盐业体制改革前后甘肃省人群碘营养状况分析

Iodine nutritional status of population before and after system reform of salt industry in Gansu Province

目的 了解盐业体制改革对甘肃省人群碘营养的影响,为相关部门政策调整提供科学依据。方法 将2014—2021年分为两个时期:盐业体制改革前(2014—2016年)、后(2017—2021年),2014年按“人口比例概率抽样(PPS)方法”抽取30个县,2016—2021年按照甘肃省碘缺乏病监测方案,以8~10岁儿童和孕妇为研究对象,采集尿样检测尿碘;抽取2014年和2018年儿童测量甲状腺容积。结果 共调查儿童尿碘90 989份,中位数为194.70μg/L;两个时期分别调查儿童尿碘7 663份、83 326份,中位数分别为180.73μg/L、196.00μg/L,差异有统计学意义(P<0.05)。共调查孕妇尿碘44 741份,中位数为176.50μg/L;两个时期分别调查孕妇尿碘4 480份、40 261份,中位数分别为160.61μg/L、178.10μg/L,差异有统计学意义(P<0.05)。两个时期分别检测1 555名、8 509名儿童甲状腺,甲状腺容积中位数分别为2.70 mL、2.55 mL,差异有统计学意义(P<0.05);甲肿率分别为3.15%、1.26%,差异有统计学意义(P<0.05)。结论 盐业体制改革后甘肃省人群碘营养未见明显波动,总体保持适宜水平;需持续关注儿童、孕妇等重点人群碘营养水平不足的潜在风险及甲状腺健康;加强科学补碘健康教育。

Objective To understand the impact of system reform of salt industry on iodine nutrition of people in Gansu Province,and to provide a scientific basis for policy adjustment of relevant departments.Methods The investigation period(2014-2021)was divided into two sub-periods:before system reform of salt industry(2014-2016)and after system reform of salt industry(2017-2021).Thirty counties were selected according to the method of"population proportional probability sampling(PPS)"in 2014.According to the iodine deficiency disease monitoring program of Gansu Province,from 2016 to 2021,children aged 8-10 years and pregnant women were taken as research objects to collect urine samples for urine iodine detection.Children in 2014 and 2018 were selected to measure thyroid volume.Results A total of 90989 children urine iodine samples were investigated,and the median urinary iodine(MUI)of children was 194.70μg/L;7663 and 83,326 children′s urinary iodine samples were investigated in the two periods,the MUI was 180.73μg/L and 196.00μg/L,respectively,and the difference was statistically significant(P<0.05).A total of 44741 pregnant women′s urinary iodine samples were investigated,and the MUI of pregnant women was 176.50μg/L;4480 and 40261 pregnant women′s urinary iodine samples were investigated in the two periods,the MUI was 160.61μg/L and 178.10μg/L,respectively,and the difference was statistically significant(P<0.05).The thyroid volume of 1555 children and 8509 children was investigated in the two periods,the median thyroid volume was 2.70 mL and 2.55 mL,respectively,and the difference was statistically significant(P<0.05).The rates of goiter in children were 3.15%and 1.26%,respectively,and the difference was statistically significant(P<0.05).Conclusion The iodine nutrition of people in Gansu Province has not fluctuated significantly after the reform of salt industry system and has maintained an appropriate level.It is necessary to pay attention to the potential risk of insufficient iodine nutrition level and thyroid health of key populations such as children and pregnant women and strengthen health education of scientific iodine supplementation.