盐碘新标准实施后苏州市8~10岁学龄儿童碘营养状况分析

目的了解苏州市实施盐碘新标准后学龄儿童碘营养状况,为动态调整食盐加碘策略提供依据。方法将2012—2019年分为2个时期:调整过渡期(2012—2014年)和调整完成期(2015—2019年),按照《江苏省碘缺乏病监测方案》,以8~10岁学龄儿童为研究对象,采集食用盐盐样、尿样,检测盐碘、尿碘含量。结果2个时期分别采集盐样2893、9132份,盐碘中位数分别为26.5、23.3 mg/kg,碘盐覆盖率为97.03%(2807/2893)、97.25%(8881/9132),合格碘盐食用率91.01%(2633/2893)、93.93%(8578/9132)。两时期间碘盐覆盖率比较差异无统计学意义(χ²=0.405,P=0.524>0.05),合格碘盐食用率差异有统计学意义(χ²=38.465,P=0.000<0.01),且呈上升趋势(χ²趋势=17.528,P=0.000<0.01)。调整过渡期,苏州市学龄儿童尿碘中位数为215.6μg/L,尿碘值<50μg/L的比例分别为1.5%;完成期中位数为192.60μg/L,比例为2.40%。两时期尿碘比较差异有统计学意义(Z=-9.918,P=0.000<0.01),其中3个地区(高新区、太仓市、昆山市)无统计学意义,其余均有统计学意义。结论食盐加碘新标准实施后,学龄儿童碘营养状况总体处于适宜水平,但是新标准调整后部分地区碘营养水平无明显差异,提示当地学龄儿童全人群碘营养状况需要进一步研究。

Iodine nutritional status of 8-10 year-old school-age children after the implementation of new salt iodine standard in Suzhou

Objective To explore the iodine nutritional status among school-age children within 5 years of implementation of the new salt iodine standard in Suzhou,and to provide a basis for dynamically adjusting the salt iodization strategy.Methods The observation period(2012-2019)was divided into two sub-periods:the adjustment transition period(2012-2014)and the adjustment completion period(2015-2019).According to the"Jiangsu Iodine Deficiency Disease Surveillance Program",household salt samples and urine samples of school-age children aged 8 to 10 years were collected to detect the content of salt iodine and urine iodine.The coverage rate of iodized salt,qualified iodized salt consumption rate,and the median urinary iodine were determined.Results Totally 2893 and 9132 salt samples were collected in the adjustment transition and adjustment completion periods,with the median salt iodine content being 26.50 and 23.20 mg/kg,respectively.The iodized salt coverage rates were 97.03%(2807/2893)and 91.01%(2633/2893),and the consumption rates of qualified iodized salt were 97.25%(8881/9132)and 93.93%(8578/9132),respectively,in the two periods.The differences between the coverage rate of iodized salt and the consumption rate of qualified iodized salt between the two periods were statistically significant(χ²=38.465,P<0.01),and showed an upward trend(χ²trend=17.528,P<0.01).During the adjustment transition period,the median urinary iodine content of school-age children in Suzhou was 215.61μg/L,and the proportion of urine iodine value<50μg/L was 1.5%,while during the adjustment completion period the median urinary iodine and proportion of urine iodine value<50μg/L were 192.60μg/L and 2.40%,respectively.The difference in urine iodine between the two periods was statistically significant(Z=-9.918,P=0.000<0.01);Conclusion Five years after the implementation of the new salt iodization standard,the iodine nutritional level of school-age children in Suzhou was generally at an appropriate level.However,there was no significant changes in iodine nutritional levels in some areas after the adjustment of the new standard,suggesting that surveillance on iodine nutrition should be continuously consolidated in the future.