT4显著增高，而对应TSH水平显著下降。结论 广州市居民成人碘营养偏低，碘营养水平不足或过量均可能导致甲状腺功能异常。

Analysis of iodine nutrition and clinical characteristics of thyroid nodule disease in adult population of Guangzhou

［Abstract］ Objective To analyze the relationship between iodine nutritional status and clinical features of thyroid nodule disease in Guangzhou residents. Methods The adult population was collected from the Second Affiliated Hospital of Guangzhou Medical University from January 1， 2018 to February 1， 2019. Thyroid ultrasound， urinary iodine and thyroid function were detected in subjects. Urinary iodine <100 μg/L was for iodine insufficient group； urinary iodine 100-199 μg/L for iodine adequate group； urine iodine 200-299 μg/L for above requirement group； urine iodine > 300 μg/L for the iodine excess group. The relationship between urinary iodine and thyroid disease and thyroid function was explored. Results A total of 1107 patients were enrolled in the study， including 309 patients with thyroid nodules. The median urinary iodine was 93.40 μg/L. Compared with the iodine adequategroup，there was no significant difference in the rate of thyroid nodule disease in other groups. Besides， iodine nutrient had no significant effect on the prevalence of thyroid nodules complicated with hyperthyroidism or autoimmune thyroiditis. Compared with the iodine adequate group， iodine insufficient and iodine excess group showed significant higher FT3 and FT4 levels， and corresponding significantly lower TSH level. Conclusion The iodine nutrition of adults in Guangzhou is insufficient， and both iodine deficiency and iodine excess could lead to abnormal thyroid function.