实用老年医学

实用老年医学 ›› 2025, Vol. 39 ›› Issue (5): 456-460.doi: 10.3969/j.issn.1003-9198.2025.05.005

• 临床研究 • 上一篇    下一篇

农村老年人维生素D水平与自身免疫性甲状腺炎的横断面研究

张杰, 汪奇峰, 密玮诺, 张丽娜, 陈国芳, 孙宇, 徐书杭, 刘超   

  1. 210028 江苏省南京市,南京中医药大学附属中西医结合医院(江苏省中西医结合医院)内分泌科(张杰,密玮诺,张丽娜,陈国芳,徐书杭,刘超); 210028 江苏省南京市,江苏省中医药研究院国家瘿病证治重点研究室(汪奇峰); 223800 江苏省宿迁市,徐州医科大学附属宿迁医院内分泌科(孙宇)
  • 收稿日期:2024-09-03 出版日期:2025-05-20 发布日期:2025-05-20
  • 通讯作者: 刘超,Email:liuchao@nfmcn.com
  • 基金资助:
    江苏省重点研发计划(BE2020726);中华国际医学交流基金会甲状腺中青年医生研究项目(BOE-JZX-202115); 江苏省卫生健康委医学科研资助项目(M2020102)

The level of vitamin D and the prevalence of autoimmune thyroiditis in rural elderly: a cross-sectional study

ZHANG Jie, WANG Qifeng, MI Weinuo, ZHANG Lina, GHEN Guofang, SUN Yu, XU Shuhang, LIU Chao   

  1. Department of Endocrinology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210028, China (ZHANG Jie, MI Weinuo, ZHANG Lina, GHEN Guofang, XU Shuhang, LIU Chao); Key TCM Syndrome and Treatment of Yingbing (Thyroid Disease) of State Administration of Traditional Chinese Medicine, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing 210028, China (WANG Qifeng); Department of Endocrinology, the Affiliated Suqian Hospital of Xuzhou Medical University, Suqian 223800, China (SUN Yu)
  • Received:2024-09-03 Online:2025-05-20 Published:2025-05-20
  • Contact: LIU Chao, Email: liuchao@nfmcn.com

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摘要： 目的 明确农村老年人自身免疫性甲状腺炎(autoimmune thyroiditis,AIT)患病率,并分析血清维生素D水平与AIT的相关性。 方法 研究对象来源于2021年5—7月进行的江苏省适碘地区老年人群甲状腺疾病流行病学、监控和干预研究(Thyroid Diseases in Older Population: Screening, Surveillance, and Intervention, TOPS study),共有2460名65岁及以上老年人被纳入最终分析。收集所有研究对象的年龄、性别、身高、体质量等一般资料,并检测促甲状腺素(TSH)、甲状腺球蛋白抗体(TgAb)、甲状腺过氧化物酶抗体(TPOAb)、尿碘、糖代谢、脂代谢及血清25羟维生素D[25(OH)D]等相关实验室指标,分析AIT的患病特征,并建立二元logistic回归模型分析血清25(OH)D与AIT的相关性。 结果 在2460名受试人群中,患有AIT者290例(11.79%),女性患病率高于男性(15.14%比8.55%,P＜0.001)。受试者中位25(OH)D水平为30.80 ng/mL,女性中位25(OH)D水平低于男性(25.80 ng/mL比36.00 ng/mL,P＜0.001);AIT病人中位25(OH)D水平显著低于非AIT人群(28.4 ng/mL比31.15 ng/mL,P＜0.001)。在农村老年女性人群中,血清25(OH)D水平下降是AIT发生的独立危险因素(OR=0.980,95%CI:0.961～0.998),但在男性中二者无相关性。 结论 农村老年女性维生素D水平与AIT存在相关性。

关键词: 自身免疫性甲状腺炎, 维生素D, 女性, 老年人

Abstract: Objective To explore the prevalence of autoimmune thyroiditis (AIT) in rural elderly and to analyze the correlation between serum vitamin D level and AIT. Methods The research subjects were derived from the study of Thyroid Diseases in Older Population: Screening, Surveillance, and Intervention (TOPS study) from May to July 2021 in iodine-adequate areas of Jiangsu Province. A total of 2460 elderly aged ≥65 years were enrolled. The general data including age, gender, height and weight were collected, and relevant laboratory indicators such as thyrotropin (TSH), thyroglobulin antibody (TgAb), thyroid peroxidase antibody (TPOAb), urinary iodine, blood glucose, blood lipids, and serum 25(OH)D were detected. The prevalence characteristics of AIT was analyzed, and a binary logistic regression model was established to analyze the correlation between serum 25(OH)D level and AIT. Results Among 2460 participants, 290 cases presented with AIT (11.79%). The prevalence rate of AIT in women was significantly higher than that in men (15.14% vs 8.55%, P<0.001). The median 25(OH)D level in the participants was 30.80 ng/mL. Women had a significantly lower median 25(OH)D level than men (25.80 ng/mL vs 36.00 ng/mL, P<0.001). Additionally, the elderly with AIT had a significantly lower median 25(OH)D level than those without AIT (28.40 ng/mL vs 31.15 ng/mL, P<0.001). In the elderly rural women, serum 25(OH)D level was an independent risk factor for AIT (OR=0.980, 95%CI: 0.961－0.998), but serum 25(OH)D level was not associated with AIT in the elderly rural men. Conclusions There is a correlation between vitamin D level and AIT in the elderly rural women.

Key words: autoimmune thyroiditis, vitamin D, female, aged

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