2016-2022年宝鸡市人群碘营养状况分析

Iodine nutrition status of Baoji population from 2016 to 2022

目的分析盐碘含量调整后陕西省宝鸡市人群碘营养状况,评价现行碘缺乏病防控工作效果。方法收集2016-2022年宝鸡市碘缺乏病监测数据资料(来自宝鸡市疾病预防控制中心和宝鸡市妇幼保健院),分析8~10岁儿童和孕妇尿碘含量、家中食用盐碘含量,及新生儿足跟血促甲状腺激素(TSH)水平测定结果。采用Mann-Kendall检验、线性趋势χ^(2)检验进行数据统计分析。结果2016-2022年共检测盐样26812份,盐碘中位数为24.09 mg/kg,合格碘盐食用率为97.84%(26234/26812)。共检测8~10岁儿童尿样17877份,尿碘中位数为218.41μg/L;共检测孕妇尿样8935份,尿碘中位数为184.59μg/L;共检测新生儿足跟血121607份,TSH中位数为2.00 mU/L。随着年份增加,盐碘、儿童尿碘和孕妇尿碘中位数均未见明显趋势变化(Z趋势=1.80、-1.50、0.30,均P>0.05),但新生儿足跟血TSH中位数总体呈下降趋势(Z趋势=-1.97,P=0.048);随着年份增加,合格碘盐(盐碘含量18~33 mg/kg)、儿童碘充足(尿碘100~299μg/L)、孕妇碘适宜(尿碘150~249μg/L)的构成比总体均呈上升趋势(χ^(2)趋势=122.74、26.56、28.43,均P<0.001),但新生儿足跟血TSH>5.0 mU/L的构成比总体呈下降趋势(χ^(2)趋势=1634.43,P<0.001)。结论2016-2022年宝鸡市盐碘含量、人群碘营养水平符合国家碘缺乏病消除标准,建议加强人群科学食用碘盐和补碘的健康教育。

Objective To analyze the iodine nutrition status of the population in Baoji City,Shaanxi Province after adjusting the salt iodine content,and evaluate the effectiveness of current prevention and control measures for iodine deficiency disorders(IDD).Methods IDD surveillance data in Baoji City from 2016 to 2022(from the Baoji Center for Disease Control and Prevention and the Baoji Maternity and Child Care Hospital)were collected,iodine content in urine of children aged 8 to 10,pregnant women and household salt was analyzed,and the thyroid stimulating hormone(TSH)of neonatal heel blood was determined.Mann-Kendall test and linear trendχ^(2)test were used to test the trend.Results A total of 26812 salt samples were tested from 2016 to 2022,with a median salt iodine concentration of 24.09 mg/kg and a qualified iodine salt consumption rate of 97.84%(26234/26812).A total of 17877 urine samples of children aged 8 to 10 were tested,with a median urine iodine of 218.41μg/L,8935 urine samples of pregnant women were tested,with a median urine iodine of 184.59μg/L,and 121607 blood samples of newborns were tested,with a median TSH of 2.00 mU/L.With the increase of years,there was no significant trend in the median of salt iodine,child urine iodine and maternal urine iodine(Ztrend=1.80,-1.50,0.30,P>0.05),however,the median of neonatal TSH showed an overall downward trend(Ztrend=-1.97,P=0.048).As the years increase,the proportion of qualified iodized salt(18-33 mg/kg of salt iodine),adequate iodine content of children(100-299μg/L of urine iodine)and appropriate iodine content of pregnant women(150-249μg/L of urine iodine)showed an increasing trend(χ^(2)trend=122.74,26.56,28.43,P<0.001),however,the proportion of TSH>5.0 mU/L in neonatal heel blood decreased linearly(χ^(2)trend=1634.43,P<0.001).Conclusions From 2016 to 2022,the salt iodine content and iodine nutrition level of the population in Baoji City have met the national standard for eliminating IDD.It is recommended to strengthen the health education of scientifically eating iodized salt and supplementing iodine.