收稿日期: 2023-09-29
网络出版日期: 2024-04-19
基金资助
国家代谢性疾病临床医学研究中心免疫学教育部重点实验室开放课题(DKME202214)
The correlation between trace elements selenium and iodine and thyroid nodules in Guangzhou area
Received date: 2023-09-29
Online published: 2024-04-19
目的 探讨广州地区甲状腺结节患者硒和碘水平及其相关性。 方法 收集甲状腺结节患者（n = 150，结节组）及对照组（n = 76，无结节组）一般资料、甲状腺功能及自身抗体、血硒以及尿碘水平等；按超声特征将结节组以结节数量、直径、TI-RADS分类进行分组（单发、多发结节组；直径< 1 cm组及≥ 1 cm组；TR < 4组及 ≥ 4组），探讨各组间硒及碘的差异。 结果 （1）结节组在年龄、体质量指数、阳性家族史构成比、抑郁状态比例、FT3、TGAb及TPOAb水平等均高于无结节组（P < 0.05）；而硒及碘水平更低（P < 0.05）。（2）对比单发结节组，多发结节组的年龄更高（P < 0.05）；相较于TR< 4组，TR ≥ 4组年龄、硒及碘水平更低（P < 0.05）。（3）logistic回归分析结果显示更高的年龄段、超重肥胖、阳性家族史、抑郁状态、更低的硒水平与甲状腺结节正相关；年龄> 40岁与多发结节正相关；更低的硒水平与TI-RADS分类≥ 4正相关。 结论 广州地区甲状腺结节患者可能年龄更大、超重肥胖更突出、更多阳性家族史、抑郁状态更明显、硒及碘水平更低。结节患者中，多发结节者年龄更大；TI-RADS分类更高者硒水平更低。
谭秀琴 , 邓顺有 , 黄才茂 , 李恩众 , 陈小燕 . 微量元素硒和碘与广州地区甲状腺结节的相关性[J]. 实用医学杂志, 2024 , 40(8) : 1153 -1159 . DOI: 10.3969/j.issn.1006-5725.2024.08.023
Objective To investigate the serum selenium and urinary iodine level and their correlation with thyroid nodule in patients in Guangzhou. Methods The general information， thyroid function and autoantibodies， blood selenium， and urinary iodine level of patients from thyroid nodule group （n = 150） and control group （n = 76， without nodule） were collected. Based on ultrasonographic features， the thyroid nodule group was further divided into subgroups based on the number of nodules and TI-RADS classification （single nodule group vs. multiple nodule group； diameter < 1 cm group vs. diameter ≥ 1 cm group； TR < 4 group vs. TR ≥ 4 group）. The difference of selenium and iodine among different groups were investigated. Results （1）The thyroid nodule group had significantly advanced age， and higher BMI， incidence of family history of thyroid nodule， incidence of depression， and level of FT3， TGAb， and TPOAb （P < 0.05）， but lower selenium and iodine level （P < 0.05）. （2）Compared to the single nodule group， the multiple nodule group had a higher average age （P < 0.05）； compared to the TR < 4 group， the TR ≥ 4 group had younger age， and level of selenium and iodine （P < 0.05）. （3）Logistic regression analysis showed that older age， overweight and obesity， positive family history， depression and lower selenium level were positively correlated with thyroid nodule. Age > 40 years was positively associated with multiple nodules. Lower selenium level was positively associated with TI-RADS classification ≥ 4. Conclusion Patients with thyroid nodule in Guangzhou may have clinical characteristics of older age， more prominent overweight and obesity， higher incidence of family history of thyroid nodule， more obvious depression and lower selenium level. Patients with multiple nodules are older， and the higher TI-RADS classification； the lower selenium level.
Key words： thyroid nodule; selenium; iodine; clinical features
| 1 | GRANI G， SPONZIELLO M， PECCE V， et al. Contemporary Thyroid Nodule Evaluation and Management［J］. J Clin Endocrinol Metab， 2020， 105（9）： 2869-2883. doi:10.1210/clinem/dgaa322 |
| 2 | KJAERGAARD A D， MAROULI E， PAPADOPOULOU A， et al. Thyroid function， sex hormones and sexual function： a Mendelian randomization study［J］. Eur J Epidemiol， 2021， 36（3）： 335-344. doi:10.1007/s10654-021-00721-z |
| 3 | DROZD V， SAENKO V， BRANOVAN D I， et al. A Search for Causes of Rising Incidence of Differentiated Thyroid Cancer in Children and Adolescents after Chernobyl and Fukushima： Comparison of the Clinical Features and Their Relevance for Treatment and Prognosis［J］. Int J Environ Res Public Health， 2021， 18（7）： 3444. doi:10.3390/ijerph18073444 |
| 4 | ZHANG F， TENG D， TONG N， et al. Gender-Specific Associations Between Metabolic Disorders and Thyroid Nodules： A Cross-Sectional Population-Based Study from China［J］. Thyroid， 2022， 32（5）： 571-580. doi:10.1089/thy.2021.0686 |
| 5 | ZAICHICK V. The Differences of relationships between iodine and some chemical elements in normal thyroid and thyroid benign nodules revealed by short-term neutron activation： Relationships between iodine and chemical elements in normal and goitrous thyroid［J］. Int J Integr Med Res， 2023， 10（2）： 48-58. doi:10.57181/ijoimr/vol10i02/106 |
| 6 | WINTHER K H， RAYMAN M P， BONNEMA S J， et al. Selenium in thyroid disorders-essential knowledge for clinicians［J］.Nat Rev Endocrinol， 2020， 16（3）： 165-176. doi:10.1038/s41574-019-0311-6 |
| 7 | GASHU D， STOECKER B J， ADISH A， et al. Association of serum selenium with thyroxin in severely iodine-deficient young children from the Amhara region of Ethiopia［J］. Eur J Clin Nutr， 2016， 70（8）： 929-934. doi:10.1038/ejcn.2016.27 |
| 8 | LIU X， SUN J， FANG W， et al. Current Iodine Nutrition Status and Morbidity of Thyroid Nodules in Mainland China in the Past 20 Years［J］. Biol Trace Elem Res， 2021， 199（12）： 4387-4395. doi:10.1007/s12011-020-02565-2 |
| 9 | 赵新保， 罗艺， 李世梅， 等. ACR TI-RADS与ATA分类法评估甲状腺结节诊断价值的比较［J］. 实用医学杂志， 2018， 34（18）： 3118-3120，3129. doi:10.3969/j.issn.1006-5725.2018.18.032 |
| 10 | DUNSTAN D A， SCOTT N， TODD A K. Screening for anxiety and depression： reassessing the utility of the Zung scales［J］. BMC Psychiatry， 2017，17（1）：329. doi:10.1186/s12888-017-1489-6 |
| 11 | WHO/UNICEF/ICCIDD，Assessment of iodine deficiency disorders and monitor ing their elimination. A guide for programme managers［R］. Geneva： World Health Organization； 2007. |
| 12 | HU L， LI T， YIN X L， et al. An analysis of the correlation between thyroid nodules and metabolic syndrome［J］. Endocr Connect， 2020， 9（9）： 933-938. doi:10.1530/ec-20-0398 |
| 13 | LEE Y J， CHO Y J， HEO Y J， et al. Thyroid nodules in childhood-onset Hashimoto′s thyroiditis： Frequency， risk factors， follow-up course and genetic alterations of thyroid cancer［J］. Clin Endocrinol， 2021， 95（4）： 638-648. doi:10.1111/cen.14490 |
| 14 | 尹琳， 霍胜男， 于明安， 等. 甲状腺结节相关病理生理特征与焦虑和抑郁情绪的关系［J］. 中国心理卫生杂志， 2019， 33（9）： 690-694. doi:10.3969/j.issn.1000-6729.2019.09.010 |
| 15 | GORKHALI B， SHARMA S， AMATYA M， et al. Anxiety and Depression among Patients with Thyroid Function Disorders［J］.Nepal Health Res Counc， 2020，18（3）：373-378. doi:10.33314/jnhrc.v18i3.2499 |
| 16 | LIU C， ZHAO H， XIA Y， et al. Active surveillance of highly suspicious thyroid nodules cohort in China shows a worse psychological status in younger patients［J］. Front Oncol， 2022， 12：981495. doi:10.3389/fonc.2022.981495 |
| 17 | TURAN E， TURKSOY V A. Selenium， Zinc， and Copper Status in Euthyroid Nodular Goiter： A Cross-Sectional Study［J］. Int J Prev Med， 2021， 12： 46. |
| 18 | KRAVCHENKO V I， ANDRUSYSHYNA I M， LUZANCHUK I A， et al. Association Between Thyroid Hormone Status and Trace Elements in Serum of Patients with Nodular Goiter［J］. Biol Trace Elem Res， 2020， 196（2）： 393-399. doi:10.1007/s12011-019-01943-9 |
| 19 | BíLEK R， DVO?áKOVá M， GRIMMICHOVá T， et al. Iodine， Thyroglobulin and Thyroid Gland［J］. Physiol Res， 2020， 69（）： S225-S236. doi:10.33549/physiolres.934514 |
| 20 | LI Y， TENG D， BA J， et al. Efficacy and Safety of Long-Term Universal Salt Iodization on Thyroid Disorders： Epidemiological Evidence from 31 Provinces of Mainland China［J］. Thyroid， 2020， 30（4）： 568-579. doi:10.1089/thy.2019.0067 |
| 21 | BEHBAHANINIA M， NABAHATI M， MOAZEZI Z， et al. Diagnostic performance of ACR-TIRADS， Korean TIRADS， and American Thyroid Association guidelines for risk stratification of thyroid nodules： a prospective study［J］. J Ultrasound， 2022， 25（4）： 887-894. doi:10.1007/s40477-022-00669-0 |
| 22 | ELBALKA S S， METWALLY I H， SHETIWY M， et al. Prevalence and predictors of thyroid cancer among thyroid nodules： a retrospective cohort study of 1，000 patients［J］. Ann R Coll Surg Engl， 2021，103（9）：683-689. doi:10.1308/rcsann.2021.0057 |
| 23 | PELLEGRITI G， FRASCA F， REGALBUTO C， et al. Worldwide increasing incidence of thyroid cancer： update on epidemiology and risk factors［J］. J Cancer Epidemiol， 2013，2013：965212. doi:10.1155/2013/965212 |
/
| 〈 |
|
〉 |