| Objective:1.To investigate the iodine nutritional status and thyroid function of women in different physiological periods,including women of childbearing age,pregnant women and one and a half years after delivery.2.To explore the relationship between urinary iodine/creatinine ratio and thyroid hormone,thyroid antibody,thyroid volume and abnormal thyroid function.3.To analyze the related factors of thyroid nodules in different physiological periods.Methods:A cross-sectional epidemiological survey was conducted in Tianjin urban area and Binhai New area.Women of childbearing age,pregnancy and one and a half years after delivery were selected.Collect basic information,disposable random urine,determine urinary iodine concentration and urinary iodine creatinine value;Collect venous blood,TSH、f T4、f T3、TPOAb、Tg Ab were measured.f T4 and f T3 were detected only when TSH was abnormal in women of childbearing age.Thyroid volume and nodules were measured by thyroid ultrasound.Results:1.A total of 1153 people were included in this study,including 443 women of childbearing age,407 women during pregnancy and 258 women in one and a half years after delivery.The average age of women of childbearing age was 27.8±4.0,the average age of pregnant women was 28.7±3.0,and the average age of postpartum women was 30.5±2.5.The median of urinary iodine in women of childbearing age,pregnancy and one and a half years postpartum was 191(127,280)μg and 168(113,248)ug and 136(87,194)μg,respectively,which were all in the suitable state of iodine.The UI/Cr ratio was divided into four groups:<100μg/g,100-150μg/g,150-250μg/g and>250μg/g.The results showed that the proportion of UI/Cr ratio<100μg/g in pregnant women and postpartum women was higher than that in women of childbearing age(P<0.001,P<0.001),and the proportion of UI/Cr ratio>250μg/g in women of childbearing age was higher than that in pregnant women(P<0.001)and postpartum women(P<0.001).2.The serum concentration of TSH in women of childbearing age was higher than that in pregnant women and postpartum women(P<0.001,P<0.001),but there was no significant difference in serum TSH concentration between pregnant women and postpartum women(P=0.739).The concentrations of f T4 and f T3 in serum of postpartum women were slightly higher than those of pregnant women(P<0.001,P<0.001).When the ratio of UI/Cr was less than 100μg/g,the concentration of TSH in serum of pregnant women decreased(P<0.004),the concentration of f T4 increased(P<0.001),and the concentration of f T3 increased(P<0.001).When the ratio of UI/Cr was less than 100μg/g,the concentration of TSH in serum of pregnant women decreased(P<0.004),and the concentration of f T3 increased compared with the groups of 100-150μg/g and 150-250μg/g(P<0.001,P<0.001).The positive rates of TPOAb and Tg Ab in pregnant women were lower than those in childbearing age women and postpartum women.The difference of the positive rate of Tg Ab antibody among the four groups of UI/Cr ratio in pregnant women was statistically significant(P=0.029).When the UI/Cr ratio was less than 100μg/g,the positive rate of Tg Ab antibody was higher.3.The incidence of hypothyroidism in women of childbearing age was significantly higher than that in pregnant women(P<0.05)and one and a half years postpartum women(P<0.05).Compared with the group with UI/Cr ratio of 150-250μg/g,the rate of abnormal thyroid function of women of childbearing age increased significantly when UI/Cr ratio was more than 250μg/g.There was a correlation between thyroid volume and BMI in women at different physiological stages(r=0.343,P<0.05;r=0.316,P<0.05;r=0.304,P<0.05),and thyroid volume increased with the increase of BMI.4.Multivariate Logistic regression analysis showed that BMI≥24(OR=1.79,P=0.044)in women of childbearing age,goiter(OR=15.35,P=0.027)in pregnant women and positive TPOAb(OR=1.88,P=0.022)in one and a half years postpartum women was the risk factor of thyroid nodules.Conclusion:1.The levels of urinary iodine in women of childbearing age,pregnancy and one and a half years after delivery are all in a suitable state.2.The concentration of TSH in serum of women of childbearing age was higher than that of pregnant women and postpartum women for one and a half years.The concentrations of f T4 and f T3 in serum of postpartum women were slightly higher than those of pregnant women.When the ratio of UI/Cr was less than 100μg/g,the concentration of TSH in serum of pregnant women decreased,while the concentration of f T4 and f T3 increased compared with the groups of 100-150μg/g and 150-250μg/g.The positive rates of TPOAb and Tg Ab in pregnant women were lower than those in childbearing age women and postpartum women for one and a half years.When the ratio of UI/Cr was less than 100μg/g,the positive rate of Tg Ab antibody was higher in pregnant women.3.Compared with the UI/Cr ratio 150-250μg/g group,the rate of thyroid dysfunction in women of childbearing age was significantly higher in the UI/Cr ratio>250μg/g group.The thyroid volume of women at different physiological stages increased with the increase of BMI.4.BMI≥24kg/m~2 in women of childbearing age,goiter in pregnant women and positive TPOAb in women one and a half years after delivery are the risk factors of thyroid nodules. |
