海南省重点人群碘营养状况及其与水碘、盐碘的相关性

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目的:了解海南省重点人群碘营养状况及其与水碘、盐碘的相关性,为科学补碘提供依据。方法:按照《全国生活饮用水水碘含量调查方案》和《全国碘缺乏病监测方案(2016版)》要求,2017、2018年在海南省21个市(县、区)进行生活饮用水水碘和重点人群碘营养状况调查。分别采集水样、8 ~ 10岁儿童和孕妇随意1次尿样及家中食用盐盐样,进行水碘、尿碘、盐碘检测。同时,采用B超法测定儿童甲状腺容积,计算甲状腺肿大率。并根据地理位置将海南省分为中部山区、西部沿海和东部沿海3个地区,比较和分析不同地区水碘、盐碘、尿碘检测结果。水碘检测采用国家碘缺乏病参照实验室推荐的“适合缺碘及高碘地区水碘检测的方法研究”;尿碘检测采用砷铈催化分光光度法;盐碘检测采用直接滴定法。结果:共检测水样2 566份,水碘中位数为6.0 μg/L。共检测儿童尿样4 220份,尿碘中位数为170.0 μg/L(适宜范围为100 ~ 199 μg/L),甲状腺肿大率为0.09%(4/4 220)。共检测孕妇尿样2 124份,尿碘中位数为120.7 μg/L(适宜范围为150 ~ 249 μg/L)。共检测盐样6 344份,碘盐覆盖率、碘盐合格率、合格碘盐食用率分别为97.76%(6 202/6 344)、97.47%(6 045/6 202)、95.29%(6 045/6 344)。中部山区、西部沿海、东部沿海水碘中位数分别为3.3、6.5、6.5 μg/L,组间比较差异有统计学意义(n H = 13.721,n P < 0.01);合格碘盐食用率分别为97.86%(1 833/1 873)、90.52%(1 613/1 782)、96.65%(2 599/2 689),组间比较差异有统计学意义(χ n 2 = 71.217,n P < 0.01);儿童尿碘中位数分别为182.4、160.1、167.4 μg/L;孕妇尿碘中位数分别为120.1、117.7、103.9 μg/L。儿童、孕妇尿碘水平与盐碘呈正相关( n r = 0.394、0.657,n P均< 0.05)。n 结论:海南省儿童碘营养总体处于适宜水平,孕妇存在碘营养不足的风险,儿童、孕妇尿碘水平与盐碘呈正相关。碘缺乏病防治应重点加强对孕妇的碘营养监测。“,”Objective:To understand the iodine nutritional status of key population and its correlation with water iodine and salt iodine in Hainan Province, and to provide scientific basis for iodine supplement.Methods:According to the “National Water Iodine Content Survey Program for Drinking Water” and the “National Iodine Deficiency Disorders Surveillance Program (2016)”, surveys on water iodine and iodine nutritional status of key populations in 21 cities (counties, districts) in Hainan Province in 2017 and 2018 were conducted. Water samples, urine samples at random and home salt samples of children aged 8 - 10 years old and pregnant women were collected to detect water iodine, urinary iodine and salt iodine. At the same time, the thyroid volume of children was measured by B-mode ultrasound, and the goiter rate was calculated. According to the geographical location, Hainan Province was divided into 3 areas: central mountainous, western coastal and eastern coastal, the results of water iodine, salt iodine and urinary iodine in different areas were compared and analyzed. Water iodine was detected by “Water Iodine Detection Method Suitable for Iodine Deficiency and High Iodine Areas” recommended by National Reference Laboratory for Iodine Deficiency Disorders; urinary iodine was detected by arsenic cerium catalytic spectrophotometry; salt iodine was detected by direct titration.Results:A total of 2 566 water samples were detected, and the median water iodine was 6.0 μg/L. A total of 4 220 urine samples of children were detected, the median urinary iodine was 170.0 μg/L (appropriate range was 100 - 199 μg/L), the goiter rate was 0.09% (4/4 220). A total of 2 124 urine samples of pregnant women were detected, the median urinary iodine was 120.7 μg/L (appropriate range was 150 - 249 μg/L). A total of 6 344 salt samples were detected, coverage rate of iodized salt, qualified rate of iodized salt and consumption rate of qualified iodized salt were 97.76% (6 202/6 344), 97.47% (6 045/6 202), and 95.29% (6 045/6 344), respectively. In central mountainous, western coastal and eastern coastal areas, medians water iodine were 3.3, 6.5, and 6.5 μg/L, respectively, the difference was statistically significant ( n H = 13.721, n P < 0.01); the consumption rates of qualified iodized salt were 97.86% (1 833/1 873), 90.52% (1 613/1 782), and 96.65% (2 599/2 689), respectively, the difference was statistically significant (χ n 2 = 71.217, n P < 0.01); the medians urinary iodine of children were 182.4, 160.1, and 167.4 μg/L, respectively; the medians urinary iodine of pregnant women were 120.1, 117.7, and 103.9 μg/L, respectively. There was a positive correlation between urinary iodine in children and pregnant women and salt iodine ( n r = 0.394, 0.657, n P < 0.05).n Conclusions:The iodine nutrition of children in Hainan Province is generally at an appropriate level, and pregnant women are at risk of iodine deficiency. There is a positive correlation between urinary iodine in children and pregnant women and salt iodine. The prevention and treatment of iodine deficiency disorders should focus on strengthening iodine nutrition monitoring of pregnant women.
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