Current Iodine Nutrition Status and Prevalence of Thyroid Disorders in Tibetan Adults in an Oxygen-Deficient Plateau, Tibet, China: A Population-Based Study

Thyroid. 2020 May;30(5):759-766. doi: 10.1089/thy.2019.0669. Epub 2020 Feb 10.


Background: Iodine deficiency (ID) is a global problem in individuals living in an iodine-deficient environment, specifically in mountainous regions. However, data regarding the iodine nutritional status of Tibetan people in the plateau are limited. Methods: A population-based survey was conducted from July 2016 to July 2017 in Lhasa, Tibet, including 12 communities in Lhasa city and 10 surrounding rural areas. The iodine nutritional status of Tibetan people was evaluated using the traditional iodine nutrition indexes: urinary iodine concentration (UIC), thyroid size, serum thyroxine, thyrotropin, thyroglobulin antibody and thyroid peroxidase antibody (TPOAb). Results: A total of 2295 healthy participants were screened, and 2160 participants who had completed all the required examinations were enrolled in this study (response rate, 94.1%). Urinary iodine showed a skewed distribution, with a median (upper and lower quartiles) of 154 (99-229) μg/L. The percentages of low iodine (UIC <100 μg/L), adequate iodine (UIC, 100-199 μg/L), and high iodine (UIC ≥200 μg/L) were 25.6%, 42.0%, and 32.4%, respectively. The urinary iodine level in the urban region was higher than that in the rural region (p < 0.05). Urinary iodine levels were lower with increasing age (p < 0.05). The prevalence of hyperthyroidism, hypothyroidism, goiter, TPOAb positivity, and thyroglobulin antibody positivity was 1.0%, 21.8%, 4.7%, 6.6%, and 10.4%, respectively. Logistic regression analysis found that urinary iodine was an independent risk factor for TPOAb positivity (odds ratio = 0.997 [95% confidence interval, 0.995-0.999]; p < 0.001). Conclusions: Compared with individuals living in the plains of China, Tibetan adults have a higher rate of ID. UIC was an independent risk factor for TPOAb positivity. This public health issue should be further investigated.

Keywords: Tibetan; iodine nutrition; oxygen-deficient plateau; thyroid disorders.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Autoantibodies / blood*
  • Female
  • Humans
  • Iodine / urine*
  • Male
  • Middle Aged
  • Nutritional Status
  • Prevalence
  • Thyroglobulin / immunology
  • Thyroid Diseases / blood
  • Thyroid Diseases / epidemiology*
  • Thyroid Diseases / immunology
  • Thyrotropin / blood
  • Thyroxine / blood
  • Tibet / epidemiology
  • Young Adult


  • Autoantibodies
  • Thyrotropin
  • Thyroglobulin
  • Iodine
  • Thyroxine