Reappraisal of the risk of iodine-induced hyperthyroidism: an epidemiological population survey

The occurrence of iodine-induced hyperthyroidism (IIH) has been reported after iodine supplementation from clinics and hospitals, but not following an epidemiologic survey. We studied the prevalence of thyroid derangement in a population following iodine supplementation. One yr after more than 75% of the population had been consuming 40 ppm iodized salt; information regarding history of endemic goiter and iodized salt production, distribution, consumption and monitoring were collected in four cities of the Islamic Republic of Iran. A total of 6048 subjects were randomly selected. All subjects were assessed for size of goiter, and urinary iodine and serum T4, T3, TSH, anti-thyroglobulin and anti-thyroperoxide were measured. Before iodine supplementation, all four cities were areas of endemic goiter. The rate of household consumption of iodized salt was 50, 75 and 90% in 1994, 1995 and 1996, respectively. Ninety-one percent of the salt samples contained 15-55 ppm iodide. Total goiter rate was 57, 62 and 68%; median urinary iodine was 188, 197 and 190 microg/l in the age groups of 6-18, 19-40 and >40 yr, respectively. Prevalence of clinical and subclinical hyperthyroidism was 0.34 and 0.41 and those of clinical and subclinical hypothyroidism were 0.51 and 1.07%, respectively. Nine point eight and 18% in the 19-40 yr age group and 17.6 and 25.6% in >40 yr old subjects had positive anti-thyroperoxidase and anti-thyroglobulin, respectively. This systemic epidemiologic study in an iodine deficient population showed that, following a well-executed iodine supplementation program, the occurrence of IIH is rare.     

Addition of microencapsulated iron to iodized salt improves the efficacy of iodine in goitrous,iron-deficient children: a randomized,double-blind,controlled trial

OBJECTIVE: In many developing countries, children are at high risk for both goiter and anemia. Iron (Fe) deficiency adversely effects thyroid metabolism and reduces efficacy of iodine prophylaxis in areas of endemic goiter. The study aim was to determine if co-fortification of iodized salt with Fe would improve efficacy of the iodine in goitrous children with a high prevalence of anemia. DESIGN AND METHODS: In a 9-month, randomized, double-blind trial, 6-15 year-old children (n=377) were given iodized salt (25 microg iodine/g salt) or dual-fortified salt with iodine (25 microg iodine/g salt) and Fe (1 mg Fe/g salt, as ferrous sulfate microencapsulated with partially hydrogenated vegetable oil). RESULTS: In the dual-fortified salt group, hemoglobin and Fe status improved significantly compared with the iodized salt group (P<0.05). At 40 weeks, the mean decrease in thyroid volume measured by ultrasound in the dual-fortified salt group (-38%) was twice that of the iodized salt group (-18%) (P<0.01). Compared with the iodized salt group, serum thyroxine was significantly increased (P<0.05) and the prevalence of hypothyroidism and goiter decreased (P<0.01) in the dual-fortified salt group. CONCLUSION: Addition of encapsulated Fe to iodized salt improves the efficacy of iodine in goitrous children with a high prevalence of anemia.     

Introduction of iodized salt to severely iodine-deficient children does not provoke thyroid autoimmunity: a one-year prospective trial in northern Morocco.

To determine if introduction of iodized salt induces thyroid autoimmunity in goitrous children, we conducted a prospective trial in iodine-deficient Moroccan schoolchildren (n = 323). Local salt was iodized at 25 microg iodine per gram of salt and distributed to households. Before introduction of iodized salt and at 10, 20, 40, and 52 weeks, we measured antithyroid peroxidase antibodies (TPO-Ab), antithyroglobulin antibodies (Tg-Ab), urinary iodine (UI), and thyroid hormones, and examined the thyroid using ultrasound. At baseline, median UI was 17 microg/L and the prevalence of goiter and hypothyroidism was 72% and 18%, respectively. Provision of iodized salt maintained median UI at 150-200 microg/L for the year (p < 0.0001). There was a significant increase in mean total thyroxine (T(4)) and a significant reduction in the prevalence of hypothyroidism (p < 0.001). There was a transient increase in the prevalence of detectable antibodies after introduction of iodized salt (p < 0.0001) with levels returning to baseline at 1 year. Only congruent with 1% of children had elevated TPO-Ab and none had elevated Tg-Ab over the course of the study, and no child with elevated TPO-Ab had abnormal thyrotropin (TSH) or T(4) concentrations. None developed clinical or ultrasonographic evidence of thyroid autoimmune disease and/or iodine-induced hypothyroidism or hyperthyroidism. Rapid introduction of iodized salt does not provoke significant thyroid autoimmunity in severely iodine-deficient children followed for 1 year.     

2008年浙江省舟山市海岛地区甲状腺疾病流行病学调查

目的 调查浙江省舟山市海岛地区食用非加碘盐的居民患甲状腺疾病状况及致甲状腺疾病的相关影响因素.方法 2008年在浙江省舟山市岱山县对737名食用非加碘盐的居民进行流行病学问卷调查、甲状腺B超检查、甲状腺功能及尿碘测定;同时抽查了183名8～10岁儿童(均为食用非加碘盐居民的子女)的尿碘.结果 舟山市岱山县食用非加碘盐的居民尿碘中位数(MUI)为122.2 μg/L,8～10岁儿童MUI为123.7μg/L;甲状腺肿、甲状腺癌、甲状腺功能亢进(简称甲亢)、亚临床甲状腺功能亢进(简称亚临床甲亢)和亚临床甲状腺功能减退(简称亚临床甲减)的患病率分别为39.9%、0.4%、0.4%、0.7%和0.8%.logistic回归分析显示,甲状腺肿患病率无性别差异(P>0.05),而年龄是甲状腺肿发生的危险因素(P<0.05);甲状腺肿、甲亢患病情况与饮食史、吸烟史、饮酒史、饮茶史、尿碘水平均无明显相关关系(P均>0.05).结论 舟山市海岛地区食用非碘盐居民碘摄入适量,但甲状腺肿和甲亢患病率较高.     

Iodine supplementation in Austria: methods and results.

Until 1963 Austria was an extremely iodine-deficient area with low iodine intake and high goiter prevalence. Therefore, for the first time in 1963, salt iodination with 10 mg of potassium iodide per kilogram of salt was introduced by federal law. Twenty years after this salt iodination, however, investigations in schoolchildren demonstrated iodine deficiency grade I to II according to the World Health Organization (WHO) (urinary iodine excretion, 42-75 microg/g Crea) and goiter prevalence of far more than 10%. In 1990, salt iodination was increased to 20 mg of potassium iodide per kilogram of salt. In 1994, further investigations in schoolchildren demonstrated an increase of urinary iodine excretion (121 microg/g Crea) and a reduction of goiter prevalence below 5%, with the exception of pupils ages 14-19 (12%). In the year 2000, 10 years after the increase of salt iodination in Austria, 430 nonselected adult inhabitants of three communities in Carinthia (a county of Austria) were investigated for iodine excretion, goiter prevalence, and prevalence of thyroid autoantibodies. This study demonstrated that although iodine supply is sufficient now in Austria (males, 163.7 microg of Crea; females, 183.3 microg of iodine per gram of Crea), goiter prevalence is still high in the elderly, who lived for a longer period of iodine deficiency (34.3% in women and 21.3% in men), whereas goiter prevalence in younger people up to age 40 years is below 5%. It could also be shown that the percentage of thyroid autoantibodies is now as high as in other countries with sufficient iodine supply (3.19% in males, 5.17% in females). In addition to the changes of urinary iodine excretion and goiter prevalence because of salt iodination, changes of incidence in hyperthyroidism and histologic types of thyroid cancer are discussed in this paper. In conclusion, the introduction of salt iodination led to an improvement in iodine supply with a marked reduction of goiter prevalence in people who were born after 1963, but also to an increase in hyperthyroidism and autoimmune thyroid diseases as well as changes in histologic types of thyroid cancer.     

Epidemiological survey on the relationship between different iodine intakes and the prevalence of hyperthyroidism

OBJECTIVE: To investigate the effect of different levels of iodine intake on the prevalence of hyperthyroidism and the impact of universal salt iodization on the incidence of hyperthyroidism. DESIGN: A comparative cross-sectional and longitudinal survey was conducted in three areas with borderline iodine deficiency, mild iodine excess (previously mild iodine deficiency) and severe iodine excess. Universal salt iodization had been introduced 3 years previously except in the area with borderline iodine deficiency. METHODS: In total 16 287 inhabitants from three areas answered a questionnaire concerning the history of thyroid disease. Among them 3761 unselected subjects received further investigations including thyroid function, thyroid autoantibodies, thyroid ultrasonography and urinary iodine excretion. RESULTS: Among areas with median urinary iodine excretion of 103 microg/l, 375 microg/l and 615 microg/l (P<0.05), the prevalence of hyperthyroidism did not differ significantly (1.6%, 2% and 1.2%). The prevalence of subclinical hyperthyroidism was higher in areas with borderline iodine deficiency and mild iodine excess than in the area with severe excess iodine intake (3.7%, 3.9% and 1.1%, P<0.001). The prevalence of Graves' disease and its proportion in hyperthyroidism did not differ among areas. The incidence of hyperthyroidism did not significantly increase after the introduction of universal salt iodization. CONCLUSION: Different iodine intakes under a certain range do not affect the prevalence and type of hyperthyroidism. Subclinical hyperthyroidism is more prevalent in the iodine deficient area than in the severe iodine excessive area. In the area with mild iodine deficiency, the introduction of universal salt iodization may not be accompanied by an increased incidence of hyperthyroidism.     

Sustainable control of iodinedeficiency in Iran: beneficial results of the implementation of the mandatory law on salt iodization

Iodine deficiency disorders (IDD) were prevalent in the Islamic Republic (IR) of IRAN before 1989, when the national salt iodization program with 40 mg l/k of salt was initiated. Despite a comprehensive IDD control program, less than 50% of the households in rural areas consumed iodized salt by 1994. A law for the mandatory production of iodized salt for households was passed in 1994. The purpose of this study was to evaluate goiter status and urinary iodine excretion 2 yr after this law was implemented. In each of 26 provinces, 30 groups of 40 schoolchildren, total 36,178, were examined for goiter and classified according to World Health Organization (WHO) classification. Urinary iodine excretion was measured in 2,917 children by digestion method. Goiter was endemic in all provinces, but the majority were small (grade 1) goiter. Median urinary iodine was 20.5 microg/dl 85.1% had urinary iodine > or =10 microg/dl. Median urinary iodine was above 13 microg/dl in all 26 provinces. In all provinces the percentage of schoolchildren with urinary iodine <5 microg/dl was less than 16%. In nine provinces the median urinary iodine was between 13 to 20 microg/dl; urinary iodine of their schoolchildren was <5 microg/dl in 10.8% and <2 microg/dl in 6-9%. No significant difference was observed between boys and girls or children of rural and urban regions in urinary iodine excretion. We conclude that 7 yr after the beginning of salt iodization and 2 yr following mandatory iodized salt consumption, urinary iodine excretion is adequate in schoolchildren; considering the data of the percent of households consuming iodized salt and programmatic setting of the IDD program, The IR of Iran has reached a sustainable control program for iodine deficiency.     

天津市食盐加碘后甲状腺肿大率与碘营养状况的调查

目的：调查和研究食盐加碘后天津市居民的甲状腺肿大率和碘营养状况,方法：在6个区共调查居民31530人,7－14岁在校儿童4415人,对调查对象进行甲状腺肿大率,尿碘浓度,食盐碘含量等项目的调查。结果：（1）食盐加碘后天津市居民的平均甲状腺肿大率为5．5％,8－10岁儿童平均甲状腺肿大率为19．7％,甲状腺肿大率较食盐加碘以前有了明显下降,但下降的速度较缓慢,（2）天津市食盐加碘以后各区居民的平均尿碘中位数为287．2ug/L,各区儿童尿碘中位数平均为271．6u/L,证明总体人群碘营养充足,（3）天津市居民总体盐碘含量超过20mg/kg水平,各区居民户盐含碘量有9．9％－41．1％超过60mg/kg,说明碘盐的含碘是偏高是一个新的现象。结论：经过3年左右的食盐加碘防治工作,天津市碘缺乏情况已得到控制。     

Effect of iodine supplementation on a pediatric population with mild iodine deficiency.

A cross-sectional study in two stages consisted of healthy children to assess the effect of iodine supplementation on a pediatric population with mild iodine deficiency in an ongoing program in the Province of Pontevedra, northwestern Spain. In the first survey (1984), 1565 schoolchildren and in the second survey (1995) 907 schoolchildren were randomly selected from the population. In January 1985, a mandatory consumption of iodized salt in our region was begun. In both surveys we studied prevalence of goiter, urinary iodine excretion, and prevalence of thyroid dysfunction. Similar prevalences of goiter were observed in both surveys, 3.7% versus 3.9%; however, significantly lower prevalence of Ib and II degree goiters were observed in the second survey. The mean iodine excretion was 88.6 +/- 73 microg/L (median 66.3) and 146.4 +/- 99 microg/L (median 115.7), p < 0.01 for the first and second surveys, respectively. Finally, the overall prevalence of thyroid dysfunction was similar in both surveys, 9.2% versus 7.0%; however, significantly lower prevalence of suppressed serum thyrotropin (TSH), considered as a marker of subclinical hyperthyroidism, was observed in the second survey when compared to the first, 0.1% versus 2%, p < 0.01. Our results are in agreement with the recent data from Denmark, where the prevention of subclinical hyperthyroidism occurring in the elderly as a consequence of longstanding mild iodine deficiency is the reason that the Danish finally started iodine supplementation on a national basis. In conclusion, long-term correction of mild iodine deficiency in a pediatric population has beneficial effects on the prevalence of high-degree goiters, and this correction reduces significantly the prevalence of subclinical hyperthyroidism. The present observation constitutes a strong argument for correcting even mild iodine deficiency.     

我国碘缺乏病高危地区重点调查结果分析

目的 调查我国碘缺乏病高危地区新发地方性克汀病(地克病)和地方性甲状腺肿(地甲肿)的流行现况,了解高危地区碘盐覆盖率较低的原因,有针对性地提出防治对策.方法 以县为单位,在西藏、青海、新疆、甘肃、宁夏、四川、海南、重庆、云南、广西、内蒙古11个省份的碘盐监测盲区(高危县)采取单纯随机抽样方法选择调查乡,在其他高危县按照典型调查原则以乡为单位选取调查点,进行10岁以下新发地克病病例搜索;对8～10岁儿童采用B超法检测甲状腺大小,采用中国瑞文测验(农村修订版)检测智商;对育龄妇女开展人户调查和采集家中盐样,盐碘测定采用半定量法,统计居民户碘盐覆盖率;采集8～10岁儿童和育龄妇女尿样,尿碘测定采用砷铈催化分光光度法;全部结果采用Epi Iinfo 6.0软件进行分析.结果 在101个高危县中搜索出地克病线索病例4122人,其中确诊地克病249例.儿童甲状腺肿大(甲肿)率为8.28%(4434/53 541),44个县儿童甲肿率在5%～20%,5个县儿童甲肿率在>20%～30%,3个县儿童甲肿率>30%.儿童智商均值为85.44,智商<70的儿童占16.52%(8713/52 745).儿童尿碘中位数为154.69;μg/L、尿碘<50μg/L的比例为17.26%(9069/52 558),有25个县的儿童尿碘中位数<100μg/L;育龄妇女尿碘中位数为107.14μg/L、尿碘<50μg/L的比例为27.50%(3722/13 534),有46个县家庭主妇尿碘中位数<100μg/L.居民户的碘盐覆盖率为77.85%(13 150/16 891),西藏、海南、青海碘盐覆盖率较低,分别为52.80%(1585/3002)、44.72%(631/1411)、72.82%(1850/2506).西藏、四川、海南、甘肃、青海居民户中>10%的人认为购买碘盐不方便,有71.39%(7652/10 719)的家庭食用土盐,土盐每公斤的平均价格(0.30～1.20元)低于碘盐(1.20～3.00元).结论 碘缺乏病高危地区存在发生地克病和地甲肿的危险,应在这些地区开展碘缺乏病监测,降低碘盐价格,提高碘盐覆盖率,对特需人群要尽快实施应急补碘,建立消除碘缺乏病的长效机制.     

Silent iodine prophylaxis in Western Europe only partly corrects iodine deficiency; the case of Belgium

OBJECTIVE: Belgium is one of the Western European countries in which no program of iodine-deficiency correction using iodized salt has been implemented, in spite of well-documented mild iodine deficiency. In 1995, the median urinary iodine concentration was 55 microg/l (normal: 100-200) and the prevalence of goiter was 11% (normal: below 5%) in representative samples of schoolchildren aged 6-12 years. Based on these results, the authors of the present study and others had emphasized to health professionals and to the public the necessity for iodine supplementation. The objective of this study was to evaluate as to whether these efforts had resulted in an improvement in the status of iodine nutrition. DESIGN: We performed a national survey of the status of iodine nutrition in Belgium based on the determination of thyroid volume, obtained by ultrasonography, and urinary iodine concentrations in schoolchildren. METHODS: A mobile van equipped with an ultrasound instrument, a computer and a deep-freeze visited 23 schools selected from across the country. The sample included 2855 schoolchildren (1365 boys and 1490 girls) aged 6-12 years. RESULTS: The results show a homogeneous situation in the whole country, with a median urinary iodine concentration of 80 microg/l and a goiter prevalence of 5.7%. Urinary iodine slightly decreases with age in girls and reaches a critical value of 59 microg/l at the age of 12 years, together with a goiter prevalence of 18.4%. CONCLUSION: Iodine nutrition has improved slightly in Belgium but mild iodine deficiency continues, with public-health consequences. The improvement indicates silent iodine prophylaxis, as no official salt-iodization measures have been taken. Silent iodine prophylaxis only partly corrects iodine deficiency in Western Europe. Active measures, including the implementation of a program of salt iodization, are urgently required.     

Status of goiter prevention in East Germany from an interdisciplinary viewpoint

The endemic goiter occurs still in many countries of Europe. Alimentary iodine deficiency could be proved as essential cause of the increased prevalence. Comprehensive epidemiological investigations refer to the medical importance of this appearance for the GDR. 200 million marks might have to be spent annually for diagnostics and therapy. Also in the production of animals sequelae of iodine deficiency play a great part. Nitrate containing and glucosinolate containing feeding stuffs (e. g. rape extraction groats) here under the conditions of the iodine deficiency additionally develop goitrogenous effects (so-called indirect or relative iodine deficiency), which lead to decrease in vitality and clinical symptoms in the agricultural useful animals cattle, pig and sheep. The iodine content of animal products was frequently low. In view of the ecological connection of these problems an interdisciplinary iodine commission was founded which in accordance with the responsible state organs elaborates adequate recommendations for the prophylaxis and control of efficiency. From 1986 was begun with the iodisation of the largest part of packet salt (32 mg KJO3/kg) und the delivery of iodized mineral mixtures for the production of animals. Thus is to be reckoned with an improved direct supply of iodine for the population by iodized table salt or an indirect one over animal product. The iodisation of the entire common salt with modified iodine concentration is striven for. Measures for the control of efficiency are introduced.     

云南省彝良县碘缺乏病高危监测结果分析

目的了解云南省碘缺乏病高危地区新发地方性克汀病、地方性甲状腺肿流行现况、人群碘营养状况及防治措施落实情况,查找影响我省高危地区碘盐覆盖率的原因,研究并提出有针对性的防治策略和措施。方法 2008、2010年在碘盐覆盖率<80%的彝良县抽取3个乡实施高危地区监测,监测内容包括搜索疑似地克病病例,检测8～10岁儿童甲状腺容积,检测8～10岁儿童和育龄妇女的尿碘浓度,入户调查和采集家中盐样进行半定量检测,调查被监测乡、村实施碘盐供应、碘油投服等防治措施情况。结果 2008、2010年两次监测都未发现疑似地克病;育龄妇女尿碘中位数分别为184.14μg/L、247.12μg/L,儿童尿碘中位数分别为204.72μg/L、282.96μg/L;2008与2010年结果比较,碘盐覆盖率由84.17%上升至99.17%,儿童和育龄期妇女尿碘中位数均有明显升高,8～10岁儿童甲肿率(触诊法)由19.34%下降至6.25%。结论我省高危地区碘缺乏病监测、防治措施及时有效,今后应不断巩固碘缺乏病防治成果;该地区居民碘营养已处于超适宜状态,应适当下调盐碘含量。     

Optimization of iodine intake in Belgium

Mild iodine deficiency (MID) is a long-standing problem in Belgium and was recognized only recently as public health issue by the Ministry of Health (MOH). The main MID-related health problems in Belgium are a high prevalence of thyroid nodules and multinodular goiter. The economic cost of thyroid nodular disease only in Belgium was estimated at about € 40 millions per year. The Belgian health authorities adopted a selective strategy to optimize iodine intake through the fortification of bread with iodized salt. A progressive, step-by-step increase of the iodine content of salt was chosen in order to minimize the incidence of hyperthyroidism. MOH monitors this strategy by assessing periodically the urinary iodine concentration in school-aged children and pregnant women, as well as by a yearly follow-up of TSH concentrations in all Belgian newborns. Although the implementation of this strategy was an important step, the main drawback of the current situation is the absence of a legal framework to support the strategy. The utilization of iodized salt in bread on a voluntary basis was endorsed by the bakery industry and MOH. However a legal framework is required to assure the effectiveness and continuity of the program and to avoid a higher than optimal iodine intake in the population.     

Iodine nutrition, nodular thyroid disease, and urinary iodine excretion in a German university study population.

We determined the influence of different nutritional factors on the urinary iodine excretion in an East German university population. First, we assessed iodine excretion in spot urine samples. Second, we measured iodine content in the university canteen meals, where approximately 20% of the probands had regular meals. Third, we used a special food questionnaire to assess for other sources of nutritional iodine intake, namely iodine tablets, fish consumption, etc. Fourth, we determined the actual prevalence of goiter and thyroid nodules in our probands by high-resolution ultrasonography. The mean urinary iodine excretion in our cohort was 109 +/- 81 microg/g level indicating a borderline adequate iodine intake (100-200). The frequency of thyroid nodules was 30% and the frequency of goiter 11%. Thyroid volumes greater than 18 mL and 25 mL were considered to be enlarged in adult women and men respectively. Urinary iodine excretion was not related to the presence of goiter or thyroid nodules. In addition urinary iodine excretion did not vary with regular consumption of canteen meals, which contained approximately 50% of the daily recommended iodine intake. In contrast probands with regular supplementary intake of iodine tablets had significantly higher values of urinary iodine excretion (169 +/- 130 microg/g) compared to participants without (103 +/- 87 microg/g). No other single nutritional factor (e.g., salt, milk, or bread) had a statistically significant impact on urinary iodine excretion or was able to raise the urinary iodine excretion above the level of marginal iodine deficiency. In summary, the nutritional iodine intake in a Saxonian study population was found to be close to the margin of iodine deficiency. This shows insufficient supplementation of iodine through iodized salt/industrialized food production.     

Iodine nutrition improves in Latin America.

Iodine deficiency has been a public health problem in most Latin American countries. Massive programs of salt iodization have achieved great progress toward its elimination but no consistent monitoring has been applied. We used the ThyroMobil model to visit 163 sites in 13 countries and assess randomly selected schoolchildren of both genders 6-12 years of age. The median urinary iodine concentration (8208 samples) varied from 72 to 540 microg/L. One national median was below the recommended range of 100-200 microg/L; five were 100-200 microg/L, and seven were higher than 200 microg/L, including three greter than 300 microg/L. Urinary iodine concentration correlated with the iodine content of salt in all countries. Median values of thyroid volume were within the normal range for age in all countries, but the goiter prevalence varied markedly from 3.1% to 25.0% because of scatter. The median iodine content of salt from local markets (2734 samples) varied from 5.9 parts per million (ppm) to 78 ppm and was greater than 15 ppm in 83.1% of all samples. Only seven countries had higher than 15 ppm iodine in 80% of the samples, and only three had greater than 15 ppm in at least 90%. Iodized salt was available at retail level in all countries but its median iodine content was within the recommended range (20-40 ppm) in only five. This study, the first to apply a standardized assessment strategy to recent iodine nutrition in Latin America, documents a remarkable success in the elimination of iodine deficiency by iodized salt in all but 1 of the 13 countries. Some iodine excess occurs, but side effects have not been reported so far, and two countries have already decreased their legal levels of salt iodization and improved the quality control of iodized salt, in part because of our results. The present work should be followed by regular monitoring of iodine nutrition and thyroid function, especially in the countries presently exposed to iodine excess.     

兰州市碘缺乏病碘盐干预效果评价

目的评价碘盐干预,为进一步加强和完善消除碘缺乏病的长效工作机制提供科学依据。方法采用PPS抽样法,1995～2009年在兰州市8个县区随机抽取8～10岁儿童进行甲状腺肿大率、尿碘、盐碘监测。结果经食盐加碘干预,8～10岁儿童甲状腺肿大率呈下降趋势,近4年达到国家碘缺乏病消除标准;尿碘中位数波动在100～300μg/L,均满足国家学龄儿童碘营养评价标准（尿碘中位数〉100μg/L）,尿碘合格率波动在67.01%～97.22%;碘盐合格率连续7年稳定在90%以上,各年碘盐中位数均达到国家标准（碘盐20～50mg/kg）。结论普及碘盐是改善人群碘营养状况、防治碘缺乏病的有效措施。     

不同浓度碘盐碘油胶丸防治地方性甲状腺肿效果观察

采用不同浓度碘盐及碘油胶丸对昆明地区4个自然村1750人进行地方性甲状腺肿(简称地甲肿)防治。2年后地甲肿患病率分别从9.60%,8.30%,18.90%,23.60%,降至3.23%,3.08%,5.44%,4.92%。尿碘均值升至113.08—200.29μgI/L。结果提示:1、轻病区选用1/10万,重病区选用1/5万碘盐防治地甲肿是可行的;2、贫困山区的重病区除选用1/5万碘盐外还在重点人群加用小剂量碘油胶丸;3、适当增加碘摄入量是防治环境污染地区地甲肿的有效方法。     

2009年西宁市碘缺乏病防治效果调查

目的 掌握西宁市基本达到消除碘缺乏病阶段目标后,碘缺乏病的防治效果及人群碘营养状况.方法 2009年调查西宁市7个县(区),每个县(区)按东、西、南、北、中抽取5个乡(镇),每个乡(镇)抽取1所学校,每所学校抽取80名8～10岁学生,采用触诊法检查儿童甲状腺肿大情况,采用过硫酸铵消化砷铈催化分光光度法测定儿童尿碘,采用直接滴定法测定学生家中食用盐含碘量.结果 共抽检2919名8～10岁儿童,检出甲状腺肿大31名,甲状腺肿大率为1.06%(31/2919).共检测儿童尿样1078份,尿碘中位数为205.3μg/L,＜20 μg/L的占1.9%(20/1078),＜50 μg/L的占4.5%(48/1078).共检测2079份盐样,盐碘中位数为32.80 mg/kg,非碘盐率为0.87%(18/2079),碘盐覆盖率为99.13%(2061/2079),碘盐合格率为98.64%(2033/2061),合格碘盐食用率为97.79%(2033/2079).结论 西宁市碘缺乏病防治工作取得了明显成效,各项指标均达到国家碘缺乏病消除标准.

Abstract：

Objective To master iodine nutritional status of people after universal salt iodization in Xining that reached the stage goal of elimination iodine deficiency disorders. Methods In the 7 counties investigated of Xining in 2009, 5 towns were randomly selected in each county, and one school was randomly selected in each town, 80 children aged 8 to 10 were randomly selected in each school, and goiter were examined, urinary iodine and salt iodine were tested. Thyroid gland goiter of children was detected by thyroid palpation, children's urinary iodine was tested by As( Ⅲ )-Ce4+ catalytic spectrophotometry, and salt iodine was tested by direct titration. Results A total of 2919 children aged 8 to 10 were examined, 31 goiter was detected, goiter rate was 1.06%(31/2919).One thousand and seventy-eight urine samples were detected, urinary iodine median was 205.3 μg/L, that lower than 20 μg/L accounted for 1.9% (20/1078), lower than 50 μg/L accounted for 4.5%(48/1078). Two thousand and seventy-nine salt samples were detected, median of salt iodine was 32.80 mg/kg, the rate of non-iodized salt was 0.87%(18/2079), the coverage rate of iodized salt was 99.13%(2061/2079), the qualified rate of iodized salt was 98.64% (2033/2061), the consumption rate of qualified iodized salt was 97.79% (2033/2079). Conclusions Prevention and control of iodine deficiency disorders has achieved remarkable results in Xining city, all indicators have reached the national standard to eliminate iodine deficiency disorders.     

单纯以食盐加碘防治碘缺乏病效果分析

目的 研究单纯以食盐加碘能否如期达到碘缺乏病消除目标。方法 按地理位置选５个乡镇的５所小学为观察点,对碘盐、８～１０岁学生的尿碘和甲状腺肿大情况进行检测。尿碘用恒温酸消化法,甲肿情况用触诊法及Ｂ超法。结果 碘盐、尿碘及甲肿率连续２年均达到国家碘缺乏病消除标准要求。结论 单纯以食盐加碘能如期达到碘缺乏病消除目标。