2018年河南省濮阳市高碘与非高碘地区儿童及孕妇碘营养水平调查

Survey of iodine nutrition levels among children and pregnant women in high iodine and non-high iodine areas in Puyang City of Henan Province in 2018

目的了解濮阳市新确定的高碘与非高碘地区居民碘营养状况,为相关部门调整补碘政策提供依据。方法根据2017年生活饮用水碘含量调查结果,于2018年采用分层、系统抽样方法,在濮阳市新确定的高碘与非高碘地区各抽取25个村,每个村调查40名儿童、20名孕妇,测定调查对象尿碘含量、家中食盐碘含量,并测定高碘与非高碘地区各10个村儿童的甲状腺容积。结果高碘与非高碘地区各调查居民家庭食用盐1357、1544份,碘盐覆盖率分别为87.91%(1193/1357)、85.62%(1322/1544),两地区碘盐覆盖率比较差异无统计学意义(χ^2=3.291,P>0.05)。高碘地区共调查1028名儿童和329名孕妇,尿碘中位数分别为337.0、289.0μg/L;非高碘地区共调查1041名儿童和503名孕妇,尿碘中位数分别为310.0、265.0μg/L,两地区儿童和孕妇尿碘中位数比较差异有统计学意义(Z=-3.825、-2.795,P均<0.05)。对高碘地区407名儿童、非高碘地区423名儿童检测甲状腺容积,甲状腺肿大(甲肿)率分别为8.85%(36/407)、3.78%(16/423),两地区儿童甲肿率比较差异有统计学意义(χ^2=9.053,P<0.05)。结论濮阳市高碘地区儿童和孕妇碘营养水平均高于非高碘地区,应尽快在高碘地区停供碘盐,在非高碘地区调查论证降低食盐加碘浓度的可行性,确保居民碘营养水平适宜。

Objective To understand the iodine nutritional status of residents in the newly identified high iodine and non-high iodine areas in Puyang,and to provide evidence for relevant departments to adjust the iodine supplementation policy.Methods According to the survey results of drinking water iodine content in 2017,in 2018 stratified and systematic sampling methods were used to extract 25 villages in the newly identified high iodine areas and non-high iodine areas in Puyang City.Each village surveyed 40 children and 20 pregnant women,the urinary iodine content of the subjects and the salt iodine content at their home were measured,and the thyroid volume of children in 10 villages in high iodine and non-high iodine areas was measured.Results In high iodine areas and non-high iodine areas,the household salt samples collected were 1357 and 1544,respectively,the iodized salt coverage rate was 87.91%(1193/1357)and 85.62%(1322/1544),respectively,and the difference was not statistically significant(χ^2=3.291,P>0.05).A total of 1028 children and 329 pregnant women in high iodine areas were investigated,their median urinary iodine content was 337.0 and 289.0μg/L,respectively;a total of 1041 children and 503 pregnant women in non-high iodine areas were investigated,their median urinary iodine content were 310.0 and 265.0μg/L,the differences of the urinary iodine content between high iodine and non-high iodine areas were statistically significant(Z=-3.825,-2.795,P<0.05).Thyroid volume was measured in 407 children in high iodine areas and 423 children in non-high iodine areas.The thyroid enlargement rate was 8.85%(36/407)and 3.78%(16/423),respectively,and the difference was statistically significant(χ^2=9.053,P<0.05).Conclusions The iodine nutrition levels of children and pregnant women in high iodine areas are higher than those in non-high iodine areas.Iodized salt should be stopped supplying in high iodine areas as soon as possible.In non-high iodine areas,the feasibility of reducing the iodine concentration of iodized salt should be investigated to ensure the iodine nutrition level of local residents.