摘要
目的调查适碘地区供应碘盐和供应未加碘盐的人群碘营养现状,为制定适碘地区补碘策略提供依据。方法2021年10月,选择河南省鹿邑县作为供应碘盐的适碘地区,宁陵县作为供应未加碘盐的适碘地区。按照水碘(50~59、60~69、70~79、80~89、90~100μg/L)分层,每层选择1个行政村,每个行政村抽取8~10岁儿童和成人各100名,以及孕妇20名,采集尿样和家中食用盐盐样,检测尿碘和盐碘水平;B超法检测甲状腺情况。结果鹿邑县共采集盐样600份,碘盐覆盖率为99.8%(599/600),合格碘盐食用率为95.5%(573/600);宁陵县共采集盐样1008份,未加碘盐率为93.8%(946/1008)。鹿邑县(n=240)儿童尿碘水平(中位数)高于宁陵县(n=468,305.0比232.0μg/L,Z=-8.10,P<0.001)。鹿邑县(n=120)和宁陵县(n=53)孕妇尿碘水平比较,差异无统计学意义(240.0比236.0μg/L,Z=-1.02,P=0.306)。鹿邑县(n=238)成人尿碘水平高于宁陵县(n=486,289.0比178.5μg/L,Z=-11.14,P<0.001)。鹿邑县儿童尿碘水平(r s=0.21,P=0.001)和宁陵县成人尿碘水平(r s=0.17,P<0001)与水碘均呈正相关。鹿邑县儿童甲状腺肿大率(0.8%,2/240)和宁陵县(0.4%,2/468)比较,差异无统计学意义(χ^(2)=0.80,P=0.586),但鹿邑县儿童甲状腺结节检出率(11.2%,27/240)高于宁陵县(1.7%,8/468,χ^(2)=27.36,P<0.001)。鹿邑县孕妇甲状腺结节检出率(23.3%,28/120)低于宁陵县(46.5%,33/71,χ^(2)=10.99,P=0.001)。鹿邑县和宁陵县成人甲状腺结节检出率比较,差异无统计学意义[29.6%(71/240)比32.9%(160/486),χ^(2)=0.86,P=0.354]。结论供应未加碘盐的适碘地区人群碘营养整体处于适宜水平;而供应碘盐的适碘地区儿童碘营养水平偏高,需要考虑供应未加碘盐或者下调碘盐浓度,而孕妇应保持目前供应碘盐政策不变。
Objective To compare iodine nutritional status of different populations consuming iodized salt and non-iodized salt in iodine adequate areas,and to provide a basis for formulating iodine supplementation strategies.Methods In October 2021,Luyi County in Henan Province was selected as an iodine adequate area consuming iodized salt,while Ningling County was selected as an iodine adequate area consuming non-iodized salt.Stratified by water iodine(50-59,60-69,70-79,80-89,90-100μg/L),one village was selected from each layer.One hundred children aged 8-10,one hundred adults,and 20 pregnant women were selected from each village to collect their urine and salt samples for testing salt and urinary iodine,and their thyroid gland was measured by ultrasound.Results A total of 600 salt samples in Luyi County were collected,with the coverage rate of iodized salt(99.8%,599/600)and the consuming rate of qualified iodized salt(95.5%,573/600).A total of 1008 salt samples in Ningling County were collected,with the rate of non-iodized salt(93.8%,946/1008).The median urinary iodine of children in Luyi County(n=240)was higher than that in Ningling County(n=468,305.0 vs 232.0μg/L,Z=-8.10,P<0.001).There was no statistically significant difference in median urinary iodine between pregnant women in Luyi County(n=120)and Ningling County(n=53,240.0 vs 236.0μg/L,Z=-1.02,P=0.306).The median urinary iodine of adults in Luyi County(n=238)was higher than that in Ningling County(n=486,289.0 vs 178.5μg/L,Z=-11.14,P<0.001).Children's urinary iodine(r s=0.21,P=0.001)in Luyi County and adults'urinary iodine(r s=0.17,P<0001)in Ningling County were positively correlated with water iodine.There was no statistically significant difference in the incidence of thyroid enlargement in children between Luyi County(0.8%,2/240)and Ningling County(0.4%,2/468,χ^(2)=0.80,P=0.586),but the incidence of thyroid nodules in children in Luyi County(11.2%,27/240)was higher than that in Ningling County(1.7%,8/468,χ^(2)=27.36,P<0.001).The incidence of thyroid nodules in pregnant women in Luyi County(23.3%,28/120)was lower than that in Ningling County(46.5%,33/71,χ^(2)=10.99,P=0.001).There was no statistically significant difference in the incidence of adult thyroid nodules between Luyi County and Ningling County(χ^(2)=0.86,P=0.354),with a ratio of 29.6%(71/240)to 32.9%(160/486).Conclusions Providing population with non-iodized salt in iodine adequate areas,the overall iodine nutrition is at an appropriate level.However,children consuming iodized salt in iodine adequate areas have high level of iodine nutrition,and it is necessary to consider supplying non-iodized salt or reducing the concentration of iodized salt.Pregnant women in iodine adequate area should maintain the current policy of supplying iodized salt unchanged.
作者
杨金
滕妍利
衡静雅
王改莉
李小烽
Yang Jin;Teng Yanli;Heng Jingya;Wang Gaili;Li Xiaofeng(Endemic Disease Prevention and Control Institute,Henan Provincial Center for Disease Control and Prevention,Zhengzhou 450016,China)
出处
《中华地方病学杂志》
CAS
北大核心
2024年第6期477-481,共5页
Chinese Journal of Endemiology
基金
河南省医学科技攻关计划(LHGJ20200122、LHGJ20210146、LHGJ20230621)
关键词
碘
尿
盐
甲状腺
Iodine
Urine
Salts
Thyroid
