摘要
目的了解《水源性高碘地区和高碘病区的划定》(GB/T 19380-2016)标准(以下简称新标准)实施4年后(2021年)河南省儿童碘营养状况和居民户非碘盐食用情况,为科学调整干预策略提供依据。方法2021年,按照新标准的要求,并依据河南省2017-2020年水碘调查结果,在全省47个存在高碘行政村(居委会,以下简称行政村)的县(市、区,以下简称县)开展水源性高碘地区儿童碘营养状况调查。每个县选取5个水碘中位数>100μg/L的行政村作为调查村,采集水样测定水碘含量;每个调查村抽取40名8~10岁非寄宿学生(年龄均衡、男女各半,不足40名时年龄扩大到6~12岁)作为调查对象,采集其家中食用盐盐样和随机1次尿样检测盐碘、尿碘含量,同时测量儿童甲状腺容积。并进一步对停供碘盐措施<4年(新高碘地区)和>10年地区(原高碘地区)的监测结果进行比较分析。结果全省共监测257个行政村,水碘范围为1.6~609.5μg/L,中位数为132.5μg/L。共对8611名儿童进行盐碘、尿碘、甲状腺容积检测,非碘盐率为58.3%(5017/8611),尿碘中位数为342.2μg/L,甲状腺肿大率为2.9%(250/8611)。新高碘地区水碘中位数(153.0比118.4μg/L)、儿童尿碘中位数(371.6比287.7μg/L)及甲状腺肿大率[3.8%(211/5537)比1.3%(39/3074)]均高于原高碘地区,差异均有统计学意义(Z=583.12、-14.09,均P<0.001;χ^(2)=44.40,P<0.001);而非碘盐率低于原高碘地区[37.2%(2057/5537)比96.3%(2960/3074)],差异有统计学意义(χ^(2)=2841.37,P<0.001)。结论2021年河南省水源性高碘地区儿童碘营养处于过量状态,但居民户非碘盐率较低。应全力保障新标准实施后高碘地区非碘盐的精准供应,并加强重点人群碘营养监测和健康教育工作,防止高碘危害。
Objective To investigate the iodine nutritional status of children and the consumption condition of non-iodized salt in Henan Province after implementation of the new standard of"Definition and demarcation of water-borne iodine-excess areas and iodine-excess endemial areas"(GB/T 19380-2016,hereinafter referred to as new standard)for four years(2021),and to provide a basis for scientific adjustment of intervention strategies.Methods In 2021,according to the requirements of the new standard and based on the results of the water iodine survey in Henan Province from 2017 to 2020,a survey was conducted on the iodine nutrition status of children in water-borne high iodine areas in 47 counties(cities,districts,hereinafter referred to as counties)with high iodine administrative village(neighborhood committee,hereinafter referred to as administrative village).In each county,5 administrative villages with median water iodine>100μg/L were selected as the investigation villages,and water samples were collected to determine the water iodine value.Forty non-boarding students aged 8-10(age balanced,half male and half female,age increased to 6-12 when less than 40)were selected from each village as investigation subjects.Salt samples from their homes and urine samples were collected to detect salt iodine and urine iodine content,and thyroid volume of children was measured.And the monitoring results of areas where the supply of iodized salt had been suspended for less than 4 years(in newly high iodine areas)and more than 10 years(in previously high iodine areas)were further compared and analyzed.Results A total of 257 administrative villages in the province were monitored,and the range of water iodine was 1.6-609.5μg/L,with a median of 132.5μg/L.A total of 8611 children were tested for salt iodine,urine iodine and thyroid volume.The non-iodized salt rate was 58.3%(5017/8611),and the median urine iodine was 342.2μg/L,thyroid enlargement rate was 2.9%(250/8611).The median water iodine(153.0 vs 118.4μg/L),the median urine iodine in children(371.6 vs 287.7μg/L)and the goiter rate[3.8%(211/5537)vs 1.3%(39/3074)]in the newly high iodine areas were higher than those in the previously high iodine areas,and the differences were statistically significant(Z=583.12,-14.09,P<0.001;χ^(2)=44.40,P<0.001);the non-iodized salt rate was lower than that of the previously high iodine areas[37.2%(2057/5537)vs 96.3%(2960/3074)],and the difference was statistically significant(χ^(2)=2841.37,P<0.001).Conclusions The iodine nutrition level of children in water-borne high iodine areas of Henan Province in 2021 is at an excess level,but the non-iodized salt rate in residential households is low.We should make every effort to ensure the precise supply of non-iodized salt in high iodine areas after implementation of the new standard,and strengthen iodine nutrition monitoring and health education for key populations to prevent the occurrence of high iodine hazards.
作者
朱琳
滕妍利
衡婧雅
郭巧云
杨金
刘洋
Zhu Lin;Teng Yanli;Heng Jingya;Guo Qiaoyun;Yang Jin;Liu Yang(Institute for Endemic Disease Control and Prevention,Henan Provincial Center for Disease Control and Prevention,Zhengzhou 450016,China;Institute for AIDS/STD Prevention and Cure,Henan Provincial Center for Disease Control and Prevention,Zhengzhou 450016,China)
出处
《中华地方病学杂志》
CAS
北大核心
2024年第1期43-48,共6页
Chinese Journal of Endemiology
基金
中央补助地方公共卫生专项资金地方病防治项目(2021年)
河南省医学科技攻关计划(联合共建)项目(LHGJ20200122、LHGJ20210146,LHGJ20220163)
关键词
碘
儿童
饮用水
尿
盐类
甲状腺肿
Iodine
Child
Drinking water
Urine
Salts
Goiter
