安徽省水源性高碘地区重点人群碘营养水平分析及防治措施探讨

Analysis of iodine nutrition level of key population and discussion on prevention and control measures in high water-iodine areas in Anhui Province

目的了解安徽省水源性高碘地区重点人群碘营养水平,为制订高碘地区防治措施提供科学依据。方法2021年,在新划定的25个水源性高碘县(市、区,以下简称县)开展调查工作,各调查县将水碘中位数>100μg/L的行政村按水碘值排序,采用系统抽样方法,每个县抽5个行政村,少于5个则全部抽取(如有水碘中位数在300μg/L以上的行政村,至少抽取1个)。采集调查村生活饮用水样、儿童尿样、盐样和甲状腺容积、孕妇尿样和盐样。结果共调查居民户食用盐5380份,其中未加碘食盐2863份,未加碘食盐率为53.2%。调查113个行政村水碘含量,水碘中位数为130.8μg/L,将水碘分为<40、40~100和>100μg/L三组,不同水碘组居民未加碘食盐率有统计学差异,<40μg/L水碘组未加碘食盐率最高(χ^(2)=43.54,P<0.001)。调查6~12岁儿童4436名,尿碘中位数为354.2μg/L,55名儿童甲状腺肿大,甲状腺肿大率为1.2%;孕妇944人,尿碘中位数为241.4μg/L。随着水碘值的升高,儿童和孕妇尿碘中位数均有升高的趋势,>100μg/L水碘组尿碘中位数最高,差异均有统计学意义(H=191.17、15.58,P均<0.001);40~100μg/L水碘组儿童和孕妇是否食用碘盐,其尿碘中位数差异有统计学意义(H=40.13、4.53,P<0.001、0.033)。结论安徽省水源性高碘地区未加碘食盐率较低,儿童尿碘处于碘过量水平,孕妇处于碘适宜水平。今后工作中,应结合水碘和尿碘监测结果变化及时调整防治措施。

ObjectiveTo investigate the iodine nutritional status of key population in high water-iodine areas in Anhui Province so as to provide scientific basis for formulating prevention and control measures in high water-iodine areas.MethodsIn 2021monitoring work was carried out in the newly designated 25 high water-iodine counties cities districts counties for short.The administrative villages with a median water iodine above 100μg/L were sorted according to the water iodine value and systematic sampling method was adopted.Five administrative villages were selected in each county if less than five all the villages were se village should be selected.Drinking water samples children.s urine samples salt samples and thyroid volume urine samples and salt samples of pregnant women were collected and investigated.ResultsA total of 5380 edible salt samples were investigated including 2863 non-iodine salts the rate of non-iodine salt was 53.2%.The water iodine content of 113 administrative villages>100μg/L.There were significant differences in the rate of non-iodine salt among residents in different water iodine groups.The highest rate of non-iodine salt was the group of<40μg/L water iodine groupχ^(2)=43.54 P<0.001.A total of 4436 children aged 6-12 years were monitored and the median urinary iodine was 354.2μg/L.Fifty-five children had goiter and the rate of goiter was 1.2%.A total of 944 pregnant women were investigated and the median urinary iodine was 241.4μg/L.With the in crease of water iodine value the medians urinary iodine of children and pregnant women increased.The highest of the median u rinary iopregnant women in the 40-100μg/L water i odine group ate iodine salt or not the differences of median urinary iodine were statistically significant H=40.134.53 P<0.0010.033.ConclusionThe rate of non-iodine salt in high water-iodine areas of Anhui Province was low.The children.s urinary iodine was at iodine excess level and the pregnant women was at the ap propriate level.In the future the prevention and control measures should be timely adjusted in combination with the monitoring changes of water iodine and urinary iodine.