血清硒水平与甲状腺功能关系的横断面研究

发布时间：2019-04-24 15:14

【摘要】：目的:了解山西地区人群硒营养状况及甲状腺功能异常的患病率,同时探究血清硒水平与甲状腺功能的关系,为硒在预防和治疗甲状腺疾病方面提供更多的理论依据。方法:本研究为横断面研究,选取山西地区1470例居民进行调查,所有参与者均测定血清硒含量及TSH、TPOAb、TGAb,TSH升高者加测FT4,TSH下降者加测FT4和FT3。比较并分析血清硒水平与各个指标的关系,不同血硒水平甲功异常的患病率,正常人群与不同类型甲功异常的人群血硒浓度的差异。数据分析采用SPSS20.0,正态分布数据多组间比较采用方差分析,非正态分布的数据用非参数统计分析,相关分析采用spearman秩相关,率的比较用c2检验,p0.05差异具有显著性。结果:1.山西地区调查居民血清硒中位数为79.38(58.85-128.05)μg/L;2.调查人群临床甲减患病率为1.77%,亚临床甲减患病率为14.08%,临床甲亢患病率为0.68%(n=10),亚临床甲亢患病率为0.48%(n=7),TPOAb阳性率为10.34%(n=152),TGAb阳性率为15.65%(n=230);3.男性血清硒水平为81.78μg/L,女性为76.22μg/L,差异不显著(p=0.078);随年龄的增加,硒水平呈下降趋势;4.血清硒水平与年龄(r=-0.083,p=0.001)、TSH(r=-0.057,p=0.030)呈负相关;TPOAb阳性时,血清硒与TPOAb滴度呈负相关(r=-0.257,p=0.002);5.除甲亢以外其他类型甲功异常组人群血清硒水平均低于甲功正常组,甲减组、TPOAb200IU/ml组血硒水平明显降低,差异具有统计学意义,其p值分别为0.008、0.007;6.随着血清硒水平升高,甲减、TPOAb、TGAb阳性的患病率呈下降趋势,硒水平为60μg/L和≥100μg/L时,甲减及TPOAb200IU/ml的患病率的差异具有显著性,其p值分别为0.004,0.049。结论:1.山西地区硒营养状况处于边缘硒充足水平;2.个体硒水平与性别无关,与年龄存在负相关,中、老年人血硒含量明显降低;3.低硒可能是TSH升高的不利因素,并且在甲减的发生、发展过程中起到一定作用;4.硒水平与甲状腺抗体滴度相关,尤其是与高水平TPOAb关系更为密切,低硒可能是诱发或加重甲状腺异常免疫的原因,而高硒可能对甲状腺组织具有一定的保护作用。
[Abstract]:Aim: to understand the nutritional status of selenium and the prevalence of thyroid dysfunction in Shanxi area, and to explore the relationship between serum selenium level and thyroid function in order to provide more theoretical basis for the prevention and treatment of thyroid diseases. Methods: this study was a cross-sectional study. 1470 residents in Shanxi province were selected for investigation. All the participants measured serum selenium content and FT4 and FT3. in patients with FT4,TSH decrease and TSH,TPOAb,TGAb,TSH elevation. To compare and analyze the relationship between serum selenium level and each index, the prevalence rate of abnormal thyroid function in different blood selenium level, and the difference of blood selenium concentration between normal population and different types of abnormal group. SPSS20.0, normal distribution data were compared with each other by variance analysis, non-normal distribution data were analyzed by non-parametric statistics, spearman rank correlation was used for correlation analysis, and c2 test was used for comparison of rates, there was significant difference between the two groups (p0.05). Results: 1. The median selenium in serum was 79.38 (58.85 / 128.05) 渭 g / L 路L ~ (- 2) 路kg ~ (- 1) 路h ~ (- 1). The prevalence rate of clinical hypothyroidism, subclinical hypothyroidism, clinical hyperthyroidism and subclinical hyperthyroidism was 1.77%, 14.08%, 0.68% and 0.48%, respectively. The positive rate of TGAb was 15.65% (n = 230). 3. The serum selenium level was 81.78 渭 g / L in males and 76.22 渭 g / L in females, and the difference was not significant (p < 0.078), but decreased with the increase of age. 4. The serum se levels in males and females were 81.78 渭 g / L and 76.22 渭 g / L, respectively. There was a negative correlation between serum se level and age (r = 0.083, p0.001), TSH (/ r = 0.057, p = 0.030), and a negative correlation between serum se level and titers of TPOAb (r = 0.257, p = 0.002) when TPOAb was positive (r = 0.257, p = 0.002), and a negative correlation was found between serum se level and TPOAb titers (r = 0.257, p < 0.05). Except for hyperthyroidism, the serum selenium level in the abnormal group was lower than that in the normal group, hypothyroidism group and TPOAb200IU/ml group, and the difference was statistically significant (p = 0.008, 0.007, respectively). With the increase of serum selenium level, hypothyroidism, TPOAb,TGAb positive prevalence rate showed a downward trend. When selenium level was 60 渭 g / L and 鈮，

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