富碘食物摄入与乳头状甲状腺癌关系的病例对照研究
Case-control study on relationship between iodine-rich food intake and papillary thyroid carcinoma
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摘要:
背景 甲状腺癌严重威胁上海市居民的健康，是肿瘤防治工作的重点。
目的 探索上海市富碘食物摄入与乳头状甲状腺癌（PTC）之间的关系。
方法 采用以医院为基础的1∶1配对病例对照研究，按照性别、年龄（±3岁）配对，共纳入402对病例和对照，所有病例均为新发病例，采用统一设计的结构化调查表和经验证的食物频率调查表，以面对面的方式，分别获得人口学和膳食摄入等资料。采用多因素条件logistic回归模型分析紫菜、海带、虾皮等富碘食物与PTC的关系。
结果 本研究共调查了402对PTC病例及对照，平均年龄为(41.17±11.51)岁。相较于对照组，PTC患者以低学历、体力型职业为主（
P <0.05）；更多PTC患者超重或肥胖、患有甲状腺良性病史和家族甲状腺相关疾病史（P <0.05）；此外，两组人群在过去10年内拍摄CT次数上差异具有统计学意义（P <0.05）。多因素条件 logistic 回归分析显示，与不吃相比，食用富碘食物与PTC风险降低有关（<1次·周−1，OR =0.20，95%CI ：0.12~0.35；1~2次·周−1，OR =0.18，95%CI ：0.10~0.33；≥3次·周−1：OR =0.13，95%CI ：0.04~0.44）（P <0.05）。其中，摄入紫菜（<1次·周−1，OR =0.18，95%CI ：0.11~0.30；1~2次·周−1，OR =0.11，95%CI ：0.05~0.23；≥3次·周−1，OR =0.15，95%CI ：0.03~0.75），食用海带（<1次·周−1，OR =0.28，95%CI ：0.18~0.43；1~2次·周−1，OR =0.24，95%CI ：0.11~0.50）、食用虾皮（<1次·周−1，OR =0.44，95%CI ：0.29~0.69；1~2次·周−1，OR =0.34，95%CI ：0.18~0.65）与PTC风险降低有关（P <0.05）。去除甲状腺良性疾病史者后，结果显示食用富碘食物、紫菜、虾皮和海带仍与PTC风险降低有关（P <0.05）。结论 PTC患者食用富碘食物的比例低于非PTC患者人群。
Abstract:Background Thyroid carcinoma is a serious threat to human health in Shanghai and a focus of cancer prevention and treatment.
Objective This study aims to assess the relationship between foods rich in iodine and papillary thyroid carcinoma (PTC)．
Methods In a hospital-based case-control study matched by gender and age (±3 years old), 402 pairs of cases (new incidences) and controls were included and studied. A validated questionnaire and food frequency questionnaire survey was conducted face to face to obtain demographic characteristics and dietary intake. A multiple conditional logistic regression model was applied to explore the relationship between foods rich in iodine (including seaweeds, kelp, and dried shrimps) and PTC.
Results The mean age of the participants was (41.17±11.51) years in this study. Compared with the controls, more cases had a lower education and a manual occupation (
P <0.05); more cases were overweight or obese, had a history of benign thyroid conditions, and had a family history of thyroid diseases (P <0.05); the two groups were different in the frequency of CT examination in the past ten years (P <0.05). The results of multiple conditional logistic regression analysis showed that consumption of iodine-rich foods was associated with a lower risk of PTC (for <1 time per week,OR =0.20, 95%CI : 0.12−0.35; for 1−2 times per week,OR =0.18, 95%CI : 0.10−0.33; for ≥3 times per week,OR =0.13, 95%CI : 0.04−0.44) (P <0.05). Specifically, those who consumed seaweeds (for <1 time per week,OR =0.18, 95%CI : 0.11−0.30; for 1−2 times per week,OR =0.11, 95%CI : 0.05−0.23; for ≥3 times per week,OR =0.15, 95%CI : 0.03−0.75), kelp (for <1 time per week,OR =0.28, 95%CI : 0.18−0.43; for ≤2 times per week,OR =0.24, 95%CI : 0.11−0.50), and dried shrimps (for <1 time per week,OR =0.44, 95%CI : 0.29−0.69; for ≤2 times per week:OR =0.34, 95%CI : 0.18−0.65) had a lower risk of PTC (P <0.05). After excluding patients who had a history of benign thyroid conditions, the favorable association remained significant among patients who had consumption of iodine-rich foods, seaweeds, shrimps, and kelp (P <0.05).Conclusion Less PTC patients consume iodine-rich foods than the controls.
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