2022年内蒙古自治区碘缺乏和适碘地区儿童和孕妇碘营养水平分析

Iodine nutrition levels of children and pregnant women in iodine deficient areas and iodine adequate areas of Inner Mongolia Autonomous Region in 2022

目的掌握内蒙古自治区(简称内蒙古)碘缺乏和适碘地区8~10岁儿童和孕妇碘营养水平,为碘缺乏病防治研究提供科学依据。方法2022年3-7月,对内蒙古12个盟市104个旗(县、市、区)的碘缺乏和适碘地区进行碘营养分析,每个监测旗(县、市、区)按东、西、南、北、中划分5个抽样片区,每个片区抽取1个苏木(乡镇、街道),每个苏木(乡镇、街道)抽取1所小学,每所小学抽取8~10岁非寄宿学生40名,对其中1/3学生进行甲状腺B超检查;每个监测旗(县、市、区)在所抽取的5个苏木(乡镇、街道)各抽取孕妇20名。采集儿童和孕妇家中食用盐盐样和一次随机尿样,检测盐碘和尿碘含量。结果2022年,内蒙古碘缺乏和适碘地区8~10岁儿童甲状腺容积中位数为2.44 ml,甲状腺肿大率(甲肿率)为1.89%(123/6496),不同盟市甲状腺容积和甲肿率比较,差异均有统计学意义(H=1229.05,χ^(2)=34.13,均P<0.001);12个盟市的碘盐覆盖率为98.51%(30628/31090),合格碘盐食用率为94.42%(29355/31090),盐碘中位数为22.80 mg/kg;儿童(n=20968)尿碘中位数为195.00μg/L,其中7个盟市的尿碘中位数处于碘适宜水平(100~199μg/L),5个盟市的尿碘中位数处于超适宜量水平(200~299μg/L);孕妇(n=10122)尿碘中位数为168.00μg/L,除了巴彦淖尔市(149.18μg/L),其他11个盟市的尿碘中位数均处于碘适宜水平(150~249μg/L)。结论内蒙古儿童和孕妇的总体碘营养均处于适宜水平,但部分孕妇仍存在碘营养不足风险,今后碘缺乏病防治重点应为特需人群的碘营养监测。

Objective To investigate the iodine nutrition levels of children aged 8-10 and pregnant women in iodine deficient areas and iodine adequate areas of Inner Mongolia Autonomous Region(Inner Mongolia for short),and to provide scientific basis for prevention and treatment of iodine deficiency disorders.Methods From March to July 2022,iodine nutrition analysis was conducted in iodine deficient areas and iodine adequate areas of 104 banners(counties,cities and districts)in 12 league cities in Inner Mongolia.Each monitoring banner(county,city and district)was divided into five sampling areas by east,west,south,north,and center,with one Sumu(township,street)selected from each area.One primary school was selected from each Sumu(township,street),and 40 non-boarding students aged 8-10 were selected from each primary school.One third of the students underwent thyroid ultrasound examination.Twenty pregnant women were selected from each of the 5 Sumus(townships,streets)in each monitoring banner(county,city and district).Household salt samples and random urine samples of children and pregnant women were collected to detect salt iodine and urinary iodine levels.Results In 2022,the median thyroid volume of children aged 8-10 in iodine deficient areas and iodine adequate areas of Inner Mongolia was 2.44 ml,and the goiter rate was 1.89%(123/6496).There were statistically significant differences in thyroid volume and goiter rate between different league cities(H=1229.05,χ^(2)=34.13,P<0.001).The coverage rate of iodized salt in 12 league cities was 98.51%(30628/31090),the consumption rate of qualified iodized salt was 94.42%(29355/31090),and the median salt iodine was 22.80 mg/kg.The median urinary iodine of children(n=20968)was 195.00μg/L,among which the median urinary iodine in 7 league cities was at the appropriate level of iodine nutrition(100-199μg/L),and the median urinary iodine in 5 league cities was at the level of iodine nutrition exceeding the appropriate level(200-299μg/L).The median urinary iodine of pregnant women(n=10122)was 168.00μg/L,among which,except for Bayannur(149.18μg/L),the median urinary iodine in other 11 league cities was at the appropriate level of iodine nutrition(150-249μg/L).Conclusions The overall iodine nutrition of children and pregnant women in Inner Mongolia is at an appropriate level,but some pregnant women still face the risk of iodine deficiency.In the future,the focus of iodine deficiency disorders prevention and control should be on iodine nutrition monitoring for special needs populations.