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ObjectiveIodine concentrations in potable water, serum, and urine for different living environments in, Heze city are detected to analyze the relationship between environmental factors, diet habit and Budd-Chiari Syndrome (BCS).Methods1580 potable water samples from 2008 to 2009 were collected from 158 towns in Heze district. Water iodine concentrations were dectected using cerium sulfate catalysis spectro -photometry, and were presented in median of ten water samples in the same town.342 BCS cases between 1995 and 2007 were collected from five hospitals in Heze, including Heze Municipal Hospital, Shanxian Central Hospital, Affiliated Hospital of Xuzhou Medical College, Shandong Provincial Hospital and Beijing Xuanwu Hospital. The map of BCS cases spatial distribution was made by ArcGIS 9.3 software, and the relationships between water iodine and BCS were analyzed using spatial statistical analysis. In survey,60 people were selected in case group,69 in case family group,123 in high-iodine control group, and 62 in low iodine control group, totaling 314 people. In case group, case family group, high-iodine control group and low-iodine control group, dietary questionnaires were conducted. Meanwhile urine and blood were sampled in case group and case family group. Data about situations, dietary habits, and individual food frequency questionnaire of dietary questionnaires were imported in Epidata 3.1 software and converted into Excel table. 3 day dietary questionnaires were converted into Excel tables using Nutrition Catering system V1.1. Data is analyzed using SPSS 16.0 software. Results1.88.72% BCS patients were distributed in age 25～65, BCS incidence in Heze area was 42.23/106. The linear equation between BCS incidence and water iodine concentraion was y=0.313x-27.964 (r=0.846, P=0.008), indicating incidence increases with water iodine. According to the national standard, water iodine concentrations were categorized, and the linear equation between incidence and the average water iodine concentration was y=26.629+0.049x, P=0.019 (P<0.05), showing incidence increases with iodine.2. Significant statistical differences were found in urine within case group, case family group, high-iodine control group and low-iodine control group;the urine concentration in the case group was higher than that in other groups. Serum iodine concentrations in case group and case family group were higher than national standard level.3. Questionnaire general condition parts, no significant statistical difference was found between case group and control group on male to female ratio, age, height, weight, BMI, and family income (P>0.05). Smoking frequency in case group was higher than that in other groups (P<0.05). There was no difference on drinking and tea (P>0.05). Consuming time of 500g salt in case group was less than that in other group, implying that patients in case group consume much more salt.4. Individual food frequency questionnaire showed that there was significant difference in brunet vegetables, light color vegetables, salted food and pork. Intake frequencies of light color vegetables, pork, fish and shrimp, eggs and egg products were lower than that in low iodine control group (P<0.05), showing that protein intake in case group high, including pork, fish and shrimp, eggs and egg products, is lower than that in low iodine group. Salted intake in case group is higher than that in other groups (P<0.05)..5.3-days meals survey showed that in case group and case family group, energy, protein and fat intake were significantly lower than that in high-iodine control group and low-iodine control group (P<0.05). Vitamin A, thiamin, vitamin C, and vitamin E intake in case group were higher than that in control group (P<0.05). Thiamin, and vitamin E intake were lower than that in control group (P<0.05). Calcium intake in case group was higher than that in control group, whereas phosphor, iron, zincand selenium intake were lower than that in control group.6. Logistic regression analysis found that vitamin E, thiamin and selenium were insufficient, smoking frequency was high, manganese, vitamin A and urine iodine were overdose,, which may constitute the risk factors in BCS.Conclusion and suggestion1. High concentration of iodine in living environment, body may be the leading cause of BCS paroxysm.2. Inadequate vitamin E, selenium and thiamin intake, smoking, excessive manganese and vitamin A intake play a deteriorating role in BCS3. Excessive vitamin E, selenium and thiamin intake, nonsmoking, inadequate manganese and vitamin A intake play a protective role in BCS.4. Advise patients and local residents use no-iodine salt.
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