目的 :对不同碘水平下人群的血糖水平进行调查,初步探讨高水碘摄入对空腹血糖水平的影响。方法:选择河北省沧州市海兴县为调查地区,收集成人空腹晨尿及静脉血,采用砷-铈催化分光光度法测定其尿碘,采用化学发光免疫法测定血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、灵敏促甲状腺激素(sTSH)水平,空腹状态下用血糖仪测定末梢指血的血糖。结果:高碘地区的水碘、尿碘显著高于非高碘地区(P<0.05),高碘地区水碘尿碘分别为841.4 μg/L、1 137.3(646.8~1 450.8)μg/L,非高碘地区为12.79 μg/L、216.6(146.5~366.9)μg/L。FT3水平分别为(4.72±0.48)pmol/L、(4.96±0.36)pmol/L,高碘地区较低(P=0.021);FT4水平分别为(14.13±1.42)pmol/L、(14.71±1.06)pmol/L,两地无差异;sTSH水平高碘地区显著高于非高碘地区(P=0.001),分别为(3.07±2.17)μIU/mL、(2.30±1.07)μIU/mL。非高碘地区甲状腺疾病患病率10.13%(8人),高碘地区甲状腺疾病患病率 22.75% (43人),高碘地区甲状腺疾病患病率显著高于非高碘地区(χ2 = 5.763,P = 0.016)。高碘地区和非高碘地区的空腹血糖水平分别为(5.7±0.4)mmol/L、(5.8±0.5)mmol/L,两地无差异。经相关性分析发现年龄、FT4与空腹血糖水平呈正相关(r=0.258,P<0.001;r=0.154,P=0.013);其他指标与空腹血糖之间没有相关性。结论:两个地区的成人空腹血糖水平无明显差异,高水碘摄入对空腹血糖水平的影响仍需在大样本流行病学调查的基础上进一步研究。
Objective:To investigate the blood glucose level in different iodine status, then explore the impact of excess-iodine-intake on fasting blood-glucose. Methods:Adults were chosen from Haixing County in Cangzhou, Hebei. Llimosis morning-urinary and venous blood were collected to measure the levels of urinary iodine. Chemilu-minescent immunoassay was used to perform free triiodothyronine (FT3), free thyroxine (FT4), and sensitive thyroid-stimulating hormone (sTSH) in serum. Fasting blood-glucose was also measured by glucometer. Results:The median of water iodine in the excess-iodine-intake area (841.4 μg/L) was higher than that in the control area (12.79 μg/L, P<0.05). For adults’ urine iodine, the excess-iodine-intake area was higher(P<0.05), with the value of 1 137.3(646.8~1 450.8)μg/L vs 216.6(146.5~366.9)μg/L. The level of FT3 in the excess-iodine-intake area was lower (P<0.05), with the value of (4.72±0.48) pmol/L vs (4.96±0.36)pmol/L. No significant difference was found in the FT4 level in the areas. The median of sTSH in the excess-iodine-intake area was higher than that in the control area, with the value of(3.07±2.17)μIU/ mL vs (2.30±1.07) μIU/mL . And the prevalence of thyroid disease in the excess-iodine-intake area was higher, with 43(22.75%) vs 8(10.13%). No significant difference in the level of the fasting blood-glucose was found in the areas (P>0.05). Age and FT4 were found positively correlated with fasting blood-glucose by correlation analysis(r=0.258,P<0.001; r=0.154,P=0.013), while the others were not related. Conclusion:Difference in fasting blood-glucose in water-iodine-excess area and the control area does not exist. Yet further study should be taken in a larger population-based epidemiological investigation to confirm the effects of excess-iodine-intake on glucose.
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基金项目 国家自然科学基金资助项目 (81330064, 30972465) 作者简介 张攀(1989-),女,硕士在读,研究方向:微量元素营养与人体健康;通信作者:张万起, E-mail: wqzhang@tijmu.edu.cn。