Abstract: Background　Iodine is one of the important raw materials for the synthesis of thyroid hormones in the thyroid.Previous studies have shown that excessive iodine intake induces the production of anti-thyroid antibodies.Our previous survey results show that excessive iodine intake is frequently seen in 8-10-year-old school-age children in Hefei，but the characteristics of urinary iodine levels and thyroid autoantibodies in adult population in this area are still unclear.Objective　To investigate the characteristics of thyroid autoantibodies and influencing factors among adult population in Hefei area.Methods　A cross-sectional survey was carried out in a cluster sample of 2 593 permanent residents aged over 18 years who lived in Baohe District，Hefei for at least 6 months and were eligible for the study during January to February 2017.Physical parameters such as height，body weight，waist circumference，systolic blood pressure，and diastolic blood pressure were measured，and body mass index was calculated.Laboratory parameters such as fasting plasma glucose，2-hour postprandial plasma glucose，triacylglycerol，total cholesterol，high-density lipoprotein cholesterol，low-density lipoprotein cholesterol，glycated hemoglobin，thyroid-stimulating hormone（TSH），thyroid peroxidase antibody（TPOAb），thyroglobulin antibody（TgAb），urinary iodine，thyroid volume（TV） were also measured.According to the TPOAb and TgAb levels，they were divided into autoantibody double-positive group（both TPOAb and TgAb were positive，n=177），autoantibody single-positive group（positive TPOAb with negative TgAb or negative TPOAb with positive TgAb，n=231），and autoantibody double-negative group（both TPOAb and TgAb were negative，n=2 185）．The rate of positive thyroid autoantibodies in the participants was analyzed by sex and age.And physical and laboratory parameters were compared by both TPOAb and TgAb levels.Multivariate Logistic regression analysis was used to investigate the influencing factors for positive thyroid autoantibodies.Results　The prevalence of positive TPOAb，positive TgAb，positive TPOAb and TgAb，positive TPOAb with negative TgAb or negative TPOAb with positive TgAb，and negative TPOAb and TgAb was 9.6%（248/2 593），11.8%（307/2 593），6.8%（177/2 593），8.9%（231/2 593），84.3%（2 185/2 593），respectively.Females had higher prevalence of positive TPOAb and TgAb compared with males（P<0.05）．Females had higher percentages than males in autoantibody double-positive group and autoantibody single-positive group（P<0.001），but had lower percentage than males in autoantibody double-negative group（P=0.002）．Autoantibody single-positive group had a greater average age than autoantibody double-negative group（P=0.001）．Autoantibody double-positive group had higher average TSH and TV levels than other two groups（P<0.05）．The TSH levels and TV in autoantibody single-positive group were significantly higher than those of autoantibody double-negative group（P<0.05）．Multivariate Logistic regression analysis showed that sex，TSH levels，and TV were influencing factors for positive thyroid autoantibodies（P<0.05）．Conclusion　The median urinary iodine for adults in Hefei was 208.59μg/L，indicating that most of them took too much iodine.The prevalence of positive thyroid autoantibody，positive TPOAb，and positive TgAb was 29.4%，9.6% and 13.0%，respectively in adults in this area，which basically coincide with those of the adult populations in central and eastern of China.Females were associated with higher prevalence of positive TPOAb，and positive TgAb.Sex，TSH and TV were the influencing factors of positive thyroid autoantibody.

Key words: Thyroid diseases, Thyrotropin, Thyroid autoantibodies, Urinary iodine, Thyroid volume, Hefei

摘要： 背景　碘是甲状腺合成甲状腺激素的重要原料之一，既往研究表明碘摄入过量会诱导抗甲状腺抗体的产生。本课题组前期调查结果显示合肥市区8~10岁学龄儿童普遍存在碘摄入过量问题，而该地区成人尿碘水平及甲状腺自身抗体的特点尚不明确。目的　调查目前合肥地区人群甲状腺自身抗体特点及其影响因素。方法　采用整群抽样横断面调查方法，于2017年1—2月，选取合肥市包河区符合研究标准的2 593例年龄>18岁的常住居民（居住时间≥6个月）作为研究对象。测量研究对象身高、体质量、腰围（WC）、收缩压（SBP）、舒张压（DBP），并计算体质指数（BMI）；检测研究对象空腹血糖（FPG）、餐后2 h血糖（2 h PG）、三酰甘油（TG）、总胆固醇（TCHO）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、糖化血红蛋白（HbA1c）、促甲状腺激素（TSH）、甲状腺过氧化物酶抗体（TPOAb）、甲状腺球蛋白抗体（TgAb）、尿碘、甲状腺体积（TV）并进行比较。根据甲状腺自身抗体结果将研究对象分为3组：TPOAb、TgAb双阳性组（抗体+/+组）177例，TPOAb、TgAb任一阳性组（抗体+/-组）231例，TPOAb和TgAb双阴性组（抗体-/-组）2 185例。应用多因素Logistic回归分析研究甲状腺自身抗体阳性的影响因素。结果　2 593例研究对象中，TPOAb单阳性者248例（9.6%），TgAb单阳性者307例（11.8%），TPOAb及TgAb双阳性者177例（6.8%），TPOAb或TgAb任一阳性者231例（8.9%），TPOAb及TgAb双阴性者2 185例（84.3%）。女性TPOAb、TGAb的阳性率均高于男性（P<0.05）。抗体+/+组、抗体+/-组女性比例高于男性（P<0.001）；抗体-/-组女性比例低于男性（P=0.002）；抗体+/-组年龄高于抗体-/-组（P=0.001）。抗体+/+组TSH、TV大于抗体+/-组、抗体-/-组，抗体+/-组TSH、TV大于抗体-/-组（P<0.05）。多因素Logistic回归分析结果显示，性别、TSH、TV是甲状腺自身抗体的影响因素（P<0.05）。结论　合肥地区成人尿碘中位数（MUI）为208.59 μg/L，普遍存在碘摄入过量问题。该地区人群甲状腺自身抗体阳性的检出率达29.4%，TPOAb 和TgAb单一阳性率分别为9.6%和13.0%，与中国中部和东部地区基本保持一致。女性TPOAb、TGAb的阳性率高于男性，并且性别、TSH、TV是甲状腺自身抗体阳性的影响因素。

关键词: 甲状腺疾病, 促甲状腺素, 甲状腺自身抗体, 尿碘, 甲状腺体积, 合肥