Prevalence and influencing factors of thyroid nodules among students aged 8 - 17 years in Jintan District, Changzhou City, Jiangsu Province, 2018 / 中华地方病学杂志

ABSTRACT

Objective:To investigate the prevalence of thyroid nodules among students aged 8 - 17 years in Jintan District, Changzhou City, Jiangsu Province, and to explore the risk factors of thyroid nodules among underage students.Methods:In September 2018, two primary and middle schools, one ordinary high school and one vocational high school in Jintan District were selected as the survey sites. Students aged 8 - 17 years were selected as the survey subjects, and questionnaire survey, physical examination and thyroid ultrasound examination were conducted. At the same time, drinking water samples from schools and towns were collected to test water iodine, and urine samples from students and family salt samples were collected to test urinary iodine and salt iodine. Multivariate logistic regression was used to analyze related factors that may affect the occurrence of thyroid nodules.Results:A total of 725 students were surveyed, including 359 (49.5%) boys and 366 (50.5%) girls. Two water samples were collected from each of the four schools, and the mean values of water iodine were 0.3, 8.5, 0.2 and 0.2 μg/L, respectively; two water samples were collected from each of the towns where the four schools were located, and the mean values of water iodine were 6.8, 8.1, 4.8 and 3.7 μg/L, respectively. A total of 725 urine samples were collected, and the median urinary iodine was 209.92 μg/L, ranging from 8.60 to 932.00 μg/L. A total of 725 edible salt samples were collected from students' families, and the salt iodine content was (23.75 ± 7.10) mg/kg, ranging from 0.00 to 60.30 mg/kg, and 95.0% (689/725) of students' families ate iodized salt. A total of 725 students were examined for thyroid gland, and 22 were diagnosed with goiter, with an enlargement rate of 3.0%; and 155 were diagnosed with thyroid nodules, with a detection rate of 21.4%. The detection rates of thyroid nodules in boys and girls were 20.9% (75/359) and 21.9% (80/366), respectively; the detection rates of thyroid nodules in students who participated and did not participate in extracurricular tuition/interest classes in the past month were 28.2% (71/252) and 17.8% (84/473), respectively. The results of multivariate logistic regression analysis showed that girls and participating in extracurricular tuition/interest classes in the past month were independent risk factors for the occurrence of thyroid nodules [odds ratio ( OR) = 2.057, 2.538, 95% confidence interval ( CI) 1.226 - 3.451, 1.532 - 4.204, P < 0.05). Conclusions:The detection rate of thyroid nodules in students aged 8 - 17 years in Jintan District is at a high level. Girls and participating in extracurricular tuition/interest classes in the past month are independent risk factors for the occurrence of thyroid nodules.