未加碘食盐地区不同水碘浓度下居民碘营养状况

许娴; 虞晨; 田翠翠; 徐署东; 刘婷婷; 李卫东

doi:10.16462/j.cnki.zhjbkz.2021.08.020

未加碘食盐地区不同水碘浓度下居民碘营养状况

doi: 10.16462/j.cnki.zhjbkz.2021.08.020

230601 合肥，安徽省疾病预防控制中心地方病与寄生虫病防治科

详细信息

通讯作者:
李卫东，E-mail: ahcdclwd@163.com

中图分类号: R591.1
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出版历程
- 收稿日期: 2021-04-02
- 修回日期: 2021-07-08
- 网络出版日期: 2021-08-24
- 刊出日期: 2021-08-10

Study on iodine nutritional status of residents with different water iodine concentrations in areas supplying non-iodized salt

Department for Endemic and Parasitic Diseases Control and Prevention, Anhui Provincial Centre for Disease Control and Prevention, Hefei 230601, China

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Corresponding author: LI Wei-dong, E-mail: ahcdclwd@163.com

摘要

摘要: 目的调查供应未加碘食盐地区居民碘营养状况，为探讨未加碘食盐供应范围提供依据。方法调查4个水碘浓度(100~<150 μg/L、90~<100 μg/L、80~<90 μg/L、70~<80 μg/L)村18~<60岁成人、8~<10岁儿童和孕妇的尿碘水平、甲状腺容积和结节、成人和孕妇甲状腺激素与抗体进行检测。结果共调查822名成人、793名儿童和87名孕妇，儿童和成人的尿碘水平在4个水碘组均超出适宜水平，孕妇尿碘除70~<80 μg/L水碘组处于适宜水平外，其他3组均处于大于适宜量水平。儿童组(χ²=25.703，P < 0.001)和成人组(χ²=13.139，P=0.004)尿碘值与饮用水含碘量均呈正向关系。不同水碘组孕妇尿碘浓度差异无统计学意义(χ²=5.178，P=0.159)。儿童甲状腺肿大率为20.8%，不同水碘组儿童甲状腺肿大率差异无统计学意义(χ²=6.361，P=0.095)；成人甲状腺结节发生率为16.0%，不同水碘组成人甲状腺结节发生率差异无统计学意义(χ²=2.863，P=0.413)。不同水碘组孕妇和成人的全血促甲状腺激素(thyroid stimulating hormone, TSH)、游离甲状腺激素(free thyroxine, FT4)、甲状腺球蛋白抗体(thyroglobulin antibodies, TGAb)和甲状腺过氧化物酶抗体(thyroid peroxidase antibodies, TPOAb)异常率差异均无统计学意义(Fisher检验，均有P>0.05)。结论饮用水碘>70 μg/L的地区应食用未加碘食盐，水碘>100 μg/L的行政村应严格落实未加碘食盐供应，水碘含量为70~<80 μg/L地区的孕妇可适当进食富碘食物补碘。
- 碘 /
- 碘盐 /
- 营养
Abstract: Objective To explore the scope of non-iodized salt supply, and to investigate the iodine nutritional status of residents in non-iodized salt supply areas. Methods The urinary iodine level, thyroid volume and nodules, thyroid hormones and antibodies of adults aged 18- < 60, children aged 8- < 10 and pregnant women in villages with 4 water iodine concentrations (100- < 150 μg/L、90- < 100 μg/L、80- < 90 μg/L、70- < 80 μg/L) were investigated. Results A total of 822 adults, 793 children, and 87 pregnant women were surveyed. The urine iodine levels of children and adults exceeded the appropriate level in the 4 water iodine groups. The urine iodine of pregnant women was at an appropriate level except for the 70- < 80 μg/L water iodine group. All three groups were at a level greater than the appropriate amount. There was a positive relationship between urinary iodine value and drinking water iodine content in children (χ²=25.703, P < 0.001) and adults (χ²= 13.139, P=0.004) group. There was no significant difference in urine iodine concentration among pregnant women in different water iodine groups (χ²=5.178, P=0.159). The rate of goiter in children was 20.8%, and there was no significant difference in the rate of thyroid gland in children between different water iodine groups (χ²=6.361, P=0.095). The incidence of adult thyroid nodules was 16.0%, and the incidence of human thyroid nodules with different water iodine composition and there was no significant difference in the incidence of adult thyroid nodules among different water iodine groups (χ²=2.863, P=0.413). There was no significant difference in the abnormal rates of TSH, PT4, TgAb and TPOAb between pregnant women and adults in different water iodine groups (Fisher test, all P>0.05). Conclusion Uniodized salt should be used in areas with the drinking water iodine>70 μg/L, and the supply of uniodized salt should be strictly implemented in administrative villages with the water iodine>100 μg/L. Pregnant women can appropriately take iodine rich food to supplement iodine in areas with water iodine content of 70- < 80 μg/L.
- Iodine /
- Iodized salt /
- Nutrition

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表 1 张庄寨镇不同水碘组儿童尿碘浓度

Table 1. Urinary iodine concentration of children in different water iodine groups in Zhangzhuangzhai Town

水碘水平(μg/L)	人数	尿碘浓度(μg/L)			尿碘浓度段(μg/L)人数
水碘水平(μg/L)	人数	P₂₅	P₅₀	P₇₅	< 50	50~<100	100~<200	200~<300	300~<500	>500
100~<150	191	212.1	352.2	527.1	2	6	33	42	55	53
90~<100	213	185.9	298.7	436.1	0	5	54	49	63	42
80~<90	208	189.3	239.9	349.4	1	8	53	70	57	19
70~<80	181	170.4	269.4	420.0	2	9	50	42	53	25
合计	793	187.7	284.2	423.1	5	28	190	203	228	139

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表 2 张庄寨镇不同水碘组成人尿碘浓度

Table 2. Adult's urinary iodine concentration of different water iodine compositions in Zhangzhuangzhai Town

水碘水平(μg/L)	人数	尿碘浓度(μg/L)			尿碘浓度段(μg/L)人数
水碘水平(μg/L)	人数	P₂₅	P₅₀	P₇₅	< 50	50~<100	100~<200	200~<300	300~<500	>500
100~<150	186	224.5	332.5	524.9	0	8	27	42	58	51
90~<100	196	200.4	288.8	400.4	3	10	35	56	58	34
80~<90	206	181.8	270.8	402.7	3	13	48	50	59	33
70~<80	180	166.5	292.9	446.3	0	13	42	39	49	37
合计	768	194.4	298.7	438.5	6	44	152	187	224	155

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表 3 张庄寨镇不同水碘组孕妇尿碘浓度

Table 3. Urinary iodine concentration of pregnant women in different water iodine groups in Zhangzhuangzhai Town

水碘水平(μg/L)	人数	尿碘浓度(μg/L)			尿碘浓度段(μg/L)人数
水碘水平(μg/L)	人数	P₂₅	P₅₀	P₇₅	< 50	50~<150	150~<250	250~<500	>500
100~<150	13	213.5	483.4	574.0	0	1	3	3	6
90~<100	33	222.2	339.2	394.6	1	2	6	24	0
80~<90	17	178.9	318.1	502.0	0	4	2	6	5
70~<80	10	178.2	199.3	258.2	0	2	5	2	1
合计	73	191.6	335.4	444.1	1	9	16	35	12

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表 4 张庄寨镇不同水碘组人群甲状腺情况

Table 4. Thyroid status of different water iodine groups in Zhangzhuangzhai Town

水碘水平(μg/L)	儿童					成人					孕妇					合计
水碘水平(μg/L)	人数	甲状腺肿大人数	甲状腺肿大率(%)	结节人数	结节率(%)	人数	甲状腺肿大人数	甲状腺肿大率(%)	结节人数	结节率(%)	人数	甲状腺肿大人数	甲状腺肿大率(%)	结节人数	结节率(%)	人数	甲状腺肿大人数	甲状腺肿大率(%)	结节人数	结节率(%)
100~<150	191	51	26.7	6	3.1	187	0	0.0	27	14.4	16	0	0.0	1	6.3	394	51	12.9	34	8.6
90~<100	213	37	17.4	0	0.0	196	2	1.0	33	16.8	38	0	0.0	1	2.6	447	39	8.7	34	7.6
80~<90	207	38	18.4	1	0.5	207	0	0.0	28	13.5	20	0	0.0	0	0.0	434	38	8.8	29	6.7
70~<80	181	39	21.5	6	3.3	221	0	0.0	42	19.0	13	0	0.0	0	0.0	415	39	9.4	48	11.6
合计	792	165	20.8	13	1.6	811	2	0.2	130	16.0	87	0	0.0	2	2.3	1 690	167	9.9	145	8.6

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表 5 张庄寨镇不同水碘组孕妇和成人甲状腺激素和抗体情况

Table 5. The status of thyroid hormones and antibodies in pregnant women and adults in different water iodine groups in Zhangzhuangzhai Town

水碘水平(μg/L)	成人											孕妇
	人数	TSH			FT4			TGAb		TPOAb		人数	TSH			FT4			TGAb		TPOAb
	人数	降低	正常	升高	降低	正常	升高	阴性	阳性	阴性	阳性	人数	降低	正常	升高	降低	正常	升高	阴性	阳性	阴性	阳性
100~<150	191	6	106	79	0	187	4	166	25	171	20	16	0	12	4	0	16	0	16	0	16	0
90~<100	196	4	121	71	2	191	3	173	23	178	18	38	0	35	3	0	38	0	34	4	34	4
80~<90	211	3	121	87	1	204	6	195	16	194	17	15	0	12	3	0	15	0	14	1	14	1
70~<80	228	1	140	87	0	225	3	207	21	210	18	13	0	13	0	0	13	0	13	0	13	0
合计	826	14	488	324	3	807	16	741	85	753	73	82	0	72	10	0	82	0	77	5	77	5

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