婴幼儿脑发育关键期碘营养与生长发育关系的研究

Study on the relationship between iodine status and growth in infants at the key period of brain development

目的探讨婴幼儿脑发育关键期碘营养状况与生长发育的关系。方法2006—2010年在甘肃省临夏回族自治州对所有乡镇的女性从孕期开始补充碘油至哺乳期结束，并对断乳的3岁内婴幼儿补充碘油，然后从8县（市）分别按照东、西、南、北、中随机抽取5个乡，每个乡随机抽取1个村，每个村随机抽取0—3岁婴幼儿、孕妇及乳母各20名（不足者从邻近村庄补足），逐年监测孕妇、乳母、婴幼儿尿碘。2010年测定部分婴幼儿智商（DQ）、身高、体重。并抽取干预前0～3岁婴幼儿作为对照。结果碘油干预前（2006年）和后（2007—2010年）各测定1056及2989名婴幼儿尿碘。干预后婴幼儿尿碘中位数从107．3μg／L上升为139．6～190．7μg，L，尿碘低于50μg／L的比例从23．9％下降为6．7％～12．9％，DQ值从92．8提高为104．3，身高发育正常及以上的比例从65．0％上升为82．1％，体重正常及以上的比例从59．3％上升至81．4％，DQ值、身高和体重与干预前相比差异均有统计学意义（P〈0．05）。孕妇尿碘从89．3pg／L上升为118．2～187．8μg／L，乳母尿碘从84．9μg/L上升为135．2～187．5μg／L。结论脑发育关键期碘营养不足会导致婴幼儿生长发育落后，通过口服碘油能改善碘缺乏造成的生长发育障碍。

Objective To investigate the relationship between iodine nutrition and growth/ development in infants at the key period of brain development. Methods All women from pregnancy to the end of lactation and the weaning infants within 3 years in the Linxia Hui Autonomous Prefecture （Linxia Prefecture） were added iodized oil in 2006-2010. In 2006, 2010 one town was randomly selected from each of the five directions （east, south, west, north, central） of each county in Linxia Prefecture. One village was chosen from every town and 20 infants, 20 pregnant women and 20 lactating women were randomly selected in each town. Urinary iodine （UI） of the infants, pregnant and lactating women were determined. DQ value, height and weight of part of infants were measured. According to the above sampling plan, UI of pregnant women, lactating women and infants had been monitored every year after intervention. 0-3 infants were choosing to be control before intervention. Results UI of 1056 and 2989 0-3 infants were investigated before and after the iodine oil intervention. After the ＇iodine oil＇ intervention, the median UI of infants increased from 107.3 μg/L to 139.6-190.7 μg/L, the percentage of UI level that lower than 50 μg/L, decreased from 23.9% to 6.7%-12.9%. DQ value increased from 92.8 to 104.3, the percentage of normal height and above increased from 65.0% to 82.1% and the percentage of the normal weight and above, increased from 59.3% to 81.4% .The outcomes of DQ value, height and weight showed statistically significant differences, compared to the preintervention outcomes （P〈0.05）. The median UI of pregnant and lactating women increased from 89.3 μg/L to 118.2-187.8 μg/L and from 84.9 μg/L to 135.2-187.5 μg/L respectively. Conclusion Infant＇ s growth and development were retarded when iodine deficiency existed at the key period of brain development. Intake of oral iodine oil at key period of brain development could provide adequate nutrition thus improve growth and development on infants.