我国孕妇尿碘状况及分布

STATUS AND DISTRIBUTION OF URINARY IODINE AMONG CHINESE PREGNANT WOMEN

目的通过分析我国不同地区孕妇尿碘水平,评价孕妇碘营养状况。方法6078名孕妇尿碘样本来源于2015年成人慢性病与营养监测项目。根据WHO/UNICEF/ICCIDD推荐的孕妇人群碘营养状况尿碘评价标准,评估孕妇碘营养状况。结果孕妇尿碘中位数146.0μg/L,城市和农村分别为147.0μg/L和143.9μg/L。51.8%孕妇尿碘水平低于150μg/L,14.6%孕妇尿碘水平介于250~499μg/L,2.3%孕妇尿碘含量大于500μg/L,只有31.3%的孕妇碘营养状况处于适宜水平(150~249μg/L)。东部地区孕妇尿碘低于<150μg/L比例最高,达到55.4%,同时东部地区合格碘盐食用率也是最低的(87.2%),并且显著低于中部和西部地区(P<0.0001)。中部地区孕妇尿碘处于适宜水平的比例最高(34.7%),其尿碘中位数显著高于东部和西部地区(P<0.0001)。孕妇孕早、中、晚期之间尿碘中位数存在显著差异(P<0.0001),孕早期尿碘中位数显著高于孕中期和孕晚期。结论我国孕妇尿碘中位数总体水平已接近适宜碘营养状况的下限(150μg/L)且部分地区合格碘盐食用率低于90%,应持续监测孕妇碘营养状况。

Objective To evaluate the nutritional status of iodine among Chinese pregnant women in different regions by analyzing their levels of urinary iodine.Methods A total of 6078 urine iodine samples were obtained from pregnant women that had participated in the 2015 Adult Chronic Disease and Nutrition Survey.The criteria for assessing iodine nutrition based on the median urinary iodine concentrations of pregnant women were recommended by the WHO/UNICEF/ICCIDD.Results The median urinary iodine concentration of pregnant women was 146.0μg/L,147.0μg/L for urban pregnant women and 143.9μg/L for rural pregnant ones.Pregnant women whose urine iodine concentrations were lower than 150μg/accounted for 51.8%,those whose urinary iodine concentrations ranged from 250 to 499μg/L made up 14.6%,those whose urine iodine concentration exceeded 500μg/L accounted for 2.3%,and only 31.3%of the pregnant women were at the levels of urinary iodine that were in the appropriate range(150-249μg/L).The proportion of pregnant women whose urinary iodine concentrations were less than 150μg/L was the highest in eastern China(55.4%),where the qualified iodized salt coverage rate was also the lowest(87.2%),significantly lower than in central and western China(P<0.0001).The proportion of pregnant women with appropriate urinary iodine concentrations was the highest(34.7%)in central China,where the median urinary iodine concentration was significantly higher than that in eastern and western China(P<0.0001).The median urinary iodine concentration of pregnant women in the first trimester was significantly higher than in the second and third trimester.Conclusion The median urinary iodine concentration of pregnant women is close to the cutoff for adequate iodine status(150μg/L)and the qualified iodized salt coverage rate is lower than 90%in some regions.The iodine nutritional status of pregnant women should be continuously monitored.