2020年湖北省重点人群碘营养水平及空间分布状况

Iodine nutrition level and its spatial distribution in key populations in Hubei Province in 2020

目的了解湖北省重点人群碘营养水平及空间分布现状,为下一步补碘政策的调整、实现科学精准补碘提供依据。方法2020年湖北省按《全国碘缺乏病监测方案(2016版)》进行抽样,监测重点人群(8~10岁儿童、孕妇)盐碘、尿碘水平。采用空间流行病学方法分析碘营养水平的空间分布。结果8~10岁儿童(17263人)家庭食用盐盐碘中位数为25.0 mg/kg,尿碘中位数为217.0μg/L;儿童县级尿碘水平分布存在显著空间聚集(Moran′s Index=0.36,P<0.001),热点地区主要在十堰和襄阳市,冷点地区主要在宜昌市。孕妇(8618人)家庭食用盐盐碘中位数为25.1 mg/kg,尿碘中位数为176.3μg/L;孕妇县级尿碘水平分布存在显著空间聚集(Moran′s Index=0.22,P=0.003),热点地区主要在恩施土家族苗族自治州,冷点地区主要在宜昌市。结论2020年湖北省儿童碘营养处于超适宜水平(200~299μg/L),孕妇碘营养接近适宜水平下限(150μg/L)。儿童和孕妇的县级尿碘水平均存在显著的空间聚集,需有针对性地对尿碘水平低于或高于正常范围的县区进行干预,以实现精准科学补碘。

Objective To learn about the iodine nutrition level and its spatial distribution status in key populations in Hubei Province,so as to provide a basis for adjustment of iodine supplementation policy and the realization of scientific and accurate iodine supplementation.Methods In 2020,a sampling was carried out in Hubei Province according to the"National Iodine Deficiency Disorders Monitoring Plan(2016 Edition)"to monitor the concentration of salt iodine and urinary iodine of key populations(children ages 8-10 years old and pregnant women).The spatial distribution of iodine nutrition levels was analyzed by spatial epidemiology.Results The median salt iodine of 17263 children's family salt samples was 25.0 mg/kg,and the median urinary iodine(MUI)was 217.0μg/L.There was significant spatial aggregation in the distribution of urinary iodine level in children at the county level(Moran's Index=0.36,P<0.001).The significant hot spot areas with high urinary iodine level among children were located in Shiyan City and Xiangyang City,while the significant cold spot areas with low urinary iodine level were mainly concentrated in Yichang City.The median salt iodine of 8618 pregnant women's family salt samples was 25.1 mg/kg,the MUI was 176.3μg/L.The urinary iodine level among pregnant women at the county level was spatially clustered(Moran's Index=0.22,P=0.003).The significant hot spot areas with high urinary iodine level among pregnant women were mainly in Enshi Tujia and Miao Autonomous Prefecture,the significant cold spot areas were mainly concentrated in Yichang City.Conclusions In 2020,the iodine nutrition of children in Hubei Province is at a super appropriate level(200-299μg/L),and the iodine nutrition status of pregnant women is more sensitive,which is close to the lower limit of the appropriate level(150μg/L).The urinary iodine level of children and pregnant women has significant spatial aggregation at the county level.Targeted intervention will be needed in counties(dictricts)where the urinary iodine level is lower or higher than the normal range,to achieve accurate and scientific iodine supplementation.