Effect of iodine intake on thyroid diseases in China
Effect of iodine intake on thyroid diseases in China
复制标题
DOI：
10.1056/nejmoa054022
复制
发表时间：
2006-06-29
影响因子：
158.5
通讯作者：
Li, Chenyang
中科院分区：
文献类型：
--
作者：
Teng, Weiping;Shan, Zhongyan;Li, Chenyang
背景：碘是甲状腺激素的重要组成部分，摄入量不足或过高都可能导致甲状腺疾病。我们观察到，在中国三个不同碘摄入水平地区的队列中，随着碘摄入量的增加，显性甲状腺功能减退症、亚临床甲状腺功能减退症和自身免疫性甲状腺炎的患病率增加：轻度缺乏（尿碘排泄中位数，84 μ g/L）、超过充足（中位数，243 μ g/L）和过量（中位数，651 μ g/L）。参与者在1999年参加了一项基线研究，并在5年的随访至2004年，我们研究了碘摄入量的地区差异对甲状腺疾病发病率的影响。方法：在3761例基线入组的受试者中，有3018例（80.2%）参加了这项随访研究。结果：轻度碘缺乏、过量碘摄入和过量碘摄入者中，显性甲减的累积发生率分别为0.2%、0.5%和0.3%，亚临床甲减的累积发生率分别为0.2%、2.6%和2.9%;自身免疫性甲状腺炎分别为0.2%、1.0%和1.3%。在基线时甲状腺功能正常和抗甲状腺抗体阳性的受试者中，碘摄入过量或过量的受试者血清促甲状腺激素水平升高的5年发生率高于碘摄入轻度不足的受试者。基线血清促甲状腺激素水平为1.0至1.9 mIU/L与随后发生的甲状腺功能异常的最低发病率相关。结论：碘摄入量过多或过量可能导致甲状腺功能减退和自身免疫性甲状腺炎。
BACKGROUND:Iodine is an essential component of thyroid hormones; either low or high intake may lead to thyroid disease. We observed an increase in the prevalence of overt hypothyroidism, subclinical hypothyroidism, and autoimmune thyroiditis with increasing iodine intake in China in cohorts from three regions with different levels of iodine intake: mildly deficient (median urinary iodine excretion, 84 microg per liter), more than adequate (median, 243 microg per liter), and excessive (median, 651 microg per liter). Participants enrolled in a baseline study in 1999, and during the five-year follow-up through 2004, we examined the effect of regional differences in iodine intake on the incidence of thyroid disease.METHODS:Of the 3761 unselected subjects who were enrolled at baseline, 3018 (80.2 percent) participated in this follow-up study. Levels of thyroid hormones and thyroid autoantibodies in serum, and iodine in urine, were measured and B-mode ultrasonography of the thyroid was performed at baseline and follow-up.RESULTS:Among subjects with mildly deficient iodine intake, those with more than adequate intake, and those with excessive intake, the cumulative incidence of overt hypothyroidism was 0.2 percent, 0.5 percent, and 0.3 percent, respectively; that of subclinical hypothyroidism, 0.2 percent, 2.6 percent, and 2.9 percent, respectively; and that of autoimmune thyroiditis, 0.2 percent, 1.0 percent, and 1.3 percent, respectively. Among subjects with euthyroidism and antithyroid antibodies at baseline, the five-year incidence of elevated serum thyrotropin levels was greater among those with more than adequate or excessive iodine intake than among those with mildly deficient iodine intake. A baseline serum thyrotropin level of 1.0 to 1.9 mIU per liter was associated with the lowest subsequent incidence of abnormal thyroid function.CONCLUSIONS:More than adequate or excessive iodine intake may lead to hypothyroidism and autoimmune thyroiditis.