第三次碘盐标准调整对北京市昌平区儿童与孕妇碘营养水平的影响

Effect of the third adjustment of iodized salt standard on iodine nutrient level of children and pregnant women in Changping District of Beijing

目的评估北京市昌平区第三次碘盐标准调整前后,儿童和孕妇碘营养水平变化,发现可能存在的碘缺乏风险,以便采取更加适宜的补碘策略。方法按照《北京市碘盐监测实施方案》和《北京市碘缺乏病监测方案》开展监测,收集昌平区2009-2019年碘缺乏病监测数据,分碘盐标准调整前后和过渡期3个阶段对盐碘及尿碘数据进行分析。结果 2009-2019年共监测居民户食用盐3 252份,8~10岁儿童尿碘2 712份,孕妇尿碘2 730份。碘盐标准调整前、过渡期和调整后盐碘中位数分别为31.2 mg/kg、25.4 mg/kg和22.3 mg/kg,3个阶段盐碘水平差异有统计学意义(H=1 362.155,P<0.01),呈显著下降趋势;碘盐标准调整前、过渡期和调整后儿童尿碘中位数分别为266.7μg/L、162.1μg/L和175.3μg/L,3个阶段儿童尿碘水平差异有统计学意义(H=325.791,P<0.01),由WHO推荐碘营养超过适宜量降至碘适宜量;碘盐标准调整前、过渡期和调整后孕妇尿碘中位数分别为181.1μg/L、150.3μg/L和139.8μg/L,3个阶段孕妇尿碘水平差异有统计学意义(H=101.111,P<0.01),由WHO推荐的碘营养适宜量下降到不足量。结论碘盐标准调整后我区学龄儿童碘营养状况更趋于适宜、合理;但孕妇碘营养不足,应通过加强健康教育使孕妇有意识增加含碘丰富的食物摄入,以改善碘不足的现状。

Objective To investigate the possible risks of iodine deficiency and adopt a more appropriate iodine supplementation strategy,we evaluated the changes in the iodine nutrition status of children and pregnant women after the third adjustment of the iodized salt standard in Changping District,Beijing.Methods The surveillance was carried out according to the Beijing iodized salt monitoring and implementation plan and the Beijing iodine deficiency disease surveillance program,the monitoring data consisted of iodine deficiency disorders in Changping District from 2009 to 2019,an analysis about the data before,after and in transitional period of iodized salt standard adjustment was given.Results From 2009 to 2019,a total of 3 252 samples of edible salt in households,2 712 samples of urine iodine in children aged 8-10,and 2 730 samples of urine iodine in pregnant women were tested.The median iodized salt before the adjustment,in transitional period and after the adjustment of the iodized salt standard was 31.2 mg/kg,25.4 mg/kg and 22.3 mg/kg,respectively.The difference of iodized salt levels among the three stages was statistically significant(H=1 362.155,P<0.01),showing a significant downward trend.The medians urinary iodine of children before the adjustment,in transitional period and after the adjustment of the iodized salt standard were 266.7 μg/L,162.1 μg/L and 175.3 μg/L,respectively.The difference of urinary iodine of children levels among the three stages was statistically significant(H=325.791,P<0.01),iodine nutrient level had reduced to the optimal amount of iodine recommended by the WHO.The medians urinary iodine of pregnant women before adjustment,in transitional period and after adjustment of the iodized salt standard were 181.1 μg/L,150.1 μg/L and 139.8 μg/L,respectively.The differences of urinary iodine of pregnant women levels among the three stages were statistically significant(H=101.111,P<0.01),iodine nutrient level of the appropriate amount recommended by the WHO fell to an insufficient amount.Conclusion After the adjustment of iodized salt standard,the iodine nutritional status of school-age children in our district was more appropriate and reasonable,but the iodine nutritional status of pregnant women was insufficient.However,in order to improve the status of pregnant women iodine deficiency,health education should be strengthened to make pregnant women consciously increase their intake of iodine-rich foods.