2008年广西沿海地区碘缺乏病重点人群碘营养状况调查

Investigation of the nutrition status of the focus groups of iodine deficiency in coastal areas in Guangxi in 2008

目的 调查2008年广西沿海5个县（区）碘缺乏病重点人群碘营养状况,提出相应防治措施.方法 在广西碘盐监测中碘盐覆盖率、碘盐合格率和居民合格碘盐食用率一直处于全区低水平的北海市海城区、铁山港区、银海区、合浦县以及钦州市钦南区5个沿海县（区）,采用随机抽样的方法,合浦县抽取6个乡（镇）,其余县（区）各抽取3个乡（镇）,每个乡（镇）抽取2个行政村,每个行政村抽取40名8～10岁学龄儿童及10名18～42岁育龄妇女（要求包括有半数比例的妊娠妇女和哺乳期妇女）,用砷铈催化分光光度法（WS/T 107-2006）检测尿碘.结果 共采集8～10岁儿童尿样1437份,尿碘中位数为191.0μg/L,〈20μg/L的比例为1.4%（20/1437）,〈50μg/L的比例为5.4%（77/1437）,〈100μg/L的比例为20.3%（292/1437）;5个县（区）儿童尿碘中位数为134.5～220.0μg/L,其中海城区、合浦县儿童尿碘中位数〉200 μg/L（分别为220.0、209.5μg/L）,其他3个县（区）儿童尿碘中位数均在100～200μg/L适宜范围内（分别为134.5、162.4、199.3μg/L）;8、9岁组儿童尿碘中位数（192.3、206.7μg/L）均高于10岁组（157.2μg/L,χ^2值分别为19.644、41.997,P均〈0.017）.共采集妇女尿样365份,5个县（区）妇女尿碘中位数为88.2～195.6μg/L,其中海城区和合浦县妇女尿碘中位数〉150 μg/L（分别为195.6、156.5μg/L）,铁山港区妇女尿碘中位数最低（88.2μg/L）且〈100μg/L;在妊娠妇女、哺乳期妇女、育龄妇女中,育龄妇女尿碘中位数最高,为152.6μg/L,哺乳期妇女尿碘中位数为131.9μg/L,妊娠妇女尿碘中位数最低（89.4 μg/L）且〈100μg/L,仅有6.7%（2/30）的妊娠妇女尿碘水平处于150～250μg/L适宜范围.结论 广西沿海5个县（区）8～10岁儿童碘营养状况良好,育龄妇女和哺乳期妇女尿碘水平在碘营养适宜范围内,妊娠妇女整体上未达碘营养适宜水平.建议将妊娠妇女碘营养监测纳入常规监测,进一步落实碘盐防治措施,加强健康教育宣传,提高碘盐覆盖率.

Objective To investigate the nutrition status of the focus groups of iodine deficiency in the 5 coastal counties（districts）in Guangxi in 2008 to propose corresponding prevention and control measures.Methods In the 5 coastal counties（districts）in Guangxi,including Haicheng,Tieshangang,Yinhai districts and Hepu county in Beihai city,Qinnan district in Qinzhou city,the rates of iodized salt coverage,qualified iodized salt and consumption of qualified iodized salt had always been below the average level of Guangxi.In the study,6 towns were randomly picked in Hepu district,and 3 towns were randomly picked in each of the other 4 coastal counties（districts）.Two administrative viRages were randomly picked in each town.Forty children ages 8 to 10 and 10 women of child-beating age from 18 to 42 which included 5 pregnant and lactating women,were picked from each administrative village.Arsenic-cerium catalyzed spectrophotometry（WS/T 107-2006）Was used to determine the urinary iodine.Results In total,1437 urine samples of the children Were picked.The median of the children＇s urinary iodine Was 191.0μg/L,with 1.4%（20/1437）of the children＇s urinary iodine〈20 μg/L,and 5.4%（77/1437）〈50 μg/L, and 20.3%（292/1437） 〈 100 μg/L. The medians of the children＇s urinary iodine were 134.5 - 220.0 μg/L.In Haicheng and Hepu, the medians of the children＇s urinary iodine were higher than 200 μg/L（220.0,209.5 μg/L, respectively）. The medians of the children＇s urinary iodine in the other 3 counties（districts） were within the suitable range between 100 and 200 μg/L（134.5,162.4,199.3 μg/L, respectively）. The medians of the 8- and 9-year-old ehildren＇s urinary iodine （192.3,206.7 μg/L, respectively） were higher than that of the 10-year-old children＇s（157.2 μg/L, χ^2= 19.644,41.997, all P 〈 0.017）. Totally, 365 urine samples of the women were picked.The medians of the women＇s urinary iodine in the 5 counties were 88.2 - 195.6 μg/L, with 195.6 μg/L in Haicheng and 156.5 μg/L in Hepu, and 88.2 μg/L in Tieshangang, which was the lowest and below 100 μg/L. The median of the childbearing-age women＇s urinary iodine was the highest（152.6 μg/L）. The median of the lactating women＇s urinary iodine was the second （131.9 μg/L）. The median of the pregnant women＇s urinary iodine was the lowest （89.4 μg/L） and below 100 μg/L. Only 6.7%（2/30） of the pregnant women＇s urinary iodine were within the suitable range between 150 and 250 μg,/L. Conclusions In the 5 coastal counties（districts） in Guangxi, 8 to 10-year-old children had good nutrition levels while childbearing-age and lactating women were within the suitable range. As a whole, the pregnant women had insufficient iodine nutrition. We propose that the iodine nutritional status of pregnant women is monitored routinely, with further prevention, control measures, health publicity and education necessary to improve iodized salt coverage.