2021-2023年北京市孕妇碘营养状况及甲状腺疾病影响因素分析  

Iodine nutritional status and influencing factors of thyroid disease of pregnant women in Beijing from 2021 to 2023

作　　者：李晓阳 李阳桦 杜丹[1] 刘博[1] 任烁 黎新宇[1] Li Xiaoyang;Li Yanghua;Du Dan;Liu Bo;Ren Shuo;Li Xinyu(Institute for Infectious Disease and Endemic Disease Control,Beijing Center for Disease Prevention and Control,Beijing 100013,China)

机构地区：[1]北京市疾病预防控制中心传染病地方病控制所,北京100013

出　　处：《中华地方病学杂志》2024年第11期879-884,共6页Chinese Journal of Endemiology

摘　　要：目的了解北京市孕妇碘营养状况,并分析甲状腺疾病影响因素。方法2021-2023年,采用横断面调查分层随机抽样方法,每年在北京市所辖的16个行政区各抽取至少100名孕妇,分别采集随意1次尿样及家庭食用盐盐样,测定尿碘和盐碘含量,分析碘营养状况,并采用二元logistic回归及限制性立方样条(RCS)模型分析孕妇甲状腺疾病影响因素(年龄、居住区域、民族和孕期等)。结果共检测孕妇尿样4878份,尿碘中位数为129.11μg/L,碘营养处于缺乏状态(<150μg/L)。各年份尿碘水平比较,差异有统计学意义(H=20.22,P<0.001)。各孕期(早、中、晚期)尿碘水平比较,差异有统计学意义(H=11.57,P=0.003)。共检测盐样4878份,盐碘中位数为24.00 mg/kg,合格碘盐食用率为75.05%(3661/4878)。各年份盐碘水平比较,差异有统计学意义(H=14.20,P<0.001)。二元logistic回归分析显示,与郊区比较,城区甲状腺患病风险较高(OR=2.01,P<0.001),而中央政务区患病风险较低(OR=0.52,P=0.044);与孕晚期比较,孕早期(OR=0.60,P=0.003)和孕中期(OR=0.71,P=0.046)患病风险均较低;补充碘剂可降低患病风险(OR=0.48,P<0.001)。RCS模型分析显示,甲状腺患病风险与尿碘呈非线性剂量-反应关系,曲线呈"U"形,切点值为127.74、472.66μg/L。结论2021-2023年北京市孕妇碘营养处于缺乏状态,居住区域、孕期、补充碘剂、尿碘水平为甲状腺患病影响因素。Objective To understand the iodine nutritional status of pregnant women in Beijing,and analyze the influencing factors of thyroid disease.Methods From 2021 to 2023,a stratified random sampling method was used to select at least 100 pregnant women from each of the 16 administrative districts under the jurisdiction of Beijing each year,using cross-sectional survey.Random urine samples and household salt samples were collected to determine urinary iodine and salt iodine levels,and were analyzed iodine nutritional status.Binary logistic regression model and restricted cubic spline(RCS)model were sued to analyze the influencing factors of thyroid disease in pregnant women(age,residential area,ethnicity,pregnancy,etc.).Results A total of 4878 pregnant women were investigated from 2021 to 2023,and the overall median urinary iodine level was 129.11μg/L,indicating a deficiency in iodine nutrition(<150μg/L).There was a statistically significant difference in the urinary iodine levels of pregnant women between different years(H=20.22,P<0.001).There was a statistically significant difference in median urinary iodine levels of pregnant women in different pregnancy stage(H=11.57,P=0.003).The median of salt iodine value was 24.00 mg/kg,and the consumption rate of qualified iodized salt was 75.05%(3661/4878).The comparison of salt iodine levels between different years showed statistically significant differences(H=14.20,P<0.001).Binary logistic regression analysis showed that the risk of thyroid disease in urban area was higher than that in suburban area(OR=2.01,P<0.001),while the risk of disease in central government areas was lower(OR=0.52,P=0.044).Compared with late pregnancy,the risk of the disease was lower in the early pregnancy(OR=0.60,P=0.003)and the middle pregnancy(OR=0.71,P=0.046).Supplementing with iodine can reduce the risk of the disease(OR=0.48,P<0.001).The analysis of the RCS model showed that there was a nonlinear dose-response relationship between the risk of thyroid diseases in pregnant women and urinary iod

关 键 词：碘 尿 孕妇 甲状腺 

分 类 号：R581[医药卫生—内分泌]