An increasing incidence of hyperthyroidism has been observed when iodine supplementation has been introduced to an iodine-deficient population. Moreover, the influence of chronic more than adequate or excessive iodine intake on the epidemiological features of hyperthyroidism has not been widely and thoroughly described. To investigate the influences of different iodine intake levels on the incidence of hyperthyroidism, we conducted a prospective community-based survey in three communities with mild-deficient, more than adequate (previously mild deficient iodine intake), and excessive iodine intake.In three rural Chinese communities, a total of 3761 unselected inhabitants aged above 13 years participated in the original investigation and 3018 of them received identical examinations after 5 years. Thyroid function, levels of thyroid peroxidase antibody (TPOAb), thyroglobulin antibody and urinary iodine excretion were measured and thyroid ultrasound examination was also performed.In three communities, median urinary iodine excretion was 88, 214, and 634 microg/l (P<0.05) respectively. The cumulative incidence of hyperthyroidism was 1.4, 0.9, and 0.8% (P>0.05) respectively. Autoimmune hyperthyroidism was predominant in thyroid hyperfunction in all the three cohorts. Either positive TPOAb (>50 U/ml) or goiter in original healthy participants was associated with the occurrence of unsuspected hyperthyroidism in 5 years (logistic regression, OR=4.2 (95% CI 1.7-8.8) for positive TPOAb, OR=3.1 (95% CI 1.4-6.8) for goiter).Iodine supplementation may not induce an increase in hyperthyroidism in a previously mildly iodine-deficient population. Chronic iodine excess does not apparently increase the risk of autoimmune hyperthyroidism, suggesting that excessive iodine intake may not be an environmental factor involved in the occurrence of autoimmune hyperthyroidism.
Background: Despite the implementation of the universal salt iodization (USI) program for correction of iodine deficiency in China for ∼20 years, the actual iodine nutrition status of Chinese residents and the prevalence of iodine deficiency and iodine excess are issues that need to be addressed. This nationally representative cross-sectional study was conducted across all 31 provinces of mainland China to gather extensive data on iodine nutrition status and the influential factors. Methods: This study included 78,470 participants, aged 18 years or older, who were interviewed and asked to answer a questionnaire. Urine iodine concentration (UIC) was measured by the inductively coupled plasma mass spectrometry method, and goiter was examined by thyroid ultrasonography. In addition, sixty 9-11 years old school children in each province were randomly selected to evaluate the UIC and thyroid ultrasonography. The iodine nutrition status was determined according to the World Health Organization guidelines. Results: The iodized salt coverage was 95.37%. The median urine iodine (MUI) was 177.89 μg/L (interquartile range [IQR], 117.89-263.90 μg/L) and goiter prevalence was 1.17% (confidence interval [95% CI 0.95-1.43]) in the adult population. The MUI was 199.75 μg/L (IQR, 128.41-303.37 μg/L) in school-age children, and goiter prevalence was 3.50% [95% CI, 2.93-4.13]. The percentage of individuals with UIC <50 μg/L was 3.43%, <20%. Analysis indicated that sex, age, geographic factors, body mass index, and smoking habits influence the iodine nutrition level. Conclusion: The mandatory USI program has successfully eliminated iodine deficiency disorders, and the findings indicate that the iodine nutrition level in the general population is within the safe range.
Individualized management, incorporating papillary thyroid cancer (PTC) variant-specific risk, is conceivably a useful treatment strategy for PTC, which awaits comprehensive data demonstrating differential risks of PTC variants to support.This study sought to establish the differential clinicopathological risk of major PTC variants: conventional PTC (CPTC), follicular-variant PTC (FVPTC), and tall-cell PTC (TCPTC).This was a retrospective study of clinicopathological outcomes of 6282 PTC patients (4799 females and 1483 males) from 26 centers and The Cancer Genome Atlas in 14 countries with a median age of 44 years (interquartile range, 33-56 y) and median follow-up time of 37 months (interquartile range, 15-82 mo).The cohort consisted of 4702 (74.8%) patients with CPTC, 1126 (17.9%) with FVPTC, and 239 (3.8%) with TCPTC. The prevalence of high-risk parameters was significantly different among the three variants, including extrathyroidal invasion, lymph node metastasis, stages III/IV, disease recurrence, mortality, and the use (need) of radioiodine treatment (all P < .001), being highest in TCPTC, lowest in FVPTC, and intermediate in CPTC, following an order of TCPTC > CPTC ≫ FVPTC. Recurrence and mortality in TCPTC, CPTC, and FVPTC were 27.3 and 6.7%, 16.1 and 2.5%, and 9.1 and 0.6%, corresponding to events per 1000 person-years (95% confidence interval [CI]) of 92.47 (64.66-132.26) and 24.61 (12.31-49.21), 34.46 (30.71-38.66), and 5.87 (4.37-7.88), and 24.73 (18.34-33.35) and 1.68 (0.54-5.21), respectively. Mortality hazard ratios of CPTC and TCPTC over FVPTC were 3.44 (95% CI, 1.07-11.11) and 14.96 (95% CI, 3.93-56.89), respectively. Kaplan-Meier survival analyses showed the best prognosis in FVPTC, worst in TCPTC, and intermediate in CPTC in disease recurrence-free probability and disease-specific patient survival. This was particularly the case in patients at least 45 years old.This large multicenter study demonstrates differential prognostic risks of the three major PTC variants and establishes a unique risk order of TCPTC > CPTC ≫ FVPTC, providing important clinical implications for specific variant-based management of PTC.
Background: The mandatory universal salt iodization (USI) program has been implemented in China for about twenty years to correct iodine deficiency. At present, the actual iodine nutrition status of Chinese residents and whether they are adversely affected by iodine excess are issues of general concerns.Method: A nationally representative cross-sectional study was conducted. 78,470 participants, aged 18 or older, were enrolled from all 31 provincial regions of mainland China. The participants were interviewed and given a questionnaire. Urine iodine concentration (UIC) were measured by ICP-MS (inductively coupled plasma mass spectrometry) method. The goiter was examined by thyroid ultrasonography. The iodine category was based on the criteria of WHO.Results: The iodized salt coverage is 95·37% in the general population. The median urine iodine (MUI) was 177·89μg/L (interquartile range, 117·89-263·90μg/L) in the general population with goiter prevalence 1·17% (95%CI, 0·95-1·43%). The MUI was 199·7(interquartile range, 128·46-303·02) in school age children with prevalence of goiter 3·50% (95% CI, 2·93% to 4·13%). The percentage of moderate iodine deficiency (UIC<50μg/L) was 3·43%. The subjects with adequate iodine and more than adequate iodine in total accounting for 63·44% of the whole population. The data also manifested that gender, age, ethnic, geographic factors, BMI, smoking habits, education and income levels have a certain degree of influence on the iodine nutrition level.Conclusion: The mandatory USI program in China has successfully eliminated iodine deficiency disorders for 20 years. Our epidemiological investigation suggested that the iodine nutrition level of Chinese residents is generally within the safe range.Funding Statement: This work is supported by the Research Fund for Public Welfare from National Health and Family Planning Commission of China (Grant No. 201402005).Declaration of Interests: There is no conflict in interest.Ethics Approval Statement: The research protocols were approved by the Medical Ethics Committee of China Medical University.
Previous studies have shown increases in the prevalence of obesity and hypertension, but nationally representative data on recent changes in prevalence adjusted for population structure changes are lacking. Two nationwide surveys were conducted in 2007 and 2017 to assess the prevalence changes of these conditions in China.A multistage stratified random sampling method was used to obtain a nationally representative sample of adults aged 20 years and older in mainland China in 2007 and 2017. Temporal changes in the prevalence of hypertension and obesity were investigated. Changes in blood pressure, body mass index (BMI) and waist circumference were also assessed. Logistic regression models were constructed to assess the changes in prevalence over time.The weighted prevalence of hypertension (25.7% vs. 31.5%, P=0.04), high-normal blood pressure (11.7% vs. 14.3%, P<0.0001), general obesity (31.9% vs. 37.2%, P=0.008), and central obesity (25.9% vs. 35.4%, P=0.0002) was significantly higher in 2017 (n=72824) than in 2007 (n=45956) in the overall population. No significant changes in the prevalence of overweight and grade 1 or grade 2 hypertension were observed in the overall population, but a significantly higher prevalence was observed among participants aged 20-29 years for grade 1 hypertension (P=0.002) and among participants aged 70 years and older for grade 2 hypertension (P=0.046) in 2017.Compared with 2007, the prevalence of hypertension and obesity was significantly higher among adults in mainland China after adjusting for demographic confounding factors in 2017. More targeted interventions and prevention strategies are needed to offset the increasing risk of cardiovascular disease due to increases in the prevalence of hypertension and obesity.The Clinical Research Fund of the Chinese Medical Association (Grant No. 15010010589), the National Natural Science Foundation of China (Grant No. 82000753), and the Chinese Medical Association Foundation and Chinese Diabetes Society (Grant No. 07020470055).
This paper introduces a small negative pressure wall-climbing robot with the ARM system. It can complete the task on the surface of vertical, steep. First of all, describes the basic system structure of robot and mechanical configuration. Secondly, the mechanic analyses of robot dynamics modeling to explain the principle of its operation. Finally, an experiment tests the all common functions of the robot.
Abstract Context Metabolic disorders and cardiovascular disease (CVD) threaten human health. Many studies have assessed the phenomenon of metabolic disorders and CVD in patients with diabetes. However, in euglycemic individuals, the relationships between glucose regulation, metabolism, and CVD remain unclear. Objective This work aimed to explore the associations between postprandial glucose dips, metabolic disorders, and CVD risk. Methods We analyzed data from the Thyroid disorders, Iodine status and Diabetes Epidemiological survey (TIDE study), which included 38 878 euglycemic individuals from all 31 provinces of mainland China. The prevalence of metabolic disorders and their related components and CVD risk were calculated according to postprandial glucose dips. Logistic regression models of quartiles of postprandial glucose dips were used to further explore whether the prevalence of these disorders was associated with postprandial glucose dips. Results Odds ratios for the fourth vs the first quartile of glucose dips were 0.59 (95% CI, 0.55-0.63) (P < .001) for metabolic disorders, 0.48 (95% CI 0.44-0.53) (P < .001) for metabolic syndrome (MetS), and 0.54 (95% CI, 0.50-0.59) (P < .001) for hyperuricemia. The odds ratio of a 10-year CVD risk greater than 20% for the fourth vs the first glucose dip quartile was 0.67 (95% CI, 0.52-0.85) (P < .001). Models adjusted for body mass index yielded similar results. Conclusion Postprandial glucose dips are associated with metabolic disorders, MetS and its related component diseases, and CVD risk. Glucose dips may be a marker of underlying metabolic abnormalities.
Background: Subclinical hypothyroidism (SCH) is associated with an increased risk of metabolic disorders and cardiovascular events. There is a delicate interplay between thyroid hormones and thyrotropin (TSH) and metabolic homeostasis. However, the association between thyroid hormone sensitivity and metabolic indices has not been elucidated in SCH. Methods: We enrolled 11,109 participants with SCH. All participants had a TSH level >4.2 mIU/L and normal free thyroxine (fT4; 12.0–22.0 pmol/L). Metabolic indices (body mass index [BMI], blood pressure, serum lipid, serum uric acid [sUA], plasma glucose and glycosylated hemoglobin [HbA1C]) were measured. The thyroid hormone sensitivity indices that include thyroid feedback quantile-based index (TFQI), TSH index (TSHI), and thyrotroph thyroxine resistance index (TT4RI) were calculated based on fT4 and TSH. Higher TFQI quartiles indicated lower thyroid hormone sensitivity. The relationship between thyroid hormone sensitivity indices and metabolic indices and cardiovascular disease (CVD) risk were calculated. Results: Participants with decreased central sensitivity to thyroid hormone had lower BMI and higher sUA levels. The odds ratio of the fourth versus the first quartile of TFQI was 0.85 [confidence interval, CI: 0.73–0.96] for obesity, 1.64 [CI: 1.37–1.92] for hyperuricemia (HUA), and 12.22 [CI: 5.32–28.07] for 10-year risk distribution for CVD >20%. Further adjustment for BMI when analyzing HbA1C, HUA, and CVD risk generated similar results. TSHI and TT4RI also yielded similar results. Conclusions: Impaired sensitivity to thyroid hormone in SCH is associated with higher risk of HUA and CVD and lower risk of obesity. These findings are potentially useful for understanding the interaction between thyroid hormone sensitivity and metabolic diseases in SCH.
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