特定地区藏族育龄妇女碘营养及甲状腺功能对比研究

Comparative study of iodine nutrition and thyroid function in Tibetan women of childbearing age in specific areas

目的研究青海省特定地区藏族育龄妇女碘营养和甲状腺功能状况,为持续消除碘缺乏病危害提供依据。方法依据青海省2019—2021年儿童碘缺乏病监测资料,选择农业区(海南州贵南县)、牧业区(玉树州杂多县、治多县、囊谦县)作为研究现场,最终纳入研究样本数量73例(农业区30例、牧业区43例),采集符合纳入标准的育龄妇女一次性随意尿样进行尿碘检测、采集血样进行甲状腺功能学指标检测。结果2019—2021年农业区、牧业区儿童尿碘不同年份两个地区比较差异均有统计学意义(Z=-12.103、-9.963、-4.758,P均<0.05),农业区和牧业区育龄妇女尿碘M(P25,P75)分别为155.35(98.35,244.98)、118.60(51.60,197.00)μg/L,不同地区比较差异无统计学意义(Z=-1.699,P>0.05),农业区、牧业区FT3、TT3水平比较差异均有统计学意义(Z=-4.009、t=-3.792,P均<0.05),FT_(4)、TT_(4)、TSH、TG水平比较差异均无统计学意义(Z=-0.908、-1.592、-1.172、-1.200,P均>0.05),TgAb阳性率、TPOAb阳性率、双抗阳性率差异无统计学意义(χ^(2)=0.852、0.073、0.001,P均>0.05)。结论历年农、牧业区儿童碘营养处于适宜状态;本次调查农、牧业区藏族育龄妇女碘营养水平处于适宜状态,甲状腺功能指标提示牧业区育龄妇女可能存在碘缺乏的风险,建议继续实施食盐加碘措施,对重点地区、重点人群落实针对性防治措施。

Objective To study the iodine nutrition and thyroid function status of Tibetan women of childbearing age in specific areas of Qinghai Province,and to provide a basis for the sustainable elimination of iodine deficiency disorders hazards.Methods Based on the iodine deficiency disorders surveillance data of children in Qinghai Province from 2019 to 2021,agricultural areas(Guinan County,Hainan Prefecture)and pastoral areas(Zaduo County,Zhiduo County and Nangqian County,Yushu Prefecture)were selected as the study sites,and the final number of samples included in the study was 73 cases(agricultural areas:30 cases,pastoral areas:43 cases).One-time random urine samples for urine iodine testing and blood samples for thyroid function tests were collected from women of childbearing age who met the inclusion criteria.Results The differences in urinary iodine of children in agricultural and pastoral areas from 2019 to 2021 were statistically significant when comparing the two areas in different years(Z=-12.103,-9.963,-4.758,all P<0.05),and the urinary iodine M(P25,P75)of women of childbearing age in agricultural and pastoral areas were 155.35(98.35,244.98),118.60(51.60,197.00)μg/L,with no statistically significant difference between different areas(Z=-1.699,P>0.05),and statistically significant difference between FT3and TT3levels in agricultural and pastoral areas(Z=-4.009,t=-3.792,both P<0.05),and no statistically significant difference between FT_(4),TT_(4),TSH and TG levels(Z=-0.908,-1.592,-1.172,-1.200,all P>0.05),and the differences in TgAb positive rate,TPOAb positive rate,and double antibodies positive rate were not statistically significant(χ^(2)=0.852,0.073,0.001,all P>0.05).Conclusion The iodine nutrition of children in agricultural and pastoral areas is in an appropriate state in previous years.The iodine nutrition level of Tibetan women of childbearing age in agricultural and pastoral areas in this survey is in an appropriate state,and thyroid function indicators suggest that women of childbearing age in pastoral areas might be at risk of iodine deficiency,and it is suggested that salt iodization measures should be continued to be implemented,and targeted prevention and treatment measures should be implemented for key areas and key population.