马品江, 林勤, 张玲, 黄佳, 王琛琛, 涂杰. 新疆严重缺碘地区妇女尿碘状况及甲状腺激素水平[J]. 上海预防医学, 2017, 29(11): 876-879. DOI: 10.19428/j.cnki.sjpm.2017.11.012
引用本文: 马品江, 林勤, 张玲, 黄佳, 王琛琛, 涂杰. 新疆严重缺碘地区妇女尿碘状况及甲状腺激素水平[J]. 上海预防医学, 2017, 29(11): 876-879. DOI: 10.19428/j.cnki.sjpm.2017.11.012
Pin-jiang MA, Qin LIN, Ling ZHANG, Jia HUANG, Chen-Chen WANG, Jie TU. Women's urine iodine status and thyroid hormone level in severe iodine defiant areas in Xinjiang[J]. Shanghai Journal of Preventive Medicine, 2017, 29(11): 876-879. DOI: 10.19428/j.cnki.sjpm.2017.11.012
Citation: Pin-jiang MA, Qin LIN, Ling ZHANG, Jia HUANG, Chen-Chen WANG, Jie TU. Women's urine iodine status and thyroid hormone level in severe iodine defiant areas in Xinjiang[J]. Shanghai Journal of Preventive Medicine, 2017, 29(11): 876-879. DOI: 10.19428/j.cnki.sjpm.2017.11.012

新疆严重缺碘地区妇女尿碘状况及甲状腺激素水平

Women's urine iodine status and thyroid hormone level in severe iodine defiant areas in Xinjiang

  • 摘要:
    目的探讨新疆严重缺碘地区妇女碘营养状况及甲状腺激素水平,为科学补碘提供依据。
    方法根据国家自然科学基金项目设计,抽取新疆拜城县、乌什县、托克逊县3个碘缺乏病高发区的妊娠期妇女、哺乳期妇女、育龄妇女共计1 003人。尿碘采用尿中碘的砷铈催化分光光度测定法(WS/T 107—2006)、酸消化砷铈接触法检测碘浓度,用罗氏公司的(E411)分析仪器及试剂盒来检测甲状腺激素水平。
    结果① 检测妇女尿碘1 003份,中位数为214.43 μg/L,孕妇组、哺乳组、育龄组中位数分别为183.53、208.11、224.68 μg/L。尿碘水平低于50、100 μg/L的比例分别占5.68%、18.14%,其中孕妇组尿碘低于50、100、150 μg/L的比例分别占孕妇人数的7.52%、21.39%、58.96%。孕妇组和哺乳组尿碘水平低于50、100 μg/L的人数分别和育龄组进行比较,组间均差异无统计学意义(χ<50 μg/L2分别为1.70、0.59;χ2 < 100 μg/L分别为2.59、3.01,均P>0.05)。②妇女的三碘甲状腺原氨酸(T3)、甲状腺素(T4)、血清游离三碘甲状腺原氨酸(FT3)、血清游离甲状腺素(FT4)、促甲状腺素(TSH)均值分别为(2.14±0.57)nmol/L、(98.60±25.53)nmol/L、(4.74±1.55)pmol/L、(13.89±3.47)pmol/L和(2.93±3.48)mU/L。③ FT4异常率为19.82%,其中偏低者占18.79%,TSH异常率为16.67%,其中偏高者占16.08%。④ T3、T4为孕妇组最高,组间比较差异有统计学意义(F=137.76,P<0.01、F=187.72,P<0.01)。FT3、FT4为哺乳组的最高,组间比较差异有统计学意义(F=19.28,P<0.01、F=14.56,P<0.01);T3、T4、FT3、FT4、组间比较孕妇组与哺乳组、育龄组差异均有统计学意义,TSH组间比较差异无统计学意义(F=0.72,P=0.48)。
    结论新疆碘缺乏高危病区妇女严重碘摄入不足,应加强监测制定更加科学合理的补碘干预措施,确保碘营养水平达到均衡。

     

    Abstract:
    ObjectiveTo investigate women's iodine nutrition and thyroid hormone levels in areas with severe iodine deficiecy in xinjiang, and provide the basis for scientific iodine supplement.
    MethodsAccording to Project design of National Natural Science Foundation of China, a total of 1 003 pregnant women, lactating women and women of childbearing age were randomly included, for them were used the method for determination of iodine in urine by As3+-Ce4+ catalytic spectrophotometry (WS/T 107—2006), Roche (E411) analysis instrument and reagent kit for detecting thyroid hormones.
    Results(1) In detecting urine iodine of 1 003 women, the median was 214.43 μg/L, and the median for pregnancy, lactation women, and childbearing age group were 183.53, 208.11, 224.68 μg/L, respectively; samples with urine iodine level below 50, 100 μg/L accounted for 5.68% and 18.14% respectively, urine iodine lower than 50, 100 and 150 μg/L in pregnant women accounted for 7.52%, 21.39% and 58.96%, respectively; within the three groups of urinary iodine less than 50 and 100 μg/L, there were no statistical differences (χ2=1.70, 0.54, χ2=2.59, 3.01). (2) The average of T3, T4, FT3, FT4, TSH were (2.14±0.57)nmol/L, (98.60±25.53)nmol/L, (4.74±1.55)pmol/L, (13.89±3.47)pmol/L and (2.93±3.48)mU/L.(3) Abnormal rate of serum free thyroxine (FT4) was 19.82%, including 18.79% lower than limits, abnormal rate of thyroid stimulating hormone (TSH) was 16.67%, including 16.08% higher than the limits. (4) The T3, T4 of pregnant women group were highest, statistically significant difference was found between groups (F=137.76, P < 0.01, F=187.72, P < 0.01); the FT3 and FT4 of lactating group were highest, there was statistical difference between groups (F=19.28, P < 0.01, F=14.56, P < 0.01); T3, T4, FT3, FT4 were compared between groups, and there were significant differences found between pregnant women and lactating women group, and there was no difference found in TSH between groups (F=0.72, P=0.48).
    ConclusionsIn Xinjiang areas with severe iodine deficiency, women are severely iodine deficient and their thyroid hormone levels are higher than the standard upper limit, so we should strengthen the monitoring of iodine to develop more scientific and reasonable iodine supplement intervention measures, to ensure that the iodine nutrition reaches an adequate level.

     

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