我们旨在研究碘摄入与乳头状甲状腺微小癌（PTMC）中央淋巴结转移（CLNM）和侧向淋巴结转移（LLNM）之间的关联。利用尿碘浓度（UIC）和临床病理特征，通过 logistic 回归分析识别与 CLNM 和 LLNM 相关的因素。共纳入 3,858 名 PTMC 患者。CLNM 或 LLNM 患者的中位数尿碘浓度（MUI）与无淋巴结转移患者的差异在统计学上无显著性。男性患者的 MUI 高于女性患者（183.4 μg/L vs. 173.6 μg/L）。有外包膜侵犯的女性患者的 MUI 高于无外包膜侵犯的女性患者（210.0 μg/L vs. 172.1 μg/L）。LLNM 的男性患者的 MUI 显著低于无 LLNM 的男性患者（134.7 μg/L vs. 187.9 μg/L）。摄入碘超过所需量的女性患者比摄入足够碘的患者更容易出现 CLNM 和甲状腺外扩，调整后的几率比值（95% 置信区间）分别为 1.23（1.01-1.51）和 1.59（1.09-2.32）。碘营养与 LLNM 无关。此外，年龄较小、肿瘤较大、甲状腺外扩和甲状腺内蔓延的患者更容易出现 CLNM，而结节性甲状腺肿对 CLNM 具有保护因素；无论是男性还是女性，CLNM 是 PTMC 中 LLNM 的唯一相关因素。总之，碘营养与女性患者的关联更为密切，高碘摄入可能与女性 PTMC 患者的 CLNM 和甲状腺外扩相关。© 2023 赵、胡、崔、宫和黄的版权所有。

We aimed to investigate the association between iodine intake and nodal metastasis stratified by central lymph node metastasis (CLNM) and lateral lymph node metastasis (LLNM) of papillary thyroid microcarcinoma (PTMC). Urinary iodine concentration (UIC) and clinicopathological characteristics were used to identify factors associated with CLNM and LLNM using logistic regression analysis. A sum of 3,858 PTMC patients were enrolled. The median UIC (MUI) of patients with CLNM or LLNM was not statistically different from those without nodal metastasis. Male patients had a higher MUI than females (183.4 μg/L vs. 173.6 μg/L). Female patients with extracapsular extension had a higher MUI than those without it (210.0 μg/L vs. 172.1 μg/L). Male patients with LLNM had a significantly lower MUI than those without LLNM (134.7 μg/L vs. 187.9 μg/L). Female patients with more than adequate iodine intake were more likely to present with CLNM and extrathyroidal extension than those with adequate iodine intake with an odds ratio (95% confidence interval) of 1.23 (1.01-1.51) and 1.59 (1.09-2.32) after adjustment. Iodine nutrition was not found to be associated with LLNM. In addition, patients with a younger age, larger tumors, extrathyroidal extension, and intrathyroidal spread were more likely to be CLNM, whereas nodular goiter presented with a protective factor; CLNM was the only factor associated with LLNM of PTMC in both genders. In conclusion, iodine nutrition has a much closer association with female than male patients, and high iodine intake may be associated with CLNM and extrathyroidal extension in female PTMC patients.Copyright © 2023 Zhao, Hu, Cui, Gong and Huang.