机构：[1]Department of Endocrinology and Metabolism and the institute of Endocrinology, The First Hospital of China Medical University, Shenyang, Liaoning, P.R. China, 110001[2]Department of Endocrinology, Chinese PLA General Hospital, Beijing, P.R. China, 100853[3]Department of Endocrinology, Southwest Hospital, Third Military Medical University, Chongqing, P.R. China, 400038[4]Department of Endocrinology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, P.R. China, 116011大连医科大学附属第一医院[5]Department of Endocrinology, Cardiovascular and Cerebrovascular Disease Hospital of Ningxia Medical University, Yinchuan, Ningxia, P.R. China, 750004[6]Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, P.R. China, 330006[7]Department of Endocrinology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, P.R. China, 150001[8]Department of Endocrinology, Hohhot First Hospital, Hohhot, Inner Mongolia, P.R. China, 010000[9]Department of Endocrinology and Metabolism, The Second Xiangya Hospital, Central South University, Changsha, Hunan, P.R. China, 410011[10]Research center of Endocrine and Metabolic Diseases, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, P.R. China, 210028[11]Department of Endocrinology and Metabolism, Fujian Institute of Endocrinology, Fujian Medical University Union Hospital, Fuzhou, Fujian, P.R. China, 350001[12]Division of Endocrinology, Department of Internal Medicine, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, P.R. China, 450052[13]Department of Endocrine, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, P.R. China, 530021[14]Department of Endocrinology, Hainan General Hospital, Haikou, Hainan, P.R. China, 570311[15]Department of Endocrinology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shannxi, P.R. China, 710061[16]Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, P.R. China, 430022华中科技大学同济医学院附属协和医院[17]Department of Endocrinology, the First Hospital of Lanzhou University, Lanzhou, Gansu, P.R. China, 730000[18]Department of Endocrinology and Metabolism, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China, 610041四川大学华西医院[19]Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, Jilin, P.R. China, 130021[20]Department of Endocrinology, Shanghai University of Medicine & Health Science Affiliated Zhoupu Hosipital, Shanghai, P.R. China, 201318[21]Department of Endocrinology, The First Hospital of An Hui Medical University, Hefei, Anhui, P.R. China, 230000[22]Department of Endocrinology, The First People's Hospital of Yunnan Province, Kunming, Yunnan, P.R. China, 650032内科片内分泌科云南省第一人民医院[23]Department of Endocrinology and Metabolism, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, P.R. China, 510120中山大学附属第二医院[24]Department of Endocrinology, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, P.R. China, 030001[25]Department of Endocrinology and Metabolism, People's Hospital of Tibet Autonomous Region, Lhasa, Tibet, P.R. China, 850000[26]Department of Endocrinology, Qinghai Provincial People's Hospital, Xining, Qinghai, P.R. China, 810000[27]Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, P.R. China, 310051[28]Department of Endocrinology and Metabolism, Affiliated Hospital of Guiyang Medical University, Guiyang, Guizhou, P.R. China, 550004[29]Department of Endocrinology, Second hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R. China, 050000[30]Department of Endocrinology, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, P.R. China, 830054[31]Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, P.R. China, 300052.
Subclinical hypothyroidism (SCH) is diagnosed based on serum thyroid-stimulating hormone (TSH) reference intervals, which in turn are affected by many factors.
Data were acquired from a Chinese nationally representative cross- sectional study of 78,470 participants (TIDE study). The total study population were participants from the TIDE program, and the reference population was a subset of the total population defined by the National Academy of Clinical Biochemistry (NACB) guidelines. Serum concentrations of thyroid hormones, TSH, thyroid antibodies, and urine iodine concentration (UIC) were measured.
The geometric mean serum TSH (2.5th-97.5th) for the reference population (defined by the NACB) and total population were 2.28 mIU/L (0.74-7.04 mIU/L) and 2.34 mIU/L (0.61-8.33 mIU/L), respectively. In the reference population, increase in UIC was significantly associated with increase in the 50th and 97.5th centiles and decrease in the 2.5th centile of TSH. The median TSH was significantly higher in women than in men (2.41 mIU/L vs. 2.16 mIU/L, P-value<0.001). Increased age was significantly associated with an increased TSH 97.5th centile. For each 10-year increase in the population age, the TSH 97.5th centile increased by 0.534 mIU/L. The prevalence of SCH diagnosed according to the kit-recommended interval (Roche 0.27-4.2 mIU/L) and NACB standard interval in the TIDE study (0.74-7.04 mIU/L) differed significantly (Roche 13.61% vs. TIDE 3.00%, P<0.05). However, there was no significant difference in future CVD risk (cardiovascular disease, reflected by the Framingham risk score) between the 0.27-4.2 mIU/L and 4.2-7.04 mIU/L thyrotropin groups.
Serum TSH concentration significantly increased with increase in iodine intake. Thus, iodine intake must be considered in establishing TSH reference intervals. To avoid overdiagnosis and overtreatment of SCH, different areas should use individual serum TSH reference intervals.
基金：
This study was funded by the Research Fund for Public Welfare, National Health and Family Planning Commission of China (Grant No. 201402005), and the Clinical Research Fund of the Chinese Medical Association (Grant No. 15010010589).
第一作者机构：[1]Department of Endocrinology and Metabolism and the institute of Endocrinology, The First Hospital of China Medical University, Shenyang, Liaoning, P.R. China, 110001
共同第一作者：
通讯作者：
通讯机构：[1]Department of Endocrinology and Metabolism and the institute of Endocrinology, The First Hospital of China Medical University, Shenyang, Liaoning, P.R. China, 110001[*1]The institute of Endocrinology, The First Hospital of China Medical University, No. 155, Nanjing Bei street, Shenyang, P.R. China, 110001.[*2]Department of Endocrinology and Metabolism, The First Hospital of China Medical University, No. 155, Nanjing Bei street, Shenyang, P.R. China, 110001.
推荐引用方式(GB/T 7714)：
Lei Zhao,Di Teng,Xiaoguang Shi,et al.The effect of increased iodine intake on serum thyrotropin: A cross-sectional, Chinese nationwide study.[J].THYROID.2020,30(12):1810-1819.doi:10.1089/thy.2019.0842.
APA：
Lei Zhao,Di Teng,Xiaoguang Shi,Yongze Li,Jianming Ba...&Weiping Teng.(2020).The effect of increased iodine intake on serum thyrotropin: A cross-sectional, Chinese nationwide study..THYROID,30,(12)
MLA：
Lei Zhao,et al."The effect of increased iodine intake on serum thyrotropin: A cross-sectional, Chinese nationwide study.".THYROID 30..12(2020):1810-1819
医学