舟山群岛嵊山镇渔民甲状腺健康状况和碘摄入量的流行病学调查
An Epidemiological Study on Thyroid Health and Iodine-intake Level in Fishermen of Shengshan Town in Zhoushan Archipelago
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摘要:
目的 调查全民食盐加碘计划后舟山群岛嵊山镇渔民甲状腺健康的现状和碘摄入水平,并分析可能的影响因素。 方法 对社区362名渔民进行甲状腺健康普查,内容包括调查问卷和体格检查,甲状腺B超和血清促甲状腺素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、甲状腺过氧化物酶抗体(TPOAb)检测以及尿碘测定。尿碘水平的组间比较采用非参数检验,甲状腺异常的影响因素分析采用logistic回归。 结果 362名渔民中甲状腺B超异常率为40.3%(146/362), TPOAb阳性率为9.7%(35/362),甲状腺功能异常率为3.3%(12/362),合并后总甲状腺异常率为44.5%(161/362)。碘盐覆盖率为86.7%(314/362),尿碘中位数为193.6μg/L,男性、食碘盐、肥胖组的尿碘水平较高(χ2=5.459, P<0.05; χ2=7.051, P<0.01; χ2=7.725, P<0.05),但甲状腺异常与否其尿碘水平差异无统计学意义(χ2=0.110, P>0.05)。甲状腺异常的危险因素有年龄大和高舒张压, OR值分别为1.266(95%CI:1.001~1.600)和6.066(95%CI:2.176~16.909);而男性则为甲状腺异常的保护性因素,其OR值为0.442(95%CI:0.282~0.694)。 结论 嵊山镇渔民的碘摄入量处于WHO推荐的"适宜"范围,但甲状腺异常率较高。碘盐、性别、肥胖程度对碘摄入量有影响;年龄大、女性和高舒张压可能是影响嵊山镇渔民甲状腺健康的影响因素。 Abstract:Objective To investigate the thyroid health status, iodine-intake level and potential impact factors in fishermen of Shengshan Town in Zhoushan Archipelago. Methods A survey on thyroid health was carried out in a fisherman residential area, including a questionnaire, physical examination, B-mode ultrasonic thyroid scan, levels of free triiodothyronine (FT3), free thyroxine (FT4), thyroid stimulating hormone (TSH) and thyroid peroxidase antibody (TPOAb) in serum, as well as urinary iodine. Kruskal-Wallis test was used to determine urinary iodine levels among groups and the risk factors of thyroid abnormalities were evaluated by a logistic regression analysis. Results A total of 362 fishermen were recruited, 44.5% (161/362) of which were found to have thyroid abnormalities, including 40.3% (146/362)with B-mode ultrasonic abnormality, 9.7% (35/362) with TPOAb-positive and 3.3% (12/362)with thyroid dysfunction. 86.7% (314/362)of fishermen used iodized-salt in daily cooking. The median of urinary iodine (MUI)was 193.6μg/L. Being male fishermen (χ2=5.459, P < 0.05), using iodized-salt (χ2=7.051, P < 0.01)or being overweight (χ2=7.725, P < 0.05)showed significantly higher iodine-intake level. No difference in urinary iodine level was found in fishermen with or without thyroid abnormality (χ2=0.110, P>0.05). Age (OR 1.266; 95%CI 1.001-1.600), gender (OR 0.442; 95%CI 0.282-0.694) and diastolic pressure (OR 6.066; 95%CI 2.176-16.909) were identified as potential risk factors to thyroid health. Conclusion A relatively high prevalence of thyroid abnormalities was found in fishermen in Shengshan island, but their iodine-intake level still met the recommendation of WHO. Iodized-salt, gender, and overweight showed various impact to io dine-intake. Age, gender and diastolic pressure are identified as potential risk factors of thyroid abnormalities.
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