摘要
目的研究甘肃省不同儿童碘营养水平地区人群碘营养和甲状腺功能状况,评估不同碘营养水平地区人群碘营养状况的健康风险,为科学补碘提供依据。方法依据2009年甘肃省8~10岁儿童尿碘监测结果,选择尿碘中位数>300μg/L的凉州区、尿碘中位数在200~300μg/L之间的临泽县和尿碘中位数在100~200μg/L之间的华亭县作为研究地点,并结合2014年本研究8~10岁儿童尿碘调查结果,华亭县为碘过量地区、凉州区为碘适宜1地区、临泽县为碘适宜2地区。于2014年6月~2014年12月对每个研究点按东、南、西、北、中随机选择一个乡,每个乡选择8~10岁儿童20名(男女各半)、18~49岁成年男性、未孕育龄妇女、哺乳期妇女和孕妇各10名,采集随机一次性尿样进行尿碘检测,采集血样进行甲状腺功能检测,采集哺乳期妇女和孕妇家中食用盐进行盐碘检测。选择其中3个乡的60名8~10岁儿童开展家庭食盐摄入量调查。采集所有集中式供水出厂水样2份,在其覆盖范围内按东、西、南、北、中五个方位,采集末梢水水样各1份;分散式供水每个乡东、南、西、北、中五个方位各采集水样1份进行水碘检测。结果碘过量地区、碘适宜1地区和碘适宜2地区水碘中位数分别为2.32μg/L、0.70μg/L和6.18μg/L,外环境缺碘。碘过量地区、碘适宜1地区和碘适宜2地区食用盐中位数分别为25.3 mg/kg、25.0 mg/kg和28.6 mg/kg,3个地区均未发现非碘盐。碘过量地区、碘适宜1地区和碘适宜2地区人群尿碘中位数之间有统计学意义(P<0.05)。碘过量地区、碘适宜1地区和碘适宜2地区TSH、FT4和FT3均有统计学意义(P<0.05)。碘过量地区不同人群TGAb和TMAb阳性率比较均无统计学意义;碘适宜1地区和碘适宜2地区不同人群TGAb和TMAb阳性率比较均有统计学意义,表现为未孕育龄妇女阳性率最高。碘过量地区、碘适宜1地区和碘适宜2地区不同人群均有甲状腺功能异常的发生,并以亚甲减发生最常见且8~10岁儿童发生率最高。结论碘过量地区、碘适宜1地区和碘适宜2地区人均日摄盐量可能是目前影响人群碘营养差异的主要因素;碘适宜地区孕妇和哺乳期妇女存在隐形碘摄入不足;甲状腺功能异常发生以亚甲减为主,尤以儿童为最高。
Objective To find out the iodine nutrition and thyroid function of people in different iodine nutrition level of children in Gansu Province,and to provide a scientific basis for iodine supplementation.Methods The median urinary iodine was greater than or equal to 300μg/L in Liangzhou district,from 200 to 299μg/L in Linze county and 100 to 199μg/L in Huating county were selected according to 8-10 years old children urinary iodine in 2009.Huating county,Liangzhou district and Linze county were respectively as area of excessive iodine,suitable area 1 of iodine and suitable area 2 of iodine according to 8-10 years old children urinary iodine in 2014.According to the east,west,south,north and middle position in each research point,salt iodine,urine samples and thyroid function randomly selected 20 children aged 8-10,adult men aged 18-49,non pregnant women of childbearing age,lactating women and pregnant women(10 of each level)in each township were collected.Salt intake was carried out on 60 children in 3 townships.2 samples were collected in each centralized water supplies,1 sample was collected in its coverage by the east,west,south,north and middle position;1 sample was collected by the east,west,south,north and middle position in decentralized water supplies.They were detected by water iodine.Results The medians of water iodine were 2.32μg/L,0.70μg/L and 6.18μg/L,respectively,and the median of salt iodine were respectively 25.3 mg/kg,25.0 mg/kg and 28.6 mg/kg for area of excessive iodine,suitable area 1 of iodine and suitable area 2 of iodine.Per capita daily intake of salt were respectively 15.0 g,11.3 g and 4.7 g for area of excessive iodine,suitable area 1 of iodine and suitable area 2 of iodine.There was statistical significance between the median of urine iodine in iodine excess area,suitable area 1 of iodine and suitable area 2 of iodine.TSH,FT4 and FT3 in iodine excess area,suitable area 1 of iodine and suitable area 2 of iodine were statistical significance.There was no significant difference in the positive rates of TGAb and TMAb in iodine excess area;There was significant difference in the positive rates of TGAb and TMAb in iodine suitable 1 area and iodine suitable 2 area.There are abnormal thyroid function in iodine excess area,suitable area 1 of iodine and suitable area 2 of iodine.The incidence of hypothyroidism is the most common and the highest among children aged 8-10 years.Conclusion Per capita daily intake of salt in iodine excess area,suitable area 1 of iodine and suitable area 2 of iodine may be the main factors affecting the difference of iodine nutrition among the population at present;Lack of invisible iodine intake in pregnant women and lactating women in suitable area of iodine,subclinical hypothyroidism is the main cause of thyroid dysfunction,especially in children.
作者
窦瑜贵
王燕玲
孙玮
曹永琴
郑菁
朱小南
DOU Yu-gui;WANG Yan-ling;SUN Wei;CAO Yong-qin;ZHENG Jing;ZHU Xiao-nan(Gansu Center for Disease Prevention and Control,Lanzhou 730020,China)
出处
《中国地方病防治》
CAS
2019年第6期601-606,共6页
Chinese Journal of Control of Endemic Diseases
基金
甘肃省卫生行业科研计划管理项目(GWGL2013-38).
