Increased Prevalence of Thyroid Nodules Across Nearly 10 Years in Shanghai, China.

OBJECTIVE: This study aimed to determine whether the prevalence of thyroid nodules (TNs) increased due to modern lifestyles or other factors, despite the advances in screening and diagnostic tools. METHODS: This study included 3474 pairs of participants, who were matched by gender and age (±3 years) from two cross-sectional sampling surveys: (1) the program on the iodine nutritional status and related health status of residents in Shanghai in 2009; (2) the thyroid disease screening program for adults in Shanghai between 2017 and 2018. The prevalence of TNs and thyroid diseases in 2009 and 2017-2018 were compared, and the potential risk factors of TNs were detected. RESULTS: The prevalence of TNs in 2009 was 28.9%: 22.5% in males and 34.5% in females. In 2017, this increased to 43.8%: 37.9% in males and 49.1% in females. The prevalence of TNs significantly increased from 2009 to 2017 (odds ratio, 1.486; 95% confidence interval, 1.238-1.786). In addition, female gender, thyroid disease history, and age were the main risk factors for TNs after adjusting for confounders in the logistic regression across the time period. CONCLUSION: The prevalence of TNs significantly increased across nearly 10 years in Shanghai.

Prevalence of Thyroid Nodules and Its Relationship with Iodine Status in Shanghai: a Population-based Study.

OBJECTIVE: This study was designed to evaluate the prevalence of thyroid nodules (TNs) and its relationship with urine iodine concentrations (UICs) after the regional rapid economic growth and lifestyle changes. METHODS: A cross-sectional survey was conducted in the general population aged 15-69 years. A questionnaire regarding general and personal characteristics and relevant information was administered. Ultrasonography of the thyroid was performed, and serum triiodothyronine (T3), tetraiodothyronine (T4), serum thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free tetraiodothyronine (FT4), thyroglobulin antibody (TgAb), thyroid peroxidase antibody (TPOAb), and TSH receptor antibody (TRAb) levels were measured for each individual subject. RESULTS: The prevalence rates of TNs in the whole population, females and males were 27.76%, 34.04%, and 21.60%, respectively. The prevalence of multiple nodules increased with age, whereas the prevalence peaks differed between males and females. The median UICs in the whole population and females with non-TNs were higher than those of subjects with TNs (P=0.0035, P=0.0068). The median UICs in subjects with a single TN were higher than those in subjects with multiple TNs (P=0.0164, P=0.0127). The result showed a U-shaped curve relationship between UIC and prevalence of TNs. The prevalence of TNs was the lowest when the UIC was 140-400 µg/L. CONCLUSION: The prevalence of TNs was nearly 30% and increased with age. The relationship between UIC and prevalence of TNs is U-shaped, with an increase in risk when the UIC was <140 µg/L and >400 µg/L. Very low or high UIC levels need attention and correction.

Prevalence of hypertension in overweight and obese children from a large school-based population in Shanghai, China.

BACKGROUND: The ongoing rise in the prevalence of hypertension in children and adolescents is considered to be accompanied with the epidemic of childhood overweight and obesity. In this study, we established a large scale cross-sectional study in Shanghai, China, which presented a new evidence for the correlation of hypertension prevalence with overweight and obesity stages in Chinese children and adolescents. METHODS: A school-based cross-sectional study was conducted during February to December 2009 in Shanghai, China, including total 78,114 children and adolescents. Body weight, height, waist circumference (WC) and blood pressure (BP) were measured. Overweight and obesity were defined according to sex- and age- specific Chinese reference data. RESULTS: Both SBP and DBP were very significantly increased in overweight (OW) and obese (OB) groups. With age and sex controlled, BMI and WC were independently positively correlated with SBP and DBP. The prevalence of high SBP, DBP and hypertension were markedly higher among OW and OB children than normal weight (NW) group. Odds ratios (ORs) for high SBP, high DBP and high BP were significantly greater in OW and OB children than NW group, and showed a trend increase correlating with obesity stages (all P <0.0001). According to the increasing OR with different combination of obese status of BMI and WC, WC has a stronger influence on hypertension. The combination of BMI and WC obese shows substantially higher ORs compared with those for either BMI or WC obese alone. CONCLUSIONS: In this study on a large school-based population in Shanghai, China, BMI and WC are positively correlated with SBP and DBP. Being overweight or obese greatly increased the risk of hypertension in Chinese children and adolescents, in which WC is considered as a more sensitive indicator than BMI.