氟斑牙儿童甲状腺激素异常与DIO1基因多态性的关系

目的　分析氟斑牙儿童甲状腺激素异常情况及与Ⅰ型脱碘酶（DIO1）基因多态性的关系。方法　2018年6月—2019年6月，在天津市历史水氟区和非水氟区共随机抽取169名7~12岁儿童，检测儿童氟斑牙水平。其中正常儿童（正常组）79名，氟斑牙儿童（氟斑牙组）90名。采集尿样，利用砷铈催化分光光度方法测定尿碘水平。采集血样，化学发光法检测促甲状腺激素（TSH）、游离三碘甲状腺原氨酸（FT3）和游离甲状腺素（FT4），采用Sequenom SNP分型检测实验测定DIO1中rs2294512位点的多态性，并进行问卷调查。根据DIO1 rs2294512位点的基因型分层后进行多因素Logistic回归分析，研究DIO1基因多态性在氟斑牙与甲状腺激素异常中的作用。结果　相对于正常组，氟斑牙组FT3水平较高，FT4水平较低（P＜0.05）。氟斑牙组FT3过高率达40.0%，高于正常组的21.5%，FT4过高率为3.3%，低于正常组的12.7%（P＜0.05）。DIO1基因AA基因型儿童中，患氟斑牙者FT3较高（OR=6.357，95%CI：1.808~22.347，P=0.004）。结论　DIO1基因rs2294512位点为AA基因型的氟斑牙儿童FT3水平更易升高。

The relationship between thyroid hormone abnormality and DIO1 gene polymorphism in children with dental fluorosis

Objective　To analyze the relationship between thyroid hormone abnormality and type 1 selenodeiodinase gene (DIO1) gene polymorphism in children with dental fluorosis. Methods　From June 2018 to June 2019, 169 children aged 7-12 years were randomly selected from the historical water fluoride area and non-water fluoride area of Tianjin to test the level of dental fluorosis. Urine samples were collected and the level of urinary iodine was determined by As3+-Ce4+ catalytic spectrophotometry. Blood samples were collected, TSH, FT3 and FT4 were detected by chemiluminescence, and the gene polymorphism of DIO1 rs2294512 was detected by sequenom SNP. The role of DIO1 gene polymorphism in dental fluorosis and thyroid hormone abnormality was studied by multivariate Logistic regression analysis after genotyping of DIO1. Results　The level of FT3 was higher in children with dental fluorosis (P＜0.05), and the level of FT4 was lower (P＜0.05). The abnormal rate of FT3 was as high as 40.0% in dental fluorosis group, and which was higher than that of normal children (P＜0.05). The abnormal rate of FT4 was reduced to 3.33%, and which was lower than that of normal children (P＜0.05). Among the children with DIO1 AA genotype, the incidence of dental fluorosis was more likely to lead to higher FT3 (OR=6.357, 95%CI: 1.808-22.347, P=0.004).　Conclusion　The FT3 level of dental fluorosis children with AA genotype of DIO1 gene rs2294512 is more likely to be higher.