贵州医科大学学报

2016, v.41;No.189(06) 692-695

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维生素D营养状况对自身免疫性甲状腺疾病的影响
The Influence of Vitamin D3 Nutrition Status on The Autoimmune Thyroid Diseases

秦翠;张巧;时立新;彭所春;
QIN Cui;ZHANG Qiao;SHI Lixin;PENG Nianchun;Department of Internal Medicine,Guizhou Medical University;Department of Endocrinology and Metabolism,Affiliated Hospital of Guizhou Medical University;

摘要(Abstract):

目的:探讨碘超足量地区居民维生素D(vit D)营养状况对自身免疫性甲状腺疾病(AITD)的影响。方法:1 492例20~79岁贵阳地区社区居民(男性636名,女性876名),测定其空腹血清促甲状腺激素水平(TSH)、甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)、25羟维生素D[25(OH)D]水平、甲状旁腺激素全段(i PTH)、血钙及血磷水平和尿碘含量,分析上述各指标、体重指数(BMI)、甲状腺疾病患病率的性别差异,不同25(OH)D营养状况人群AITD患病率及影响AITD患病的因素与各指标的相关性。结果:女性血磷,血清TSH、TGAb及TPOAb水平高于男性,血清i PTH、尿碘水平及BMI低于男性(P<0.05);女性的TGAb及TPOAb阳性率高于男性,(P<0.05);且女性较男性更易患甲状腺功能减退症、甲状腺功能亢进及AITD等甲状腺疾病(P<0.05);Vit D缺乏及不足组的TPOAb、TGAb的水平及AITD患病率均高于vit D正常组,但仅TGAb水平及阳性率差异有统计学意义(P<0.05);女性(OR=2.596,P=0.000)、尿碘水平(OR=0.837,P=0.010)对受试者的AITD患病率有明显影响;尿碘中位数与TPOAb(r=-0.089)、TGAb(r=-0.056)呈负相关(P<0.05)。结论:维生素D营养状况不良人群及女性患者可能具有较高AITD患病率。
Objective: To investigate the influence of vitamin D levels on autoimmune thyroid diseases( AITD) in residents living in regions where the iodine was more than adequate. Method: The data was based on the research of the Guiyang metabolic epidemiological investigation in 2009. 1512 subjects( 636 males and 876 females) ranging from 20 years old to 79 years old were included in this study,all of them were tested serum thyroid hormones( TSH),thyroid peroxidase autoantibodies( TPOAb),thyroglobulin antibody( TGAb),serum 25( OH) D,parathyroid hormone( i PTH),urine iodine,blood glucose,blood lipid. Analyzing the relationship between 25( OH) D nutrition condition and AITD. Result: Blood phosphorus,serum TSH,TGAb and TPOAb of women were higher than men,serum i PTH,urinary iodine level and BMI were lower than men( P < 0. 05); TGAb and TPOAb positive rates of female were higher than male( P < 0. 05); women were more likely to suffer from thyroid diseases such as hypothyroidism,hyperthyroidism and AITD( P < 0. 05); The levels of TPOAb,TGAb and AITD prevalence in Vit D deficiency group were higher than those in normal Vit D group while only TGAb levels and positive rate between the two groups were statistically different( P <0. 05); female( OR = 2. 596,P = 0. 000),urinary iodine level( OR = 0. 837,P = 0. 010) obviously influenced AITD prevalence rate; the median urinary iodine was negatively correlated with TPOAb( r=- 0. 089),TGAb( r =- 0. 056,P < 0. 05). Conclusion: AITD is more likely to appear in people who is female and those vitamin D condition is abnormal.

关键词(KeyWords): 25羟维生素D;甲状腺疾病,自身,免疫性;甲状腺过氧化物酶抗体;甲状腺球蛋白抗体
25 hydroxy vitamin D;thyroid disease;autoimmune;thyroid peroxidase antibody;thyroid globulin antibody

Abstract:

Keywords:

基金项目(Foundation): 贵州省优秀科技教育人才省长专项基金[2010(82)];; 贵州省科技厅社会发展项目[2011(016)]

作者(Author): 秦翠;张巧;时立新;彭所春;
QIN Cui;ZHANG Qiao;SHI Lixin;PENG Nianchun;Department of Internal Medicine,Guizhou Medical University;Department of Endocrinology and Metabolism,Affiliated Hospital of Guizhou Medical University;

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DOI: 10.19367/j.cnki.1000-2707.2016.06.016

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