Five-year change in morphological and functional alterations of the thyroid gland: the Study of Health in Pomerania.
Five-year change in morphological and functional alterations of the thyroid gland: the Study of Health in Pomerania.
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DOI：
10.1089/thy.2011.0525
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发表时间：
2012-06
期刊：
影响因子：
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通讯作者：
H. Völzke;T. Ittermann;M. Albers;N. Friedrich;M. Nauck;H. Below;A. Kramer
中科院分区：
文献类型：
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作者：
H. Völzke;T. Ittermann;M. Albers;N. Friedrich;M. Nauck;H. Below;A. Kramer
背景虽然有关甲状腺流行病学的横断面数据很常见，但有关甲状腺疾病发生率和进展的纵向数据却很少。本研究的目的是分析5年的变化和发生率的甲状腺形态和功能的改变，在以前碘缺乏地区。方法：我们使用了基于波美拉尼亚人群健康研究的2941名参与者（20-79岁）的5年随访数据。超声测量甲状腺结构和大小。评价甲状腺功能和血清甲状腺过氧化物酶自身抗体（抗TPO-Ab）。结果随访期间，碘/肌酐比值中位数从134.2 μg/g略微下降至130.4 μg/g。平均甲状腺体积无显著性增加0.73 mL [置信区间（CI）-1.68-3.41 mL]。甲状腺肿的发病率为34.0 [CI 30.7-37.7]/1000人年（py），结节的发病率为16.6 [CI 14.5-19.1]/1000 py。中位血清促甲状腺激素水平轻微升高（0.10 [CI -0.10-0.34 mIU/L]）。抗TPO抗体阳性的发生率为3.4 [CI 2.6-4.7]/1000 py。对于所有甲状腺参数，回归率均高于发生率。结论：在这个以前缺碘的地区，碘强化生效后，甲状腺肿和结节的发生和消退之间存在负净平衡。沿着甲状腺功能亢进和甲状腺功能减退的发病率平衡，以及自身免疫相关结果的发生率低，这些结果表明，目前的碘营养状况足以预防研究区域成年人群中碘缺乏相关疾病。
BACKGROUND While cross-sectional data on thyroid epidemiology are common, few longitudinal data on the incidence and progression of thyroid disorders exist. The aim of this study was to analyze the 5-year change and the incidence of morphological and functional alterations of the thyroid gland in a previously iodine-deficient area. METHODS We used 5-year follow-up data based on 2941 participants (20-79 years) of the population-based Study of Health in Pomerania. The thyroid structure and size were measured by ultrasonography. Thyroid function and serum autoantibodies to thyroperoxidase (anti-TPO-Ab) were evaluated. RESULTS During follow-up, the median iodine/creatinine ratio decreased slightly from 134.2 to 130.4 μg/g. The mean thyroid volume was nonsignificantly increased by 0.73 mL [confidence interval (CI) -1.68-3.41 mL]. The incidence rate of goiter was 34.0 [CI 30.7-37.7] per 1000 person-years (py), the incident rate of nodules was 16.6 [CI 14.5-19.1] per 1000 py. Median serum thyrotropin levels increased slightly (0.10 [CI -0.10-0.34 mIU/L]). The incidence of positive anti-TPO-Ab was 3.4 [CI 2.6-4.7] per 1000 py. For all thyroid parameters, the regression rates were higher than the incidence rates. CONCLUSIONS After iodine fortification became effective in this previously iodine-deficient region, there is a negative net balance between occurring and reverting goiter and nodules. Along with balanced incidences of hyper- and hypothyroid dysfunction and the low incidence of autoimmune-related findings, these findings indicate that the current iodine status is sufficient to prevent iodine deficiency-related disorders in the adult population of the study region.