2019-2020年巴中市8~10岁儿童碘营养状况及甲状腺容积调查

Investigation on iodine nutrition status and thyroid volume of children aged 8 to 10 years old in Bazhong,Sichuan Province from 2019 to 2020

目的评价巴中市8~10岁儿童碘营养及甲状腺容积状况,为碘缺乏病防治效果评估提供依据。方法2019-2020年巴中市5个县(区)分别在其东、西、南、北、中5个片区各抽取1所小学,每所小学共抽取40名8~10岁非寄宿制儿童开展随机尿样、家中盐样碘含量检测。2019年通江县和南江县、2020年平昌县开展儿童甲状腺B超容积测量和身高、体重测量。2020年5个县(区)对抽取学校的食堂和所有学生配餐点的食盐采样检测碘含量,计算合格碘盐覆盖率。结果2019年、2020年巴中市8~10岁儿童尿碘中位数分别为239.35μg/L和248.75μg/L;儿童家中碘盐覆盖率分别为100%和99.6%,合格碘盐食用率分别为92.8%、94.4%。2020年学校食堂和配餐点的合格碘盐占100%,合格碘盐覆盖率为94.4%。2019年、2020年8~10岁儿童甲状腺肿大率分别为1.75%和3.00%,儿童甲状腺容积中位数分别为2.70 ml和2.90 ml。不同性别儿童甲状腺容积差异无统计学意义(Z=-0.759,P=0.448),不同年龄儿童甲状腺容积差异有统计学意义(H=32.520,P<0.001)。儿童甲状腺容积与身高、体重呈正相关(r=0.283,P<0.001;r=0.314,P<0.001),与尿碘、盐碘均未检出相关关系(r=0.000,P=0.998;r=-0.013,P=0.752)。不同年龄、性别和家中是否食用合格碘盐的儿童尿碘差异均无统计学意义(H=1.724,P=0.422;Z=-1.782,P=0.075;Z=-0.182,P=0.856),儿童尿碘与其家中食用盐碘未检出相关关系(r=-0.084,P=0.636)。结论巴中市8~10岁儿童碘营养状况总体充足,儿童尿碘中位数、甲状腺肿大率和合格碘盐覆盖率均达到碘缺乏病消除标准,年龄、身高和体重影响儿童的甲状腺容积,需持续开展儿童碘营养和病情监测,持续消除碘缺乏病。

Objective To evaluate the iodine nutrition status and thyroid volume of children aged 8 to10 years old in Bazhong city,and to provide a basis for the evaluation of the prevention and control effect of iodine deficiency disorders.Methods From 2019 to 2020,one primary school was selected from each of the five district:east,west,south,north and central of five counties(districts)in Bazhong city,and a total of 40 non-boarding children aged 8 to10 years old from each primary school were selected to carry out detection of iodine concentration in urine and iodine content in salt samples.The thyroid volume of children was measured by B-ultrasound and the height and weight were measured in Tongjiang,Nanjiang in 2019 and Pingchang in 2020.In 2020,salt samples were collected from school canteens and all students′catering points to detect iodine content,and the coverage rate of qualified iodized salt was calculated.Results In 2019 and 2020,the median of urinary iodine of children aged 8 to 10 years old in Bazhong were 239.35μg/L and248.75μg/L respectively,the coverage rates of iodized salt in children′s home were 100%and99.6%respectively,and the consumption rates of qualified iodized salt were 92.8%and 94.4%respectively.In 2020,the proportion of qualified iodized salt in school canteens and catering points was 100%,and the coverage rate of qualified iodized salt was 94.4%.In 2019 and 2020,the goiter rates in children aged 8 to 10 years old were 1.75%and 3.00%respectively,and the median of thyroid volume were 2.70 ml and 2.90 ml respectively.The thyroid volume was no statistical difference between different gander children(Z=-0.759,P=0.448),and increased with age(H=32.520,P<0.001),positively correlated with height(r=0.283,P<0.001),weight(r=0.314,P<0.001),but not correlated with the urine iodine and salt iodine(r=0.000,P=0.998;r=-0.013,P=0.752).There were no statistical differences in urinary iodine among children of different ages,genders and whether consumed qualified iodized salt(H=1.724,P=0.422;Z=-1.782,P=0.075;Z=-0.182,P=0.856),there was no correlation detected between urinary iodine and salt iodine in children(r=-0.084,P=0.636).Conclusions The iodine nutritional status of children aged 8 to10 years old in Bazhong city is generally at a sufficient level,and the median of urinary iodine,the goiter rate and the coverage rate of qualified iodized salt have reached the elimination standard of iodine deficiency disorders.The age,height and weight affect the thyroid volume of children,so it is necessary to carry out continuous monitoring of iodine nutrition and condition of iodine deficiency disorders of children to continuously eliminate iodine deficiency disorders.