摘要
目的:了解新疆维吾尔自治区不同碘营养水平地区儿童甲状腺功能和智商现状,探讨尿碘中位数处于200~299 μg/L范围内对儿童的健康风险,为科学补碘提供依据。方法:2019年5月,在新疆维吾尔自治区,选择8~10岁儿童尿碘中位数连续3年(2017 - 2019年)处于100~199 μg/L范围内的阿勒泰地区和处于200~299 μg/L范围内的喀什地区,采用分层随机抽样方法抽取8~10岁儿童各400名,采集尿样和血样进行尿碘和血清甲状腺功能[促甲状腺素(TSH)、游离甲状腺素(FT 4)、游离三碘甲状腺原氨酸(FT 3)、抗甲状腺球蛋白抗体(TgAb)、抗甲状腺过氧化物酶抗体(TPOAb)]检测,同时运用中国联合型瑞文测验图册(CRT-C2)和农村儿童智商常模(CRT-RC2)测试及判定儿童智商。 结果:阿勒泰地区和喀什地区8~10岁儿童的尿碘中位数分别为188.6、250.1 μg/L。两个地区血清甲状腺功能指标TSH、FT 3水平比较差异均无统计学意义( Z =- 0.58, t = 0.49, P均> 0.05),FT 4水平比较差异有统计学意义( t = 60.08, P < 0.001),TgAb阳性率[3.6%(14/ 394)、4.0%(16/399)]比较差异无统计学意义(χ^(2) = 0.11, P = 0.736),TPOAb阳性率[9.6%(38/394)、30.6%(122/399)]比较差异有统计学意义(χ^(2) = 53.93, P < 0.001),双抗阳性率[0.8%(3/394)、2.0%(8/399)]比较差异无统计学意义( P = 0.134)。两个地区儿童亚临床甲状腺功能减退[8.9%(35/394)、11.0%(44/399)]、亚临床甲状腺功能亢进[1.0%(4/394)、1.3%(5/399)]、甲状腺功能亢进[0.3%(1/394)、0.8%(3/399)]检出率比较差异均无统计学意义( P均> 0.05)。两个地区儿童智商测试结果分别为96.55 ± 11.36、89.57 ± 12.35,二者比较差异无统计学意义( t = 2.79, P = 0.095)。 结论:在8~10岁儿童尿碘中位数处于100~199 μg/L和200~299 μg/L范围内的两个地区,儿童甲状腺功能状态相近,但TPOAb阳性率出现较大差异;碘营养水平处于适宜和超过适宜量的儿童,智力未见明显改变,提示尿碘中位数处于200~299 μg/L范围内是一个相对安全的碘营养状态。
Objective To learn about the status of thyroid function and intelligence quotient(IQ)of children in areas with different iodine nutrition levels in Xinjiang Uygur Autonomous Region,and to explore the health risk of children with median urinary iodine of 200-299μg/L,and to provide a basis for scientific iodine supplementation.Methods In May 2019,in Xinjiang Uygur Autonomous Region,Altay Prefecture and Kashgar Prefecture were selected,where the median urinary iodine of children aged 8 to 10 years were 100-199 and 200-299μg/L for three consecutive years(2017-2019).A stratified random sampling method was used to select 400 children aged 8 to 10 years in each of the two regions,urine and blood samples were collected to detect urinary iodine and thyroid function[thyrotropin stimulating hormone(TSH),free thyroxine(FT4),free triiodothyronine(FT3),anti-thyroglobulin antibody(TgAb),and anti-thyroperoxidase antibody(TPOAb)].At the same time,children's IQ was measured and determined by Second Revision of Combined Raven's Test(CRT-C2)in China and Second Revision of Combined Raven's Test for Children-the Rural,in China(CRT-RC2).Results The median urinary iodine of children aged 8 to 10 years in Altay Prefecture and Kashgar Prefecture was 188.6 and 250.1μg/L,respectively.There was no statistically significant difference in thyroid function indexes TSH and FT3 levels between the two regions(Z=-0.58,t=0.49,P>0.05),while there was statistically significant difference in FT4 level(t=60.08,P<0.001).There was no statistically significant difference in TgAb positive rate[3.6%(14/394),4.0%(16/399)]between the two regions(χ2=0.11,P=0.736),but the difference of TPOAb positive rate[9.6%(38/394),30.6%(122/399)]was statistically significant(χ2=53.93,P<0.001),while the difference of dual antibody positive rate[0.8%(3/394),2.0%(8/399)]was not statistically significant(P=0.134).There was no statistically significant difference in the detection rates of subclinical hypothyroidism[8.9%(35/394),11.0%(44/399)],subclinical hyperthyroidism[1.0%(4/394),1.3%(5/399)]and hyperthyroidism[0.3%(1/394),0.8%(3/399)]in children between the two regions(P>0.05).The IQ results of children in the two regions were 96.55±11.36 and 89.57±12.35,respectively,and there was no significant difference between them(t=2.79,P=0.095).Conclusions The thyroid function status of children is similar in the two regions with median urinary iodine of 100-199μg/L and 200-299μg/L in children aged 8 to 10 years,but the TPOAb positive rate is significantly different.Children whose iodine nutritional level is at or above the appropriate level have no obvious changes in intelligence.It is suggested that median urinary iodine at 200-299μg/L is a relatively safe iodine nutrition state.
作者
黄佳
潘凯
马品江
孙丽
李慧
罗秀玲
李健玲
张伟
Huang Jia;Pan Kai;Ma Pinjiang;Sun Li;Li Hui;Luo Xiuling;Li Jianling;Zhang Wei(Institute of Environmental Health and Endemic Disease Control,Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region,Urumqi 830002,China;Center for Disease Control and Prevention of Yingsar,Kashgar,Xinjiang Uygur Autonomous Region,Kashgar 844000,China;Center for Disease Control and Prevention of Fuhai,Altay,Xinjiang Uygur Autonomous Region,Altay 836000,China;Center for Disease Control and Prevention of Makit,Kashgar,Xinjiang Uygur Autonomous Region,Kashgar 844000,China;Center for Disease Control and Prevention of Habahe,Altay,Xinjiang Uygur Autonomous Region,Altay 836000,China;National Institute of Environmental Health,Chinese Center for Disease Control and Prevention,Beijing 100021,China)
出处
《中华地方病学杂志》
CAS
北大核心
2022年第7期570-575,共6页
Chinese Journal of Endemiology
基金
新疆维吾尔自治区自然科学基金(2018D01C086)。
关键词
碘营养
甲状腺功能
智商
Iodine nutrition
Thyroid function
Intelligence quotient
