惠州地区居民碘营养状况调查及甲状腺结节的危险因素分析

目的 了解惠州地区居民碘营养状况,并分析该地区甲状腺结节的危险因素,为今后甲状腺结节的防治提供依据。方法 于2015年1月-2016年12月采用多阶段、随机抽样的方法抽取惠州地区25~70岁的人群共896例作为研究对象,通过问卷调查了解研究对象姓名、性别、年龄等基本情况,并检查其尿碘水平和甲状腺结节发生情况,应用单因素χ²检验及多因素logistic回归分析分析甲状腺结节发生的相关因素。结果 惠州地区居民总体人群尿碘1.42~2 537.73 μg/L,中位数149.25 μg/L,男性尿碘中位数显著高于女性,农村人群尿碘中位数显著高于城市人群(Z=4.092、-5.984,均P<0.05)。单因素分析显示,惠州地区居民甲状腺结节发生与性别、年龄、地区、吸烟、饮酒、尿碘水平、常吃海产品、甲状腺疾病史有关(均P<0.05),与常吃腌制食品无关(P>0.05)。多因素logistic回归分析显示,女性(OR=2.418)、年龄≥60岁(OR=2.143)、吸烟(OR=2.113)、饮酒(OR=1.826)、低尿碘(OR=3.582)、甲状腺疾病史(OR=2.425)是惠州地区居民甲状腺结节发生的危险性因素,常吃海产品(OR=0.356)是惠州地区居民甲状腺结节发生的保护性因素(P<0.05)。结论 惠州地区居民总体碘营养水平处于适宜范围,但仍应加大重点人群甲状腺结节的检查,给予有效的治疗。

Status of iodine nutrition and risk factors of thyroid nodules among residents in Huizhou region

Objective To investigate the status of iodine nutrition among residents in Huizhou region, to analyze the risk factors of thyroid nodules in this region, and to provide a basis for prevention and treatment of thyroid nodules in future. Methods Multi-stage and random sampling method was used to select 896 adults aged 25-70 years in Huizhou region to serve as the subjects from January 2015 to December 2016. The subjects’ name, gender, age and other general information were investigated through a questionnaire survey; moreover, the level of iodine in urine and the prevalence of thyroid nodules were examined. Univariate chi-square test and multivariate logistic regression analysis were used to analyze the factors related to thyroid nodules.Results The level of urinary iodine in the overall population of Huizhou region was 1.42-2,537.73 μg/L, and the median was 149.25 μg/L. The median urinary iodine level was significantly higher in males than in females (Z=4.092, P<0.05) as well as higher in rural population than in urban population (Z=-5.984, P<0.05). Univariate analysis showed that the occurrence of thyroid nodules among the residents in Huizhou region was related to gender, age, district, smoking, drinking, urinary iodine level, often eating seafood and history of thyroid diseases (all P<0.05), but unrelated to often eating preserved food (P>0.05). Multivariate logistic regression analysis showed that female (OR=2.418), age greater than or equal to 60 years old (OR=2.143), smoking (OR=2.113), drinking (OR=1.826), low urinary iodine (OR=3.582) and history of thyroid diseases (OR=2.425) were the risk factorsfor the occurrence ofthyroid nodules among the residents in Huizhou region, while often eating seafood (OR=0.356) was a protective factor for the occurrence ofthyroid nodules (P<0.05). Conclusions The overall level of iodine nutrition of the residents in Huizhou region is adequate, but it is still necessary to strengthen the examination of thyroid nodules in the key population and give effective therapies.