The Relationship Between Iodine Nutritional Status And Nodular Goiter And Papillary Thyroid Carcinoma

Background:Iodine,as a raw material for the synthesis of thyroid hormones,is an essential micronutrient.With the implementation of universal salt iodization,iodine nutritional status has been improved,and iodine deficiency disorders reduced gradually.However,many problems,such as the relationship between iodine excess caused by salt iodization and the increase of the incidence of thyroid disease,has received more attention.Objectives:To explore the relationship between iodine nutritional status and nodular goiter and thyroid papillary carcinoma.Methods:From May 2015 to January 2017,30 patients with nodular goiter and 90 with thyroid papillary carcinoma were collected to give surgical treatment in Peking Union Medical College Hospital.All patients were tested the serum iodine,urinary iodine and urinary iodine/creatinine ratio before surgery,and their normal thyroid tissue specimens were collected during operation for the detection of iodine content in tissue.We compared the difference of iodine nutrition index between patients with nodular goiter and thyroid papillary carcinoma,as well as in the patients with different stages of thyroid papillary carcinoma.Results:(1)Serum TSH concentration(1.991 vs.1.218 μ IU/ml),serum iodine concentration(64vs.54ug/L),and tissue iodine content(2035.77 vs.759.43mg/kg)in group of papillary thyroid carcinoma were higher than that of nodular goiter group,and the difference was statistically significant(P values were =0.033,=0.004,<0.001).Multi-factor regression analysis showed that the increase of serum iodine and tissue iodine are independent risk factors for thyroid cancers.(2)The levels of serum iodine(P=0.030)and tissue iodine(P=0.024)in papillary thyroid carcinoma patients with lymph node metastasis were higher than those without lymph node metastasis,and the difference was statistically significant.(3)The tissue iodine(P=0.031)in the patients with membrane invasion was higher than that in the group without membrane invasion,and the difference was also statistically significant(P=0.031).(4)Urinary iodine in 54.44%(49/90)patients with thyroid cancer was higher than iodine sufficiency(MUI 100-199μg/L).(5)There was a correlation between serum iodine,urinary iodine and tissue iodine with Pearson correlation(P<0.05).Conclusion:The increase of serum iodine is an independent risk factor for,especially in patients with lymph node metastasis.In patients with papillary thyroid carcinoma,tissue iodine content was increased,especially in patients with lymph node metastasis/thyroid membrane invasion.There was no significant difference in the urinary iodine and urinary iodine/creatinine ratio between the groups of papillary thyroid carcinoma and nodular goiter.Thyroid stimulating hormone levels are elevated in patients with papillary thyroid carcinoma.There was correlation between serum iodine,urinary iodine and urinary iodine/creatinine ratio.