天津市不同水碘地区孕妇碘摄入量及碘营养状况调查

An investigation of iodine intake and iodine nutrition status of pregnant women in different water iodine areas of Tianjin

目的了解天津市不同水碘地区孕妇碘摄入量及碘营养状况,为高水碘地区制定适宜的干预措施提供依据。方法2016年1-9月,在天津市不同水碘地区(≤150、>150~300和>300μg/L),采用随机抽样方法,分别选取90、91、71名孕妇作为调查对象,采集孕妇家庭盐样、饮用水水样和尿样;并采用半定量食物频率调查表,对过去1年中孕妇12类食物的摄入情况进行调查。采用直接滴定法检测盐碘含量,采用硫酸铈催化分光光度法检测水碘含量,采用砷铈催化分光光度法检测尿碘含量。结果不同水碘地区孕妇食盐摄碘量比较差异无统计学意义(H=2.29,P=0.318);饮水摄碘量(7.50、282.60、544.35μg/d)比较差异有统计学意义(H=223.31,P<0.001),进一步两两比较,差异均有统计学意义(P均<0.001);食物摄碘量比较差异无统计学意义(H=2.19,P=0.334)。各地区随着水碘含量的升高,饮水摄碘量贡献率逐渐增大。不同水碘地区孕妇的尿碘中位数分别为113.50、180.55、268.55μg/L,尿碘与碘摄入总量呈正相关(rs=0.31,P<0.001)。结论水碘≤150μg/L地区孕妇碘营养水平不足(<150μg/L),应提高碘盐食用率,防止碘缺乏病发生;水碘>300μg/L地区孕妇碘营养水平为超适宜量(250~499μg/L),孕妇应控制碘含量较高食物的摄入,并及早采取改水降碘措施。

Objective To investigate the iodine intake and iodine nutritional status of pregnant women in different water iodine areas of Tianjin,and to provide a basis for formulating appropriate intervention measures in high water iodine areas.Methods From January to September 2016,90,91 and 71 pregnant women were randomly selected as research subjects in different water iodine areas in Tianjin(water iodine≤150,>150-300 and>300μg/L)via the random sampling method.Samples of salt,drinking water and urine were collected from pregnant women.A semi-quantitative food frequency questionnaire was used to investigate the intake of 12 kinds of food eating by pregnant women in the past year.Salt iodine content was determined by direct titration,water iodine content was determined by ceric sulfate catalytic spectrophotometry,and urinary iodine was determined by arsenic-cerium catalytic spectrophotometry.Results There was no statistically significant difference in salt iodine intake among pregnant women in different water iodine areas(H=2.29,P=0.318);the difference in drinking water iodine intake(7.50,282.60,544.35μg/d)was statistically significant(H=223.31,P<0.001),and further pairwise comparison found that the differences were statistically significant(P<0.001);the difference in food iodine intake was not statistically significant(H=2.19,P=0.334).With the increase of water iodine content in various regions,the contribution rate of drinking water iodine intake gradually increased.The medians of urinary iodine in pregnant women in different water iodine areas were 113.50,180.55 and 268.55μg/L,respectively,and there was a positive correlation between urine iodine content and total iodine intake(rs=0.31,P<0.001).Conclusions The iodine nutrition level of pregnant women in areas with water iodine≤150μg/L is insufficient(<150μg/L),so the consumption rate of iodized salt should be increased to prevent the occurrence of iodine deficiency disorders.The iodine nutrition level of pregnant women in areas with water iodine>300μg/L exceeds the appropriate amount(250-499μg/L),pregnant women should control the intake of foods with high iodine content and take measures to improve water as soon as possible to reduce iodine.