摘要
目的 以世界卫生组织（WHO）推荐的标准作依据,分析我国正常孕妇的尿碘水平,推荐作为评价孕妇人群碘营养状况的参考值,用于孕期碘营养监测及其相关研究.方法 在横断面调查中选择健康、碘营养充足、甲状腺功能正常、甲状腺自身抗体阴性的604名孕妇和192名当地非妊娠妇女作为本次研究对象,采用标准方法检测饮水、食盐、尿液的碘含量,采用化学发光免疫测定方法检测血清TSH、FT4、FT3、甲状腺过氧化物酶抗体（TPOAb）、甲状腺球蛋白抗体（TgAb）.结果 （1）平均饮水碘含量为3.0μg/L,提示饮水提供的碘量很低.（2）平均食盐碘含量为31.7mg/kg,推测每日至少从食盐中获得240μg碘（按每人每日摄盐10 g计算,再减去烹饪过程可能丢失20%碘量）,足以满足孕妇对碘的需求量.（3）604名孕妇的尿碘中位数为173.1μg/L,早、中、晚孕期分别为174.5、167.0和180.7μg/L,均达到了WHO推荐的150～249μg/L适宜水平,但未超过200μg/L.非妊娠妇女尿碘中位数为240.2μg/L,达到了WHO推荐的成人200-299 μg/L＂超需要量＂水平.（4）这些妇女都是甲状腺功能正常及抗体阴性者,但孕期TSH水平明显低于非妊娠妇女,以孕早期为最低;FT4及FT3,也低于非妊娠妇女,并随孕期进展而逐渐降低.结论 WHO推荐的孕妇适宜尿碘中位数水平（150-249μg/L）适用于我国孕期妇女,但我国孕妇尿碘偏低,位于150-200μg/L之间;同地区的非妊娠妇女尿碘水平偏高,建议市场可以供应不同浓度碘盐以满足不同人群的需求.
Objective To analyze the median urinary iodine（MUI）level in normal pregnant women based on World HeMth Organization（WHO） recommended criterion,and to provide the MUI reference values for monitoring and evaluating iodine nutrition during pregnancy and related studies.Methods Total 604 normal pregnant and 192 non-pregnant women（as a comparison）were selected from a cross-sectional survey.These women were all healthy,iodine sufficient,with normal thyroid function,and negative anti-thyroid antibodies.The iodine content in drinking water,edible salt,and urine was determined by standard methods,and serum TSH,FT4,FT3,thyroid peroxidaseantibody（TPOAb）,and thyroglobulin antibody（TgAb）were measured using chemiluminescent immunoassay.Resuits （1）The iodine in drinking water was 3.0μg/L indicating such small amount of iodine could be neglected for daily iodine intake.（2）All women consumed iodized salt with the median iodine in salt of 31.7 mg/kg.The daily iodine intake of at least 240 μg could be roughly estimated if an average of 10 g salt was taken per person per day and further subtracted by 20%iodine lost during cooking,which could meet the iodine needs during pregnancy.（3）The MUI of 173.1μg/L was calculated from 604 pregnant women having 174.5,167.0,and 180.7 μg/L during the first,second,and third trimesters,respectively,reaching the optimal level of 150-249 μg/L recommended by WHO for pregnant women.However,our data showed relatively lower levels,not reaching 200μg/L.The MUI of 240.2μg/L was calculated from 192 non-pregnant women,reaching the level of＂above requirement＂（200-299μg/L） recommended by WHO for adults.（4）All women were euthyroid and antibody-negative,but the TSH level in pregnant women was lower than that in non-pregnant women,in particular during the first trimester,while FT4 and FT3 were considerably decreased compared with the non-pregnant（with an exception of FT4 in the first trimester）,and both gradually declined with the gestational age.Conclusions The optimal MUI level of 150-249 μg/,L recommended by WHO can be applied to pregnant Chinese women,but our data provided a relatively low range of 150-200μ/L throughout pregnancy.The higher MUI of 240.2μg/L in non-pregnant women indicated that iodized salt with different contents should be supplied on market to meet the requirement of different groups of population.
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2011年第4期307-310,共4页
Chinese Journal of Endocrinology and Metabolism
基金
国家自然科学基金资助项目（30671816）致谢 参与本次调查工作的：天津市妇女儿童保健中心：李义民、叶涛
新疆巩留县疾病预防控制中心：马合木提、戴少慧
北京疾病预防控制中心：李文玲
杭州市疾病预防控制中心：朱素娟
关键词
孕妇
尿碘中位数
碘盐
参考值
Pregnant women
Median urinary iodine
Iodized salt
Reference Values
