2019 - 2021年武汉市成人碘营养及甲状腺结节患病状况调查

Investigation on iodine nutrition and prevalence of thyroid nodules among adults in Wuhan City from 2019 to 2021

目的了解武汉市成人碘盐食用情况、碘营养水平及甲状腺结节患病状况,为武汉市继续贯彻落实食盐加碘政策提供依据。方法2019-2021年,采用多阶段整群随机抽样方法,在武汉市13个区,每个区抽取2个社区或乡镇,每个社区或乡镇抽取16岁及以上常住居民100人,采集家中食用盐盐样和个体随机尿样,检测盐碘、尿碘含量,并进行体格检查和甲状腺超声检查等。结果共调查武汉市16岁及以上常住居民2578人,碘盐覆盖率为92.09%(2374/2578),合格碘盐食用率为86.11%(2220/2578),成人尿碘中位数为185.32μg/L。甲状腺结节检出率为35.49%(915/2578),其中男性低于女性(χ^(2)=62.43,P<0.001),有随年龄增加而增高的趋势(χ^(2)_(趋势)=91.83,P<0.001),中心城区低于远城区(χ^(2)=23.17,P<0.001)。甲状腺正常组与结节组、单发结节组与多发结节组的食用盐碘含量、碘盐覆盖率、合格碘盐食用率、尿碘含量比较差异均无统计学意义(均P>0.05)。经Spearman相关分析,甲状腺结节检出率与食用盐碘含量及尿碘含量均无相关性(r=-0.012、0.017,均P>0.05)。结论盐业改革后武汉市成人合格碘盐食用率较低,碘营养处于适宜水平,甲状腺结节检出率较高,且检出率随年龄增加而增高,女性高于男性,未发现碘盐食用状况及碘营养水平与甲状腺结节患病相关。

Objective To study the status of iodized salt consumption,iodine nutrition and thyroid nodules among adults in Wuhan City,so as to provide a basis for continuing implement the salt iodization policy in Wuhan City.Methods From 2019 to 2021,a multi-stage cluster random sampling method was used in 13 districts of Wuhan City.Two communities or townships were selected from each district,and 100 permanent residents over 16 years old were selected from each community or township.Household salt samples and individual random urine samples were collected.Physical examination,salt iodine test,urinary iodine test and thyroid ultrasound examination were performed.Results A total of 2578 permanent residents over 16 years old in Wuhan City were surveyed,with an iodized salt coverage rate of 92.09%(2374/2578)and a qualified iodized salt consumption rate of 86.11%(2220/2578).The median adult urinary iodine was 185.32μg/L.The detection rate of thyroid nodules was 35.49%(915/2578).The detection rate of thyroid nodules was significantly lower in males than in females(χ^(2)=62.43,P<0.001),with a trend of increasing with age(χ^(2)_(trend)=91.83,P<0.001),with a lower detection rate in central urban areas than in remote urban areas(χ^(2)=23.17,P<0.001).There were no statistically significant differences in the iodine content of edible salt,iodized salt coverage rate,qualified iodized salt consumption rate,and urinary iodine content between adults with and without thyroid nodule,as well as between the single nodule group and the multiple nodule group(P>0.05).According to Spearman correlation analysis,there was no correlation between the detection rate of thyroid nodules and the iodine content in edible salt and urine(r=-0.012,0.017,P>0.05).Conclusions After the salt industry reform,the qualified iodized salt consumption rate among adults in Wuhan City has slightly decreased,and the iodine nutritional status is at an appropriate level.The prevalence of thyroid nodules is relatively high,and increases with age,which is higher in females than in males.Iodine nutrition and iodized salt consumption are not found to be associated with thyroid nodules.