上海市居民碘营养及膳食碘摄入状况综合评估

Comprehensive assessment on iodine nutrition and dietary iodine intake among Shanghai residents

目的评价全面实行食盐加碘20年来上海市居民碘营养及膳食碘摄入状况的变化。方法采用砷铈催化分光光度法测定1995—2015年上海市学龄儿童、孕妇、乳母及成年人的尿碘水平,B超测定学龄儿童的甲状腺容积,计算甲状腺肿大率;采用直接滴定法/仲裁法定量检测居民户食盐中碘含量水平;采用3 d 24 h膳食询问调查及调味品称量方法开展膳食调查,分析全部食用碘盐及全部食用无碘盐情况下各人群碘摄入水平及来源。结果上海市学龄儿童尿碘水平1995年为72.3μg/L,1997—1999年为214~231μg/L,2002年之后稳定于100~200μg/L,儿童甲状腺肿大率均低于5%。孕妇尿碘的中位数为126.5~139.8μg/L,成年人、哺乳期妇女、婴幼儿及育龄妇女的尿碘中位数分别为138.4、123.1~131.1、150.1及125.6μg/L。2001—2009年居民合格碘盐食用率在90%以上,2010年开始逐年下降。如全部食用碘盐,总碘摄入量中位数7~10岁、11~13岁、14~18岁及18岁以上男性分别为200.3、235.5、252.7及215.4μg/L;女性分别为193.0、213.8、208.3及186.1μg/L。碘盐在男、女性膳食中贡献率分别为51.6%~54.1%和49.1%~53.0%。海带、紫菜及鱼虾类对碘的贡献率分别为7.6%~16.6%和4.5%~7.4%。结论近20年上海市居民的碘营养状况趋于稳定,总体处于适宜和安全的水平,但孕妇碘营养不足。碘盐是沿海地区膳食碘的主要来源。为保证居民碘的日常需要,控制居民的碘缺乏风险,上海地区继续实施食盐加碘的策略仍有必要。

Objective To assess the changes in iodine nutritional status and dietary iodine intake among Shanghai residents since universal salt iodization 20 years ago. Methods As（Ⅲ）-Ce4 ＋Catalytic spectrophotometry was used to determinate the urine iodine level in school-age children,pregnant women,lactating women and adults of Shanghai between 1995 and 2015. B ultrasonic was used to determinate the thyroid volume of school-age children. And then the goiter rate was calculated. Direct titration or arbitration methods were applied to detect the household salt iodine level quantitatively. The survey was conducted by using 3 day 24-hour dietary recall and condiment weighing methods to analyze the level of iodine intake and sources for the cases of all iodized salt consumption and all consumption of non-iodized salt. Results The median urine iodine concentration（UIC） of school age children was 72. 3 μg/L in1995,rose to 214-231 μg/L from 1997-1999,and then remain stable between 100 μg/L and 200 μg/L since 2002. The goiter rate was below 5% among children aged 8-10 from 1995-2015 in Shanghai. The median urine iodine of pregnant women was between 126. 5 μg/L and 139. 8 μg/L. The median UIC of other populations were all between 100 μg/L and 200 μg/L. For adults,lactating women,infants and young children and women of childbearing age,the median urinary iodine were 138. 4,123. 1-131. 1,150. 1 and 125. 6 μg/L. The qualified iodized salt at household consumption rates were more than 90%from 2001 to 2009,the percentage declined year by year from 2010. In the cases of all consuming iodized salt,the median iodine intake for male aged 7-10,11-13,14-18 and over 18 were 200. 3,235. 5,252. 7and 215. 4 μg/L,and women aged 7-10,11-13,14-18 and over 18 were 193. 0,213. 8,208. 3 and186. 1 μg/L. The contribution of iodine from iodized salt were 51. 6%-54. 1% and 49. 1%-53. 0% in men and women. Kelp,seaweed and fish and shrimp on the contribution of iodine were 7. 6%-16. 6% and4. 5%-7. 4%. Conclusion In the past 20 years,iodine nutritional status of residents in Shanghai has stabilized totally in a appropriate and safe level. However,the iodine nutrition of pregnant women is insufficient. As iodized salt is the major source of dietary iodine in coastal areas,it is still necessary to continue the policy of universal salt iodization in Shanghai to ensure residents＇ needs for iodine and control the risk of iodine deficiency.