甘肃省人群高氯酸盐暴露水平及对甲状腺功能影响分析

  目的  对甘肃省人群高氯酸盐暴露水平进行评估并探讨其与甲状腺功能的关系，为该地区高氯酸盐污染防控提供依据。  方法  采用现况研究设计，选取兰州市城关区和定西市陇西县的随机两个社区中参与义诊的居民作为研究对象，采用问卷调查、体格检查和生化检查收集研究对象的基本资料及相关信息。应用多因素线性回归分析模型和限制性立方样条分析高氯酸盐暴露水平与甲状腺功能的关联及剂量-反应关系。  结果  本研究共纳入研究对象100名，包括男性48名和女性52名。尿高氯酸盐浓度的中位数(四分位间距)为23.90(13.30~43.54)μg/g Cr。多因素线性回归分析发现，调整混杂因素后，高氯酸盐暴露水平与血清总三碘甲状腺原氨酸(total triiodothyronine, TT3)、游离三碘甲状腺原氨酸(free triiodothyronine, FT3)和游离甲状腺素(free thyroxine, FT4)水平呈正相关趋势(均有P < 0.05)。限制性立方样条分析发现高氯酸盐暴露水平与血清TT3和FT4水平呈非线性剂量-反应关系(均有P < 0.05)。  结论  甘肃省地区人群的高氯酸盐暴露水平较高。高氯酸盐暴露水平与血清TT3、FT4水平有相关关联。

Analysis of perchlorate exposure level and its effect on thyroid function in the population of Gansu

  Objective  To explore the association between perchlorate exposure level and thyroid function in the population of Gansu, in order to provide a basis for the prevention and control of perchlorate pollution in the region.  Methods  Using the cross-sectional study design, residents who participated in voluntary clinic in two random communities in Chengguan District, Lanzhou City and Longxi County, Dingxi City, Gansu Province were selected as the subjects of this study, and questionnaires, physical and biochemical examinations were used to collect basic data and relevant information of the subjects. The multivariate linear regression and restricted cubic spline model were used to analyze the association and dose-response relationship between perchlorate exposure levels and thyroid function.  Results  A total of 100 subjects were included in the study, including 48 males and 52 females. The median average exposure level (quartile spacing) of urinary perchlorate was 23.90 (13.30-43.54) μg/g Cr. The results of multivariate linear regression analysis revealed that after adjusting the confounding factors, the level of perchlorate exposure was positively correlated with the level of serum total triiodothyronine (TT3), free triiodothyronine (FT3) and free thyroxine (FT4) levels (all P < 0.05). The restrictive cubic spline model analysis indicated a non-linear dose-response correlation between perchlorate exposure levels with serum total triiodothyronine and free thyroxine levels (all P < 0.05).  Conclusions  The population in Gansu has a high level of perchlorate exposure. There is a correlation between perchlorate exposure levels and serum total triiodothyronine and free thyroxine levels.