Associations between iodine intake, thyroid volume, and goiter rate in school-aged Chinese children from areas with high iodine drinking water concentrations
Associations between iodine intake, thyroid volume, and goiter rate in school-aged Chinese children from areas with high iodine drinking water concentrations
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中国高碘饮用水浓度地区学龄儿童碘摄入量、甲状腺体积和甲状腺肿发生率之间的关系
DOI：
10.3945/ajcn.116.139725
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发表时间：
2017-01-01
影响因子：
7.1
通讯作者：
Zhang, Wanqi
中科院分区：
文献类型：
--
作者：
Chen, Wen;Li, Xiang;Zhang, Wanqi
目的：我们通过检查甲状腺体积（Tvol）、总甲状腺肿率（TGR）和碘摄入量之间的关系，评估从富碘饮用水中摄入高碘对儿童甲状腺大小的不良影响。设计：在一个多阶段的横断面调查中，我们收集了2个非连续2天的24小时尿液样本，测定24小时尿碘排泄量，然后计算习惯性每日碘摄入量。测量超声Tvol，并根据国际和中国儿童Tvol参考范围计算TGR。结果：本研究纳入山东省2089名儿童，其饮用水碘浓度中位数（IQR）为183 μ g/L （69406 μ g/L）。两组标本24小时尿碘浓度中位数（IQR）分别为381 μ g/L （203649 μ g/L）和398 μ g/L （202687 μ g/L）。儿童每日习惯性碘摄入量中位数（IQR）为298 μ g/d （186437 μ g/d）。男孩Tvols略高于女孩（P = 0.035）。总体TGR为9.7%，性别差异不大。710岁和1114岁儿童在碘摄入量分别为200249和250299 μ g/d时的TGR与5%相似。采用logistic回归和两步线性回归分析，发现Tvol、TGR与碘摄入量呈非线性相关，阈值摄入量为150 μ g/d。结论：儿童每日碘摄入量为150 μ g/d时Tvol开始升高，710岁儿童每日碘摄入量为250 μ g/d时TGR超过5%，1114岁儿童每日碘摄入量为300 μ g/d时TGR超过5%，提示710岁儿童每日碘摄入量为150249 μ g/d， 1114岁儿童每日碘摄入量为150299 μ g/d。
Objective: We assessed the adverse effects of high iodine intake from iodine-rich drinking water on thyroid size in children by examining associations between thyroid volume (Tvol), total goiter rate (TGR), and iodine intake.Design: In a multistage cross-sectional survey, we collected two 24-h urine samples on 2 nonconsecutive days and determined 24-h urinary iodine excretion, then calculated habitual daily iodine intake. Ultrasonographic Tvol was measured, and TGR was calculated based on international and Chinese reference ranges for Tvol in children.Results: This study included 2089 children from Shandong province, where the median (IQR) drinking water iodine concentration was 183 mu g/L (69406 mu g/L). The median (IQR) 24-h urinary iodine concentrations for the 2 collections were 381 mu g/L (203649 mu g/L) and 398 mu g/L (202687 mu g/L), respectively. The median (IQR) habitual daily iodine intake of children was 298 mu g/d (186437 mu g/d). Tvols were slightly higher in boys than in girls (P = 0.035). The overall TGR was 9.7% and did not differ by sex. The TGR was similar to 5% for children aged 710 and 1114 y at iodine intakes of 200249 and 250299 mu g/d, respectively. With the use of logistic regression and 2-step linear regression, a nonlinear association was observed between Tvol, TGR, and iodine intake, with a threshold intake of 150 mu g/d.Conclusions: Tvol begins to increase in children when iodine intake is =150 mu g/d, and the TGR exceeds 5% when daily iodine intake is =250 mu g/d for children aged 710 y and >= 300 mu g/d for children aged 1114 y. Our findings suggest that 150249 and 150299 mu g/d seem to be safe upper iodine intake ranges for children aged 710 and 1114 y, respectively.