Relationship between thyroid volume and autoantibodies in patients with autoimmune thyroid disease / 中华地方病学杂志

Objective:To study the relationship between thyroid volume (TV) and thyroid autoantibodies in patients with autoimmune thyroid disease (AITD), and to explore the factors affecting goiter in patients with AITD.Methods:The newly diagnosed AITD adult patients in the Affiliated Hospital of Shanxi Institute for Endemic Disease Prevention and Control from November 2019 to October 2020 were selected for questionnaire survey, physical examination, thyroid function and thyroid autoantibody test, determination of serum iodine content and thyroid ultrasound, and the correlation between thyroid volume and thyroid autoantibody was analyzed.Results:A total of 147 newly diagnosed adult AITD patients were included, including 63 cases of Graves' disease (GD, 30 males and 33 females) and 84 cases of chronic lymphocytic thyroiditis (HT, 29 males and 55 females). The TV of male and female patients with GD was positively correlated with the levels of thyrotropin receptor antibody (TRAb) ( rmen = 0.515, rwomen = 0.412, P < 0.05). The TV of male and female patients with HT was not correlated with the levels of thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TGAb, rmen = - 0.137, 0.168, rwomen = 0.184, - 0.088, P > 0.05). There were no correlation between TPOAb levels and TGAb levels in male and female HT patients ( rmen = 0.153, rwomen = 0.102, P > 0.05). The TV of male and female patients with GD or HT was not correlated with the serum levels of iodine ( rmen = 0.230, 0.013, rwomen = 0.096, 0.069, P > 0.05). Conclusion:TRAb level is positively correlated with the TV in GD patients.

Relationship between iodine and hypothyroidism / 中华地方病学杂志

Objective:To explore the relationship between iodine and hypothyroidism.Methods:Patients with primary hypothyroidism (hypothyroidism group) and healthy people (control group) from Linfen City who first came to the Affiliated Hospital of Shanxi Institute for Endemic Disease Prevention and Treatment in 2017 and 2018 were selected as the research subjects. One random urine sample and fasting venous blood sample were collected from the research subjects. The levels of urinary iodine, blood iodine and serum total triiodothyronine (TT 3), total thyroxine (TT 4), free triiodothyronine (FT 3), free thyroxine (FT 4), thyroid stimulating hormone (TSH), anti-thyroglobulin antibody (TgAb) and anti-thyroid peroxidase antibody (TPOAb) were detected. According to the results of TSH level, hypothyroidism group was divided into hypothyroidism Ⅰ group (TSH≥10.00 mU/L) and hypothyroidism Ⅱ group (4.20 mU/L < TSH < 10.00 mU/L), and they were compared with control group (0.27 mU/L≤TSH≤4.20 mU/L). Results:A total of 97, 96 and 175 research subjects were included in hypothyroidism Ⅰ group, hypothyroidism Ⅱ group and control group, respectively. There was no significant difference in urinary iodine levels among the three groups ( H = 0.631, P > 0.05). The blood iodine levels [(40.70 ± 21.08), (58.59 ± 14.55), (59.50 ± 11.89) μg/L] in the three groups were significantly different ( F = 50.559, P < 0.01), and the blood iodine level in hypothyroidismⅠgroup was lower than that in hypothyroidism Ⅱ group and control group ( P < 0.01). The levels of TT 3 [median (interquartile range): 1.59 (0.99, 2.05), 2.25 (1.98, 2.59), 2.14 (1.89, 2.49) nmol/L], TT 4 [35.18 (16.06, 70.23), 105.68 (83.38, 133.19), 107.18 (89.92, 128.30) nmol/L], FT 3 [3.48 (1.94, 4.52), 5.01 (4.57, 5.50), 5.02 (4.64, 5.55) pmol/L] and FT 4 [7.14 (3.12, 10.76), 15.31 (13.87, 17.11), 16.69 (14.87, 18.20) pmol/L] in the three groups were significantly different ( H = 66.197, 142.461, 94.508, 166.557, P < 0.01). After further pairwise comparison, the levels of TT 3, TT 4, FT 3, and FT 4 in hypothyroidism Ⅰ group were significantly lower than those in hypothyroidism Ⅱ group and control group ( P < 0.01). The levels of TgAb and TPOAb in the three groups were significantly different ( H = 85.507, 101.726, P < 0.01). After further pairwise comparison, the levels of TgAb and TPOAb in hypothyroidismⅠgroup were significantly higher than those in hypothyroidism Ⅱ group and control group ( P < 0.01); and the levels of TgAb and TPOAb in hypothyroidism Ⅱ group were significantly higher than those in control group ( P < 0.01). The correlation analysis showed that urinary iodine was positively correlated with blood iodine ( r = 0.170, P < 0.05); blood iodine was positively correlated with TT 3, TT 4, FT 3, and FT 4 levels ( r s = 0.484, 0.594, 0.383, 0.509, P < 0.01), and it was negatively correlated with TSH level ( r s = - 0.373, P < 0.01). Conclusion:Hypothyroidism patients with TSH≥10.00 mU/L may have low blood iodine level.

Analysis of monitoring results of drinking-water type endemic arsenism in Shanxi Province from 2012 to 2017 / 中华地方病学杂志

Objective To evaluate the effect of water improvement projects on drinking-water-borne endemic arsenism in Shanxi Province,to work out and refine sustainable prevention and control strategies.Methods The operating situation of water-improvement projects was investigated and monitored,and the arsenic content in drinking water was determined in drinking-water-borne arseniasis areas,which including 14 monitored sites in 5 countries from 2012 to 2017.The condition of arsenic poisoning in the resident population of the monitored sites was investigated and the arsenic content in the urine of patients was determined.Results Totally 14 monitored sites were already finished water improvement,the rate of water-improvement was 100％.Totally 11 water-improvement projects were monitored,including 7 small-scale water-improvement projects and 4 large-scale water-improvement projects,which all qualified and operated normally from 2012 to 2015.In 2016,one water-improvement project was found with excessive level (＞ 0.01 mg/L) of arsenic in drinking water in Shanyin County,and the other 10 water-improvement projects' arsenic contents were qualified.In 2017,two unqualified large-scale water-improvement projects had water arsenic content over (＞ 0.01 mg/L) in Shanyin County and Ying County,respectively.And the other 9 water-improvement projects were qualified.The detection rates of arsenic poisoning from 2012 to 2017 were 1.36％ (104/7 641),1.57％ (123/7 832),1.61％ (123/7 621),1.53％ (120/7 857),1.28％ (102/7 963) and 1.56％ (124/7 958),respectively,and the differences were not statistically significant (x2 =4.979 9,P ＞0.05).Most patients with arsenic poisoning were mild to moderate patients,accounted for 82.61％ (575/696) and no new case was detected.Conclusions Arsenic poisoning in drinking-water-borne arseniasis areas in Shanxi Province has been controlled.Natural operation of water-improvement projects has kept water arsenic levels normal.Water arsenic content has exceeded the standard in some of the water-improvement projects.The key point of next stage is strengthen the management of water improvement projects in prevention and treatment of drinking-water type endemic arsenism.

Risk factors of thyroid nodules / 中华地方病学杂志

Objective To investigate the factors affecting the occurrence of thyroid nodules,and to offer scientific methods to prevent the occurrence of this disease.Methods A total of 220 subjects were involved in the study from January 2012 to December 2014 at the Affiliated Hospital of Shanxi Institute for Endemic Disease Prevention and Treatment.A case-control study was designed.The case group with thyroid nodules was confirmed by color Doppler ultrasonography and pathology.The control group,at the same time,was confirmed by ultrasound and thyroid function tests.Face to face questionnaire was used to collect the demographic data,family history of disease and thyroid function test results.The differences in general conditions,living habits,family history,and clinical test results were compared between the two groups.Finally,multivariate logistic regression model was used to analyze risk factors,which may affect the occurrence of thyroid nodules,odds ratio (OR) was calculated.Results This study collected 209 valid samples.The rate of valid samples was 95.00％ (209 / 220).The average age was (42.28 ± 11.86) years old,and the ratio of male to female was 1.0 ∶ 5.3 (33 ∶ 176).There were significant differences in age,sex,body mass index (BMI),the use of hair dye,total thyroid thyroxine (TT3),serum free thyroxine (FTg),and thyroid-stimulating hormone (TSH),anti-thyroid microsomal antibodies (TMAb) between the case group and the control group (P ＜ 0.05).Those variables,which were significant in single factor analysis such as age,gender,BMI,hair dye,TT3,FT4,TSH and TMAb,were put into the logistic model to adjust confounding.After that,the results suggested that the risk increased 9.7％ [OR:1.097,95％ confidence interval (CI):1.017-1.183] with increase in age by one year.Women were 3.214 times (OR:3.214,95％CI:1.025-5.923) more likely to have thyroid nodules.TSH increased by 1 level,the risk increased by 1.030 times (OR:2.030,95％CI:1.050-3.922).TMAb increased by 1％ on average,an increase in the risk of disease by up to 28.3％ (OR =1.283,95％CI:1.076-1.529).Conclusions Women are at higher risk of thyroid nodules than men.And older age,high levels of TSH and TMAb also increase the risk of thyroid nodules.

An analysis of the changes of serum lipid and liver enzyme content in patients with primary hypothyroidism before and after treatment / 中华地方病学杂志

Objective To observe the changes of serum lipid and liver enzyme after levothyroxine sodium treatment in patients with primary hypothyroidism.Methods Data from 104 patients with primary hypothyroidism together with increased serum lipid and liver enzyme were collected from August 2006 to November 2015.The date were compared of the changes of thyroid three triiodothyronine (T3),thyroxine (T4),free three triiodothyronine (FT3),free thyroxine thyroid (FT4),thyroid stimulating hormone (TSH),total cholesterol (TC),glycerol triester (TG),high density lipoprotein (HDL-C),low density lipoprotein (LDL-C),alanine aminotransferase (ALT),aspartate aminotransferase (AST) before the levothyroxine sodium treatment and after three month of the treatment.Results After three months of levothyroxine sodium treatment,thyroid function (T3,T4,FT3,FT4,TSH) gradually returned to normal levels [(2.02 ± 0.40) vs (0.96 ± 0.24) nmol/L,(95.76 ± 15.23) vs (24.31 ± 9.99) nmol/L,(4.79 ± 0.58) vs (1.96 ±0.57) pmol/L (15.15 ± 1.77) vs (4.70 ± 1.57) pmol/L,(3.05 ± 1.00) vs (82.41 ± 17.18) mU/L,t =-23.57,-44.13,-34.03,-46.48,48.07,P ＜ 0.01],TC,TG,LDL-C,ALT,AST apparently decreased [(4.30 ± 0.67) vs (7.54 ± 1.26) mmol/L,(2.05 ± 0.34) vs (2.14 ± 0.47) mmol/L,(2.35 ± 0.49) vs (4.28 ± 0.88) mmol/L,(23.31 ±3.92) vs (46.27 ± 0.98)U/L,(26.63 ± 4.64) vs (55.33 ± 11.99) U/L,t =33.68,4.24,24.87,29.36,33.83,P ＜0.01],the decrease was less obvious than before treatment in HDL-C [(1.62 ± 0.36) vs (1.63-± 0.38) mmol/L,t =1.49,P ＞ 0.05].Conclusion Levothyroxine sodium treatment in patients with hypothyroidism can effectively reduce blood lipid and liver enzyme content.

An analysis of the changes of serum lipid and liver enzyme content in patients with primary hypothyroidism before and after treatment / 中华地方病学杂志

Objective To observe the changes of serum lipid and liver enzyme after levothyroxine sodium treatment in patients with primary hypothyroidism.Methods Data from 104 patients with primary hypothyroidism together with increased serum lipid and liver enzyme were collected from August 2006 to November 2015.The date were compared of the changes of thyroid three triiodothyronine (T3),thyroxine (T4),free three triiodothyronine (FT3),free thyroxine thyroid (FT4),thyroid stimulating hormone (TSH),total cholesterol (TC),glycerol triester (TG),high density lipoprotein (HDL-C),low density lipoprotein (LDL-C),alanine aminotransferase (ALT),aspartate aminotransferase (AST) before the levothyroxine sodium treatment and after three month of the treatment.Results After three months of levothyroxine sodium treatment,thyroid function (T3,T4,FT3,FT4,TSH) gradually returned to normal levels [(2.02 ± 0.40) vs (0.96 ± 0.24) nmol/L,(95.76 ± 15.23) vs (24.31 ± 9.99) nmol/L,(4.79 ± 0.58) vs (1.96 ±0.57) pmol/L (15.15 ± 1.77) vs (4.70 ± 1.57) pmol/L,(3.05 ± 1.00) vs (82.41 ± 17.18) mU/L,t =-23.57,-44.13,-34.03,-46.48,48.07,P ＜ 0.01],TC,TG,LDL-C,ALT,AST apparently decreased [(4.30 ± 0.67) vs (7.54 ± 1.26) mmol/L,(2.05 ± 0.34) vs (2.14 ± 0.47) mmol/L,(2.35 ± 0.49) vs (4.28 ± 0.88) mmol/L,(23.31 ±3.92) vs (46.27 ± 0.98)U/L,(26.63 ± 4.64) vs (55.33 ± 11.99) U/L,t =33.68,4.24,24.87,29.36,33.83,P ＜0.01],the decrease was less obvious than before treatment in HDL-C [(1.62 ± 0.36) vs (1.63-± 0.38) mmol/L,t =1.49,P ＞ 0.05].Conclusion Levothyroxine sodium treatment in patients with hypothyroidism can effectively reduce blood lipid and liver enzyme content.