乌鲁木齐社区血清维生素D水平与自身免疫性甲状腺疾病的关系及在维汉民族间的比较研究

发布时间：2018-06-17 23:10

  本文选题：维吾尔族 + 汉族　； 参考：《新疆医科大学》2015年硕士论文

【摘要】：目的本研究主要探讨维生素D缺乏和自身免疫性甲状腺疾病在维汉两民族之间的关系及差异研究。方法本研究一共纳入1655名于2013年5月在乌鲁木齐某社区行流行病学调查的本地居民,通过检测其血清25(OH)D、甲状腺相关抗体水平、尿碘等生化指标,统计分析维汉两民族间血清维生素D水平与自身免疫性甲状腺疾病之间的关系及差异,并用统计学中的相关与回归分析血清25(OH)D水平对甲状腺自身抗体的影响。结果①总人群自身免疫性甲状腺疾病相关抗体阳性率(TPOAb和TGAb)为32.63%(单纯TGAb抗体阳性率为6.4%),男性人群为21%、女性人群为37.5%。女性甲状腺相关抗体阳性率显著高于男性(χ2=43.81,P0.001),汉族人群抗体阳性率为29.8%、维吾尔族人群抗体阳性率为36.3%,维吾尔族抗体阳性率高于汉族(χ2=7.691,P=0.006)；②维生素D缺乏的患病率分别为男性63.29%、女性77.03%、维吾尔族76.5%、汉族54.6%,女性显著高于男性、维族显著高于汉族(P均0.001)；维生素D不足的患病率男性为30.95%、女性为15.37%、维族为9.27%、汉族为28.32%、无论民族差异男性均显著高于女性,无论性别差异汉族均显著高于维族(P均0.001)；维生素D充足率在男女之间无统计学差异,无论男女性别差异、汉族人群维生素D充足率均显著高于维族(P均0.001)；③无论民族差异,维生素D缺乏组与比维生素D不足组相比,自身免疫性甲状腺疾病患病率有降低的趋势,但差异无统计学意义；两组中汉族人群AITDs患病率分别为30.3%、27.5% (χ2=0.717,P=0.397),维族人群AITDs患病率分别为36.1%、34.8%(χ2=0.047,P=0.829)；无论民族差异,碘过量组与碘缺乏组相比,自身免疫性甲状腺疾病患病率有增高的趋势,但差异无统计学意义,碘缺乏组和碘过量组中,汉族人群AITDs患病率分别为33.9%、34.7% (χ2=0.023,P=0.497),维族人群AITDs患病率分别为35.6%、40.2% (χ2=0.607,P=0.436)；④Logistic回归模型分析中,调整了年龄,吸烟状态、BMI、腹围、甲状腺减退病程,是否合并甲状腺结节及尿碘水平等指标后,40-60岁的汉族女性血清维生素D水平与自身免疫性甲状腺疾病呈负相关(B=-0.052、P=0.009)。结论维生素D缺乏在乌鲁木齐地区普通成人中很常见,对于40-60岁的乌鲁木齐社区汉族女性,维生素D可以作为评价自身免疫性甲状腺病的一个风险指标,可能参与自身免疫性甲状腺疾病的发生发展。
[Abstract]:Objective to investigate the relationship and difference between vitamin D deficiency and autoimmune thyroid disease in the Uygur two ethnic groups. Methods a total of 1655 local residents who were investigated in a community of Urumqi in May 2013 were included in this study, and the serum level of serum 25 (OH) D, the level of thyroid related antibody, and urine iodine were detected. The relationship and difference between vitamin D level and autoimmune thyroid disease among the two nationalities of the Han Dynasty were statistically analyzed, and the effects of serum 25 (OH) D level on the thyroid autoantibodies were analyzed by statistical correlation and regression. Results (1) the positive rate of autoimmune thyroid disease related antibodies (TPOAb and TPOAb) TGAb) 32.63% (the positive rate of TGAb antibody was 6.4%), the male population was 21%, the positive rate of thyroid related antibody in female population was significantly higher than that of male (x 2=43.81, P0.001), the positive rate of antibody in the Han population was 29.8%, the positive rate of Uygur population was 36.3%, and the positive rate of Uygur antibody was higher than that of the Han nationality (x 2=7.691, P=0.006). (2) the prevalence of vitamin D deficiency was 63.29% for men, 77.03% in women, 76.5% in Uygur, 54.6% in Han, and significantly higher in women than in men. The prevalence of vitamin D was significantly higher than that of Han (P 0.001); the prevalence rate of vitamin D deficiency was 30.95%, women were 15.37%, Uygur was 9.27% and Han was 28.32%, no matter the ethnic differences were significantly higher than those of women. No matter the sex difference, the Han nationality was significantly higher than the Uygur (P 0.001), and the vitamin D adequacy ratio was not statistically significant between men and women. The vitamin D adequacy ratio of the Han population was significantly higher than that of the Uygur (all P 0.001). The prevalence of adenosine was reduced, but the difference was not statistically significant; the prevalence rate of AITDs in the two groups of Han population was 30.3%, 27.5% (x 2=0.717, P=0.397), and the prevalence rate of AITDs in the Uygur population was 36.1%, 34.8% (2=0.047, P=0.829), respectively. No matter the ethnic difference, the iodine excess group was compared with the iodine deficiency group and the autoimmune thyroid disease patients were compared. The incidence of disease was higher, but the difference was not statistically significant. The prevalence rate of AITDs in the iodine deficiency group and the iodine excess group was 33.9%, 34.7% (x 2=0.023, P=0.497), and the prevalence rate of AITDs in the Uygur population was 35.6%, 40.2% (2=0.607, P=0.436), respectively. (4) the Logistic regression model was used to adjust the age, smoking, BMI, abdominal circumference, and nail shape. The level of vitamin D in serum of 40-60 year old Han women was negatively correlated with autoimmune thyroid disease (B=-0.052, P=0.009). Conclusion vitamin D deficiency is common among ordinary adults in Urumqi area, and vitamin D deficiency is very common for Han women of 40-60 years old in the community of Han nationality. D can be used as a risk indicator for autoimmune thyroid disease and may be involved in the development of autoimmune thyroid diseases.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R581.9
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本文编号：2032863