2009 - 2018 年哈尔滨市居民碘营养状况调查

目的 调查及评价碘盐标准调整及盐业体质改革对哈尔滨市居民碘营养状况的影响。方法 收集哈尔滨市2009 - 2018年碘缺乏病监测数据，分碘盐标准调整前后和盐业体质改革前后3个阶段对盐碘及尿碘数据进行分析。结果 3个阶段盐碘中位数为31.1、26.8、24.11 mg/kg，呈下降趋势（P＜0.0167），合格碘盐食用率为97.58%、98.23%、97.32%，出现先升后降趋势（P＜0.0167）。5年儿童尿碘中位数为205.90、177.90、169.31、154.83、152.12 μg/L，3个阶段逐渐下降（P＜0.005）；碘盐标准调整前碘缺乏人群构成（10.67%）低于碘过量人群构成（20.67%），碘盐标准调整后碘缺乏人群构成（12.08%～ 19.14%）均大于碘过量人群构成（4.94%～13.95%），盐业体制改革后碘缺乏是碘过量人群构成的2倍以上。5年孕妇尿碘中位数无统计学差异（183.45、164.17、198.21、193.00、186.31 μg/L，P＞0.005）；碘缺乏人群构成（23.06%～43.18%）均大于碘过量人群构成（1.33%～3.84%），且比值均大于10倍以上。结论 碘盐标准调整使哈尔滨市儿童碘营养状况得到进一步改善，对孕妇影响不大。盐业体质改革后，合格碘盐食用率有所下降，使儿童碘缺乏风险加大。各阶段孕妇碘缺乏风险一直较高。

Investigation and analysis of iodine nutrition status of residents in Harbin from 2009 to 2018

Objective To investigate and evaluate the effect of the adjustment of iodized salt standard and the reform of salt industry system on the iodine nutrition status of residents in Harbin. Methods The monitoring data of iodine deficiency disease in Harbin from 2009 to 2018 were collected, and divided into three stages: before iodized salt standard adjustment, after iodized salt standard adjustment and before salt industry reform, after salt industry reform. Results The salt iodine median in three stages were 31.1 mg/kg, 26.8 mg/kg, and 24.11 mg/kg respectively, and the trend was in decline (P<0.0167); the edible rate of qualified iodized salt was 97.58%, 98.23%, and 97.32% respectively, with a trend of rising and then falling (P<0.0167). The median urinary iodine of children were 205.90μg/L, 177.90μg/L, 169.31μg/L, 154.83μg/L, and 152.12μg/L respectively in five years, and three stages gradually declined(P<0.005); before iodized salt standard adjustment iodine deficiency group(10.67%) was lower than iodine excess group(20.67%), after iodized salt standard adjustment iodine deficiency groups(12.08%-19.14%) were greater than iodine excess groups(4.94%-13.95%), after salt industry reform the iodine deficiency group were more than 2 times of iodine excess population. The median urinary iodine of pregnant women within 5 years were 183.45μg/L, 164.17μg/L, 198.21μg/L, 193.00μg/L, and 186.31μg/L, respectively, and there were no statistically significant differences(P>0.005); the composition of iodine deficiency population(23.06%-43.18%) was greater than that of iodine excess population(1.33%-3.84%), and the ratio was more than 10 times. Conclusion The adjustment of iodized salt standard has further improved the iodine nutrition of children and has little effect on pregnant women. After the reform of salt industry system, the consumption rate of qualified iodized salt decreased, which increased the risk of iodine deficiency for children. Pregnant women have been at higher risk of iodine deficiency.