不同水碘地区加碘盐浓度对儿童碘营养干预效果的研究  

Study on effect of iodized salt concentration on children’s iodine nutrition in different water iodine areas

作　　者：王健辉[1] 王偲茜[1] 阚忠媛[1] 冯晓伟[1] 孙蕾[1] 高嵘[1] 郑照霞[1] 范雪丽[1] WANG Jian-hui;WANG Si-qian;KAN Zhong-yuan;FENG Xiao-wei;SUN Lei;GAO Rong;ZHENG Zhao-xia;FAN Xue-li(Department for Endemic Disease Control,Liaoning Provincial Center for Control and Prevention,Shenyang 110005,China)

机构地区：[1]辽宁省疾病预防控制中心地方病预防控制所

出　　处：《中国地方病防治》2019年第5期481-484,共4页Chinese Journal of Control of Endemic Diseases

基　　金：辽宁省自然科学基金(20170540490)

摘　　要：目的探讨不同水碘地区加碘盐浓度对8~10岁儿童的碘营养干预效果,预测适宜的食用盐加碘量。方法 2016-2018年每年在辽宁省的100个县(市、区)按东西南北中5个地理方位各抽取1个乡(镇、街道),在抽取的乡(镇、街道)中各抽取1所小学的8~10岁学生40人,采集其尿样、家庭食用盐样及居住地自来水厂(改水工程)水样,检测尿碘、盐碘、水碘含量;每年抽取不少于60%的调查县(市、区),对8~10岁儿童采用超声法进行甲状腺肿、甲状腺结节检查;7~14岁儿童饮水消耗量采用辽宁省2018年居民食物消费量调查数据,7~10岁儿童食盐消耗量采用辽宁省居民营养与健康状况监测数据。剔删居住地为分散供水和盐碘、尿碘、水碘任何1项数据缺失的调查对象,计算8~10岁儿童饮水与碘盐来源的膳食碘摄入量。结果不同水碘地区的50 820名8~10岁儿童平均盐碘含量为24.4 mg/kg,尿碘中位数为169.0μg/L,平均膳食摄碘量为231.6μg/d,尿碘总体为碘适宜水平,膳食摄碘量是平均需要量(EAR)的3.51倍和推荐摄入量(RNI)的2.54倍,94.4%儿童摄碘量分布在RNI^UL间,0.1%儿童UL;儿童甲状腺结节检出率与水碘线性拟合模型呈现"U"曲线,甲状腺肿大率随水碘升高呈现"波状"升高趋势。结论水碘含量0~39μg/L地区儿童碘适宜的盐碘为10~24.9 mg/kg;水碘含量40~59μg/L地区儿童碘营养适宜的盐碘为5~19.9 mg/kg;水碘含量≥60μg/L时儿童膳食碘摄入量>UL比例较高,需进一步扩大样本量探讨食用盐加碘必要性。Objective To explore the effect of iodized salt concentration on iodine nutritional status of children aged 8-10 years in different iodine-water areas, and to predict the appropriate iodized salt.Methods From 2016 to 2018,a cross-sectional survey was conducted in 100 counties and 500 township of Liaoning Province to collect 40 students aged from 8 to 10 at random every year.And collected their urine, edible salt samples and drinking water samples from waterworks where children lived,iodine contents were determined;the children were sampled every year for goiter and thyroid nodule examination by ultrasound in more than 60 counties.And deleted some people who lived in without centralized water supply community and lacked anyone data of salt iodine, urine iodine and water iodine and calculated the dietary iodine intake from drinking water and salt sources.Results 50 820 children aged 8-10 years in the central water supply area were investigated.The average salt iodine of children was 24.4 mg/kg. The median urinary iodine was 169.0 μg/L.The average dietary iodine intake was 231.6 μg/d,which was 3.51 times of the Estimated Average Requirement(EAR) and 2.54 times of the Recommended Nutrient Intake(RNI).The iodine intakes of 94.4% of children between RNI and Upper Limits(UL),0.1% of children below EAR,0.2% of children between EAR and RNI, 5.3% of children above UL.The detection rate of thyroid nodules in children and the linear fitting model of water iodine showed a "U" curve, and the goiter rate in children also showed a "wavy" trend with the increase of water iodine.Conclusion The salt iodine for children’s appropriate iodine nutrition is 10-24.9 mg/kg in water iodine below 40 μg/L of area.The appropriate salt iodine is 5-19.9 mg/kg for iodine nutrition of children in water iodine 40-59 μg/L area.When water iodine is above 60 μg/L, children’s dietary iodine intake was higher than UL. It is necessary to further expand the sample size to explore the necessity of eating iodized salt.

关 键 词：儿童 尿碘 摄碘量 甲状腺肿大率 食盐加碘量 

分 类 号：R591.1[医药卫生—内科学]