高水碘地区学龄儿童、成人及孕妇的碘营养状况调查

Survey on iodine nutrition in high water regions of children,adult and the third trimester pregnant women in China

目的了解高碘地区停供碘盐后高碘地区学龄儿童、成人及孕妇的碘营养状况，探讨高碘地区不同人群碘营养状况是否存在差异。方法采用现况调查的方法，选择河北省沧州市高碘地区7个乡镇村落的371例儿童、506例成人及210例孕妇为研究对象，采集调查对象晨尿，测定尿碘水平；采集当地饮水，测定饮水碘含量。结果调查地区水碘在150．3～962．6μg／L范围内；所调查儿童、成人及孕妇的尿碘中位数分别为1032．08、1152．01和1240．70μg／L，其中儿童和成人中分别有96．2％和93．1％尿碘水平大于300μg／L，84．3％的孕妇尿碘水平大于500μg／L，处于碘过量状态。高碘地区儿童、成人及孕妇尿碘分布具有统计学差异（χ2=44．84，P=0．000），并且Kruskal—WallisH秩和检验表明，高碘地区儿童、成人及孕妇尿碘中位数不全相同（χ2=12．83，P=0．002），两两分析表明孕妇的尿碘中位数与儿童及成人有显著性差异。结论停供碘盐以来，高水碘地区儿童、成人及孕妇3个不同人群仍处于碘过量状态，应当加强高碘地区不同人群的碘营养状况监测及指导；儿童的尿碘水平不能完全代表孕妇的碘营养状况，应建立孕妇自身的碘营养状况监测标准。

Objective To investigate the iodine nutrition status of the susceptible population after stop supplying iodized salt and discuss whether there is iodine nutritional status difference in different populations in high-iodine areas in China. Methods Spot investigation methods were being used, 371 children, 506 adults and 210 cases of pregnant women during the third trimester were selected as respondents. The morning Urine was collected to determinate the urine iodine level. Drinking water was collected to determinate the local water iodine level. Results The water iodine level was betweenlSO. 3 -962.6μg/L in investigation areas; The median urinary iodine （MUI） of children, adults and pregnant woman was respective 1032.08 μg/L, 1152.01 μg/L and1240.70 μg/L. Meanwhile 96.2% children and 93.1% adults urine iodine level was more than 300 μg/L and 84. 3% of pregnant womeb urine iodine level was more than 500 μg/L, which belongs to excessive iodine intake. The chi-square test on the distribution of urinary iodine indicate that there is statistical differences in three different population （χ2 = 44.84, P = 0. 000）. Kruskal-Wallis H test show that the MUI in three different crowd are not all the same （χ2 = 12.83 ,P =0. 002） , when compared by pairs, the difference in MUI between pregnant and children or adults was founded. Conclusion The iodine nutrition status of children, adult and the third trimester pregnant women in high water regions were iodine excess. The monitor on iodine nutrition status in different peoples should be enhaneedo Urinary iodine level of Children can＇t completely represent the iodine nutritional status of pregnant women, iodine nutritional status monitor standard for pregnant women should be established.