Influencing factors of thyroid volume in children aged 6-12 years in Gansu Province and comparison of different thyroid volume correction methods
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摘要:
目的 分析甘肃省6~12岁儿童甲状腺容积的影响因素，探讨适宜的甲状腺容积校正方法。 方法 根据甘肃省2019年碘缺乏病监测结果，选择碘营养适宜的武威市凉州区和平凉市崆峒区作为调查点。采用多阶段分层抽样方法抽取非寄宿制6~12岁儿童(地区、性别比例均衡)，测量儿童的身高、体重、甲状腺容积、尿碘和所在家庭食用盐盐碘。分析儿童甲状腺容积影响因素，比较体质容积指数(body mass volume index, BMIV)、体表面积容积指数(body surface area volume index, BSAV)、体重身高容积指数(weight height volume index, WHVI)、身高容积指数1(height volume index1, HVI1)和身高容积指数2(height volume index2, HVI2)对甲状腺容积校正的效果。 结果 不同性别儿童甲状腺容积差异无统计学意义(Z=-0.837, P=0.403)。Spearman秩相关分析显示身高、体重、BMI、体表面积(body surface area, BSA)、年龄、尿碘与甲状腺容积均呈正相关(均P＜0.001)。其中，BSA与甲状腺容积相关性最强(r=0.787)。分位数回归分析显示年龄和BSA对甲状腺容积整体分布均有影响。通过身高、体重与校正后甲状腺容积的Spearman秩相关分析显示BSAV可最大程度减小身高、体重对甲状腺容积的影响。 结论 年龄和BSA均影响甲状腺容积。BSAV对儿童甲状腺容积校正效果较好，建议将其作为儿童甲状腺容积的评价指标。 Abstract:Objective To analyze the influencing factors of thyroid volume at children aged 6-12 years in Gansu Province, and to explore the appropriate correction method of thyroid volume. Methods Based on the results of the 2019 iodine deficiency disease monitoring in Gansu Province, Liangzhou District of Wuwei City and Kongtong District of Pingliang City, where iodine nutrition is appropriate, were selected as survey sites. A multi-stage stratified sampling method was used to extract non-residential children aged 6-12 years (with balanced regional and gender ratio). The height, weight, thyroid volume, urinary iodine and salt iodine in their families were measured. The influencing factors of thyroid volume in children were analyzed. The thyroid volume correction effects of body mass volume index (BMIV), body surface area volume index (BSAV), weight height volume index (WHVI), height volume index (WHVI), height volume index1 (HVI1) and height volume index2 (HVI2) were compared. Results Thyroid volume was not statistically significant when children of different genders (Z=-0.837, P=0.403). Spearman rank correlation analysis showed that height, body weight, BMI, body surface area (BSA), age, urinary iodine were positively correlated with thyroid volume (P < 0.001). Among them, BSA had the strongest correlation with thyroid volume (r=0.787). Quantile regression analysis showed that age and BSA had significant effects on the overall distribution of thyroid volume. Spearman rank correlation analysis of height, weight and corrected thyroid volume showed that BSAV could eliminate the influence of height and weight on thyroid volume to the greatest extent. Conclusions Age and BSA significantly affected thyroid volume. BSAV has a good correction effect on children′s thyroid volume, and it is recommended to be used as an evaluation index of children′s thyroid volume. -
Key words:
- Children /
- Thyroid volume /
- Influencing factors /
- Correction methods
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表 1 各调查点基本情况
Table 1. Basic information of each survey point
地区 District 例数 Number of case MUIC /(μg·L-1) 碘盐覆盖率 Iodised salt coverage rate/% 合格碘盐食用率 Qualified iodised salt consumption rate/% 武威市 Wuwei City 城市 Urban 408 278.6 100.0 77.0 农村 Rural 429 251.2 99.5 73.2 平凉市 Pingliang City 城市 Urban 412 237.4 99.0 86.4 农村 Rural 417 240.0 100.0 95.0 合计 Total 1 666 252.5 99.6 82.8 注：MUIC，尿碘中位数。
Note: MUIC, median urinary iodine concentration.
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表 2 6~12岁儿童甲状腺容积检查结果
Table 2. Results of thyroid volume examination in children aged 6-12 years old
年龄/岁 Age/years 男生 Boys 女生 Girls 合计 Total 例数 Number of case M(P25, P75) /mL 例数 Number of case M(P25, P75) /mL 例数 Number of case M(P25, P75) /mL 6 117 1.9(1.7, 2.5) 115 1.9(1.5, 2.4) 232 1.9(1.6, 2.4) 7 126 2.1(1.7, 2.6) 122 2.1(1.9, 2.6) 248 2.1(1.8, 2.6) 8 127 2.5(2.2, 3.0) 119 2.5(2.2, 3.0) 246 2.5(2.2, 3.0) 9 118 3.0(2.6, 3.4) 119 2.9(2.4, 3.6) 237 3.0(2.6, 3.5) 10 125 3.5(2.9, 4.3) 120 3.3(2.7, 3.9) 245 3.3(2.8, 4.1) 11 123 4.0(3.4, 4.5) 117 4.0(3.5, 4.9) 240 4.0(3.4, 4.7) 12 112 4.4(3.7, 5.1) 106 4.4(3.8, 5.3) 218 4.4(3.7, 5.2) 合计 Total 848 3.0(2.3, 3.9) 818 2.9(2.2, 3.9) 1 666 2.9(2.2, 3.9)
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表 3 甲状腺容积与体格发育指标和尿碘的相关性分析
Table 3. Correlation analysis between thyroid volume and physical development indicators and urinary iodine
变量 Variable r值 value P值 value 年龄/岁 Age/ years 0.744 < 0.001 体重 Weight/kg 0.769 < 0.001 身高 Height/cm 0.761 < 0.001 BMI/(kg·m-2) 0.544 < 0.001 BSA/m2 0.787 < 0.001 尿碘 Urinary iodine/(μg·L-1) 0.090 < 0.001 注：BSA，体表面积。
Note: BSA, body surface area.
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表 4 6~12岁儿童甲状腺容积影响因素多元线性回归分析
Table 4. Multiple linear regression analysis of influencing factors of thyroid volume in children aged 6-12 years
因素 Factor 未标准化系数Unstandardised coefficient 标准化系数β值 Standardized β value t值value P值value β值 value 标准误差 Standard error 常量 Constant -1.885 0.106 ― -17.823 ＜0.001 BSA/m2 3.189 0.147 0.539 21.736 ＜0.001 年龄/岁 Age/years 0.176 0.016 0.280 11.325 ＜0.001 尿碘 Urinary iodine/(μg·L-1) ＜0.001 ＜0.001 -0.002 -0.151 0.880 注：BSA，体表面积；―，无法获取
Note: BSA, body surface area；―，unavailable.
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表 5 6~12岁儿童身高与校正前后甲状腺容积的Spearman相关性分析
Table 5. Spearman correlation analysis between of height and thyroid volume before and after correction in children aged 6-12 years old
年龄/岁 Age/years 甲状腺容积 Thyroid volume BMIV BSAV WHVI HVI1 HVI2 r值 value P值 value r值 value P值 value r值 value P值 value r值 value P值 value r值 value P值 value r值 value P值 value 6 0.195 0.003 0.060 0.364 -0.096 0.145 -0.393 ＜0.001 0.060 0.365 -0.091 0.165 7 0.173 0.006 0.073 0.254 -0.096 0.133 -0.356 ＜0.001 0.040 0.535 -0.104 0.103 8 0.282 ＜0.001 0.074 0.247 -0.119 0.061 -0.460 ＜0.001 0.100 0.116 -0.098 0.124 9 0.381 ＜0.001 0.206 0.001 0.010 0.883 -0.357 ＜0.001 0.194 0.003 0.005 0.943 10 0.451 ＜0.001 0.258 ＜0.001 0.073 0.257 -0.335 ＜0.001 0.277 ＜0.001 0.092 0.149 11 0.426 ＜0.001 0.197 0.002 -0.030 0.645 -0.416 ＜0.001 0.231 ＜0.001 -0.022 0.739 12 0.349 ＜0.001 0.190 0.005 0.02 0.774 -0.316 ＜0.001 0.193 0.004 0.018 0.791 注：BMIV，体质容积指数；BSAV，体表面积容积指数；WHVI，体重身高容积指数；HVI1，身高容积指数1；HVI2，身高容积指数2。
Note: BMIV, body mass volume index; BSAV, body surface area volume index; WHVI, weight height volume index; HVI1, height volume index1; HVI2, height volume index2.
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表 6 6~12岁儿童体重与校正前后甲状腺容积的Spearman相关性分析
Table 6. Spearman correlation analysis between of weight and thyroid volume before and after correction in children aged 6-12 years
年龄/岁 Age/years 甲状腺容积 Thyroid volume BMIV BSAV WHVI HVI1 HVI2 r值 value P值 value r值 value P值 value r值 value P值 value r值 value P值 value r值 value P值 value r值 value P值 value 6 0.416 ＜0.001 -0.026 0.696 0.028 0.668 -0.355 ＜0.001 0.294 ＜0.001 0.161 0.014 7 0.379 ＜0.001 -0.024 0.712 0.033 0.600 -0.335 ＜0.001 0.275 ＜0.001 0.162 0.011 8 0.418 ＜0.001 -0.095 0.138 -0.022 0.726 -0.469 ＜0.001 0.295 ＜0.001 0.151 0.018 9 0.461 ＜0.001 -0.088 0.176 0.016 0.803 -0.450 ＜0.001 0.355 ＜0.001 0.221 0.001 10 0.551 ＜0.001 -0.013 0.839 0.137 0.031 -0.414 ＜0.001 0.463 ＜0.001 0.337 ＜0.001 11 0.480 ＜0.001 -0.110 0.088 0.011 0.865 -0.479 ＜0.001 0.358 ＜0.001 0.209 0.001 12 0.427 ＜0.001 -0.131 0.053 0.020 0.763 -0.433 ＜0.001 0.336 ＜0.001 0.228 0.001 注：BMIV，体质容积指数；BSAV，体表面积容积指数；WHVI，体重身高容积指数；HVI1，身高容积指数1；HVI2，身高容积指数2。
Note: BMIV, body mass volume index; BSAV, body surface area volume index; WHVI, weight height volume index; HVI1, height volume index1; HVI2, height volume index2.
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