实施新盐碘标准前后甘肃省武威市人群碘营养状况调查分析

Iodine nutritional status among the population before and after implementation of a new standard of edible iodized salt in Wuwei City of Gansu Province

目的了解实施新盐碘标准前后甘肃省武威市各类人群碘营养状况，评价新的盐碘含量能否满足不同人群的碘营养需求，为科学补碘提供科学依据。方法于实施新盐碘标准前后的2009年和2015年，选择甘肃省武威市城市和农村4类目标人群共计1 243人（包括402名8-10岁儿童、406名18-45岁成人、211名孕妇及222名哺乳妇女）作为研究对象，采集任意1次尿样，尿碘测定采用砷铈催化分光光度法（WS/T 107-2006），根据尿碘水平评价4类目标人群的碘营养状况。采用分层抽样法采集居民户盐样，盐碘测定采用直接滴定法（GB/T 13025.7-2012）。结果实施新碘盐标准前后，居民户合格碘盐食用率均在94%以上，碘盐合格率均在96%以上。盐碘中位数由31.0 mg/kg降至26.9 mg/kg；实施新盐碘标准后，8-10岁儿童、成人、孕妇和哺乳妇女的尿碘中位数分别由实施前的290.84、225.52、200.42、180.65 μg/L降至187.37、174.96、159.99、152.88 μg/L；而8-10岁儿童、成人、哺乳妇女尿碘〈 100 μg/L的比例分别由5.15%（10/194）、12.57%（24/191）、16.19%（17/105）升高至10.58%（22/208）、15.81%（34/215）、33.33%（39/117）；孕妇尿碘〈 150 μg/L的比例由39.78%（37/93）升高至43.22%（51/118）；儿童和成人尿碘在100-〈 200 μg/L的比例分别从15.46%（30/194）和30.37%（58/191）升高至44.23%（92/208）和43.26%（93/215）；8-10岁儿童、成人、孕妇、哺乳妇女尿碘≥300 μg/L的比例分别由47.94%（93/194）、34.55%（66/191）、27.96%（26/93）、28.57%（30/105）降低至17.31%（36/208）、19.07%（41/215）、16.95%（20/118）、11.97%（14/117）。结论实施新盐碘标准后，各人群碘营养水平均有所下降，其中8-10岁儿童和成人的碘营养更趋于适宜水平，孕妇和哺乳妇女碘缺乏的风险增加。

ObjectiveTo explore the iodine nutritional status of all people after the practice of new standard of edible iodized salt, to assess whether the new standard of edible iodized salt can satisfy the iodine nutrition need in different populations, and to provide a scientific basis for supplementation of iodine.MethodsBefore and after the implementation of new salt iodine concentration, in 2009 and 2015, a contrastive study was performed in 1 243 people （including 402 children aged 8 to 10 years, 408 adults aged 18 to 45 years, 211 pregnant women and 222 lactating women） who lived in urban and rural areas of Wuwei City. Random urine samples were collected to measure the urinary iodine in all populations and household salt samples were collected. Urinary iodine was detected by arsenic cerium catalytic spectrophotometry （WS/T 107-2006）. The iodine level in salt was determined by direct titration （GB/T 13025.7-2012） .ResultsBefore and after the implementation of new iodine salt standard, the coverage of adequately iodized salt was consistently higher than 94%, the qualified rate of iodized salt was consistently higher than 96%, the median of iodized salt was reduced from 31.0 mg/kg to 26.9 mg/kg; the medians of urinary iodine of children aged 8 to 10 years, adults, pregnant and breastfeeding women were reduced from 290.84, 225.52, 200.42 and 180.65 μg/L to 187.37, 174.96, 159.99 and 152.88 μg/L; the ratios of urinary iodine which was less than 100 μg/L in children aged 8 to 10 years, adults and breastfeeding women were risen from 5.15% （10/194）, 12.57% （24/191） and 16.19% （17/105） to 10.58% （22/208）, 15.81% （34/215） and 33.33% （39/117）; the ratio of urinary iodine which was less than 150 μg/L in pregnant women was risen from 39.78% （37/93） to 43.22% （51/118）; the ratios of urinary iodine between 100 and 200 μg/L in children aged 8 to 10 years and adults were risen from 15.46% （30/194） and 30.37% （58/191） to 44.23% （92/208） and 43.26% （93/215）; the ratios of urinary iodine greater than 300 μg/L in children aged 8-10, adults, pregnant and breastfeeding women were reduced from 47.94% （93/194）, 34.55% （66/191）, 29.76% （26/93） and 28.57% （30/105） to 17.31% （36/208）, 19.07% （41/215）, 16.95% （20/118） and 11.97% （14/117）.ConclusionAfter the implementation of new salt iodine concentration standard, the iodine nutrition level has decreased in all groups and better suited for children aged 8 to 10 years and adults, but the risk of iodine deficiency is increased in pregnant and breastfeeding women.