【摘要】 目的 研究广西合浦县西场镇老年人群的碘、硒营养状态与甲状腺体积及结节的相关性。方法 对年龄≥65岁且在广西合浦县居住≥10年的100名老年人进行问卷调查、查体、甲状腺功能、抗体及超声检查、尿碘及血硒测定。使用简单线性回归模型及多元线性回归模型探讨甲状腺体积、结节与血硒、尿碘及各影响因素之间的关系。结果 调查人群中尿碘中位数是110.65(76.05～159.35)μg/L,尿碘平均为(139.25±19.97)μg/L;血硒中位数(经过对数转换):4.82(4.75～4.91)μg/L,血硒平均为(131.36±4.83)μg/L,碘和硒营养状态均适宜；女性甲状腺结节数量、体积及多发甲状腺结节均显著高于男性(P<0.001,P<0.01);血硒与年龄呈显著负相关(P=0.013);男性甲状腺体积显著大于女性(P=0.033),简单线性回归模型中发现甲状腺体积与体重指数及结节体积正相关(β=0.062 4,P=0.004及β=0.064 3,P<0.001),在多元线性回归模型中，甲状腺体积与结节体积正相关(β=0.061 3,P<0.001),与血硒(β=-0.225 6,P=0.460)、尿碘(β=-0.000 4,P=0.153)均无显著相关性；血硒、尿碘在无结节、单发结节、多发结节患者中的比较均未发现统计学差异(P>0.05)。结论 广西合浦地区老年人碘、硒营养适宜，低碘可能是甲状腺结节发生及多发结节的危险因素，血硒与甲状腺结节数量及体积均未发现关联。更多还原

【Abstract】 Objective To investigate the correlation between the nutritional status of iodine and selenium with the thyroid volume and nodules in the elderly population of Hepu county of Guangxi.Methods Questionnaire survey, physical examination, serum thyroid function and antibody test, thyroid ultrasound, urine iodine and serum selenium were conducted among 100 elderly people who aged≥65 years and living in Hepu county, Guangxi for more than 10 years.The univariate linear regression model and the multivariate linear regression model were used to explore the association between thyroid volume and nodules with serum selenium and urinary iodine, and various related factors.Results In the survey population, the median urinary iodine value was 110.65(76.05～159.35)μg/L,and the mean±standard deviation of urine iodine was(139.25±19.97)μg/L;the median serum selenium(after logarithmic conversion)was 4.82(4.75～4.91)μg/L,the mean±standard deviation of serum selenium was(131.36±4.83)μg/L,indicating the nutritional status of iodine and selenium was adequate; the number and size of thyroid nodules, both the prevalence of multiple thyroid nodules in women were significantly higher than those in men(P<0.001,<0.01);Serum selenium was inversely correlated with age(P=0.013);male thyroid volume was larger than female′s(P=0.033).In the univariate linear regression model, the thyroid volume were positively correlated with body mass index and nodule size(β=0.062 4,P=0.004 and β=0.064 3,P<0.001).Whereas in the multivariate linear regression model, thyroid volume was only related to nodule size(β=0.061 3,P<0.001),not related to serum selenium(β=-0.225 6,P=0.46) and urine iodine(β=-0.000 4,P=0.153);there was no significant difference in serum selenium and urinary iodine levels among patients without nodules, single nodules and multiple nodules(P>0.05).Conclusions Elderly people in Hepu area of Guangxi have adequate iodine and selenium nutrition status.Iodine deficiency may be a risk factor for the prevalence of thyroid nodules and multiple nodules.No associations are found between serum selenium, thyroid volume and nodules.更多还原