2013-2021年西藏自治区大骨节病病区学龄儿童体内硒营养变化评估

Changes of selenium nutritional level of school-age children in Kashin-Beck disease areas in Tibet Autonomous Region from 2013 to 2021

目的评估西藏自治区(简称西藏)大骨节病病区拉萨市林周县、日喀则市谢通门县学龄儿童体内硒营养变化情况,为采取针对性防治措施提供科学依据。方法根据大骨节病历史病情,2013、2021年在林周县大骨节病病区卡孜乡、非病区江夏乡,2015、2021年在谢通门县大骨节病病区仁钦则乡、非病区通门乡所在地中心小学,共采集学龄儿童发样344份,测定硒元素含量。结果相较2013/2015年,2021年4个乡的儿童发硒水平均上升(均P<0.001),约90%儿童体内硒营养水平达中等及以上(发硒>0.25μg/g)。2021年卡孜、仁钦则病区乡女童发硒水平均低于男童(Z=-2.83、-2.83,均P<0.05)。结论林周县、谢通门县大骨节病病区学龄儿童体内硒营养水平近年来快速上升,但女童体内硒营养水平明显低于男童。建议加强相关防控和监测,家校联动进一步改善学龄儿童膳食结构。

Objective To assess the changes of selenium nutrition of school-age children in Kashin-Beck disease(KBD)areas of Linzhou County,Lhasa City and Xietongmen County,Shigatse City in Tibet Autonomous Region(referred to as Tibet),and provide a scientific basis for evaluating the effectiveness of prevention and control measures.Methods According to the historical condition of KBD,a total of 344 children's hair samples were collected to determine the content of selenium in Kazi(KBD area)and Jiangxia townships(non-KBD area)of Linzhou County in 2013 and 2021,Renqinze(KBD area)and Tongmen townships(non-KBD area)of Xietongmen County in 2015 and 2021.Results Compared to 2013/2015,in 2021,the hair selenium level of children in the four townships increased(P<0.001).The selenium nutritional level of more than 90%of the children reached medium or above(hair selenium>0.25μg/g)in 2021.The hair selenium levels of girls in the two KBD areas(Kazi and Renqinze townships)were lower than those of boys(Z=-2.83,-2.83,P<0.05).Conclusions The selenium nutrition level of school-age children in KBD areas in Linzhou and Xietongmen counties has increased rapidly in recent years.However,the selenium nutrition level of girls is significantly lower than that of boys.It is necessary to strengthen prevention,controlling and monitoring,and to further improve the dietary structure of school-age children through the joint efforts of families and schools,to increase the proportion of exogenous high selenium food intake.