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Title: [Correlation analysis of low-dose X-ray ionizing radiation and thyroid function in radiation workers].
Author: Lu BF, Yin WJ, Xu T, Li NN, Yi GL.
Journal: Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi; 2022 Oct 20; 40(10):733-736. PubMed ID: 36348552.
Abstract:
Objective: To investigate the effect of low-dose X-ray ionizing radiation on thyroid function of radiation workers. Methods: From January to December 2021, a total of 1039 medical workers in some tertiary hospitals in Wuhan were selected as the survey subjects, of which 518 radiation workers were selected as the exposure group, and 521 non-radiation workers were selected as the control group. The general conditions of the two groups were collected, and 5 indicators of thyroid function were measured, including total thyroxine (TT(4)) , total triiodothyronine (TT(3)) , free triiodothyronine (FT(3)) , thyroid stimulating hormone (TSH) , and free thyroxine (FT(4)) . The annual cumulative dose of ionizing radiation exposure in the exposure group was collected. Pearson χ(2) test and independent sample t test were used to compare the general conditions, 5 indicators of thyroid function and abnormal rate between the two groups. Linear regression model was used to analyze the correlation between the annual cumulative dose and 5 indicators of thyroid function in the exposure group. Binary logistic regression was used to analyze the influencing factors of thyroid dysfunction in the exposure group. Results: The TT(4) levels of the workers in the control group and the exposure group were (7.95±1.07) μg/dl and (8.26±1.41) μg/dl, respectively, and the FT(4) levels were (16.33±2.19) pmol/L and (17.15±2.42) pmol/L, respectively, the rate of thyroid dysfunction was 4.80% (25/521) and 8.49% (44/518) , and the above differences were statistically significant (P<0.05) . Linear regression analysis showed that the annual cumulative dose of the exposure group was significantly correlated with TT(4), TT(3), FT(4), and TSH (P<0.05) . For every 1 mSv increase in the annual cumulative dose, TT(4) increased by 1.661 μg/dl, FT(4) increased by 1.422 pmol/L, TT(3) decreased by 0.113 ng/ml, and TSH decreased by 0.731 μIU/ml. Binary logistic regression analysis showed that the older the radiation workers, the higher the risk of thyroid dysfunction (OR=1.080, 95% CI: 1.016-1.148, P=0.013) ; the greater the annual cumulative dose, the higher the risk of thyroid dysfunction (OR=6.400, 95%CI: 1.796-22.811, P=0.004) . Conclusion: The annual cumulative dose of low-dose X-ray ionizing radiation is positively correlated with thyroid function TT(4) and FT(4) of radiation workers, and negatively correlated with TT(3) and TSH; the greater the age and annual cumulative dose, the higher the risk of thyroid dysfunction. 目的： 探讨低剂量X射线电离辐射对放射工作人员甲状腺功能的影响。 方法： 于2021年1至12月，将武汉市部分三甲医院1 039名医务人员作为调查对象，其中518名放射工作人员作为暴露组，521名非放射工作人员作为对照组。收集两组人群的一般情况，测量甲状腺功能5项指标：总甲状腺素（TT(4)）、总三碘甲状腺原氨酸（TT(3)）、游离三碘甲状腺原氨酸（FT(3)）、促甲状腺激素（TSH）、游离甲状腺素（FT(4)），同时收集暴露组接触电离辐射的年累积剂量。采用Pearson χ(2)检验、独立样本t检验对两组人群一般情况、甲状腺功能5项指标及异常率等进行比较，采用线性回归模型分析暴露组年累积剂量与甲状腺功能5项指标的关联性，采用二元logistic回归分析暴露组甲状腺功能异常的影响因素。 结果： 对照组与暴露组工作人员的TT(4)水平分别为（7.95±1.07）μg/dl和（8.26±1.41）μg/dl，FT(4)水平分别为（16.33±2.19）pmol/L和（17.15±2.42）pmol/L，甲状腺功能异常率分别为4.80%（25/521）和8.49%（44/518），以上差异均有统计学意义（P<0.05）。线性回归分析显示，暴露组年累积剂量与TT(4)、TT(3)、FT(4)、TSH均存在明显关联（P<0.05），年累积剂量每增加1 mSv，放射工作人员TT(4)升高1.661 μg/dl，FT(4)升高1.422 pmol/L，TT(3)降低0.113 ng/ml，TSH降低0.731 μIU/ml。二元logistic回归分析显示，放射工作人员年龄越大，甲状腺功能异常的风险越高（OR=1.080，95%CI：1.016~1.148，P=0.013）；年累积剂量越大，甲状腺功能异常的风险也越高（OR=6.400，95%CI：1.796~22.811，P=0.004）。 结论： 低剂量X射线电离辐射年累积剂量与放射工作人员甲状腺功能TT(4)、FT(4)存在正向关联，与TT(3)、TSH存在负向关联；年龄、年累积剂量越大，甲状腺功能异常的风险越高。.

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