| Objective: To research the iodine nutrition status of Tianjin adults from non-high-iodine area,and to discover the status of thyroid disorders,explore the relationship of iodine status and thyroid disorders,to provide scientific evidence for iodine nutrion monitoring and thyroid disease management in Tianjin district.Methods: On the basis of distribution of iodine of drinking water,we choosed adults population of a urban area(Hedong district)and a rural area(Hangu district)where water iodine continent was below 150 ?g/L,and belonged to non-high water iodine district.The objects chosen were over 18 years old,having been living in Tianjin at least 5 years,and no recording of using iodine drugs.The research program contained adopting basic information,collecting of morning spot urine,blood sample,ultrasound determination of thyroid,et al.The urine sample was determinate by As(III)-Ce4+ catalytic spectrophotometry,The TSH level was tested by chemiluminescence immunoassay,Serum levels of free thyroxin(FT4)and free triiodothyronine(FT4)are determinate when TSH level is abnormal,according to the clinical practical,thyroid disease was diagnosed.The ultrasound determinated the thyroid volume and the thyroid nodule.Certain training research stuff helped the objects to complete three days consecutive 24 hours dietary record and collected the iodine intake level of adult population from food.The data entry collected from research used Epidata13.0 and Excel2007.SPSS 20.0 was using for statistical analysis.Consecutive normal distribute data was described by `x±SD,abnormal distribute data was described by mean;the measurement data compared by non-parametric test,various rate compared by Chi-square test,Spearman rank correlation analysis,significant differences of determination standard for ?=0.05.Results: The total number of adult residents included 1452 from urban area,with average age 43.2±15.5,and 1329 from rural area,whose average age 43.1±15.5.There was no significant differences between the sex and age composition(P<0.05).The usage rate of household iodine salt was 95.2% for urban area,which was higher than rural area(90.1%).The statistic results of level of having salt,comparing the two areas,66.3% of subjects in urban area ate salt adequately,but most subjects in rural area had salt over 10g/d.Water iodine of urban area and rural area are 2.33?g/L and 9.11?g/L respectively,both are non-high water iodine district.1376 and 1254 adults urine samples were collected and tested,The median of urine iodine of urban and rural areas was 185.1 mg /L and 156.1mg/L respectively,both had statistical significant difference after Kruskal-Wallis non-parametric test(P<0.05).By Kreskas-Wallis H test,distribution of urine iodine median varied among the age group,the youth group showed the highest urine iodine medium no matter in both areas(202.7?g/L and 203.6?g/L respectively,P<0.05).The thyroid ultrasound tested 1359 adults in urban area and 1257 rural adults.The goiter rate was 2.0% and 2.5% respectively.The rate of thyroid nodule was 26.7% and 25.4% in urban and in rural areas.Both showed no significant difference(P>0.05).But the female showed a higher rate than the male.In the group of inadequate iodine(P<0.05),thyroid nodule rate had a higher testing rate(P<0.05).The total number of diagnosed thyroid disorders in urban area among objects was 163,rating 11.7%,11 hyperthyroidism(0.8%)7 sub-hyperthyroidism(0.5%),10 hypothyroidism(0.7%),135 sub-hypothyroidism(9.7%),and in rural area,131 out of 1272 were diagnosed with thyroid disorders,the epidemical distribution of thyroid disorders was 10 hyperthyroidism(0.8%),3 sub-hyperthyroidism(0.2%),27 hypothyroidism(2.1%),91 sub-hypothyroidism(7.2%).The sub-hypothyroidism was the main type of thyroid disorders,and urban area had a higher rating than rural area.The testing rates of positive incidence of TGAb and TPOAb were 11.8% and 11.7%.The female showed a higher rate than the male,but no district difference.In the group of inadequate iodine,the positive incidence of TGAb and TPOAb were higher than other group.By multiple logistic regression analysis,the female(OR=1.563,P=0.002),50-59 year old(OR=1.500,P=0.045),smoking frequently(OR=2.048,P=0.001),TPOAb positive(OR=3.755,P<0.001),TGAb positive(OR=2.662,P<0.002)were the risk factors of thyroid disorders.Conclusion: The adult population in Tianjin non-high-iodine areas were in iodine adequate state with the rural area residents a little lower urine iodine.The testing rate of thyroid disorders of both areas had no significant difference,but female showed a higher rate.The highest rate of thyroid disorders was sub-clinical hypothyroidism,with the urban residents a higher rate.The low urine iodine group,hypothyroidism had a higher testing rate and in the high iodine group,hyperthyroidism had a higher testing rate.By pay attention to the female group,the low urine iodine,the high urine iodine and positive thyroid antibody group,we could protect them from thyroid disorders. |
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