新国标盐碘含量实施下保山市8~10岁学龄儿童碘营养监测结果分析

目的 调查新国标实施后保山市重点人群8~10岁儿童的碘营养水平,为碘缺乏病防治提供参考。 方法 2016年根据《云南省碘缺乏病监测方案》,采用分层随机抽样方法,从腾冲市和隆阳区抽取414名8~10岁学龄儿童,用尿中碘的砷铈催化分光光度测定方法测定尿碘,用B超法对儿童甲状腺进行检查。同时采集学生家中食用盐,用氧化还原法和直接滴定法测定盐碘。用SPSS软件分析儿童尿碘水平、甲状腺异常情况及家庭食用盐碘含量。 结果 2016年共计调查保山市8~10岁儿童414人,实验室检测尿样414人份,尿碘中位数为250.60 μg/L(195.86~-329.76 μg/L),其中腾冲市尿碘中位数为258.26 μg/L,隆阳区为250.27 μg/L,差异无统计学意义(Z=-1.071,P=0.284);城区儿童尿碘中位数高于农村,差异有统计学意义(Z=-3.303,P=0.001)。采集学生家中食用盐检测共计414 份,盐碘中位数为23.26 mg/kg,腾冲市盐碘中位数(25.38 mg/kg)高于隆阳区(20.07 mg/kg),差异有统计学意义(Z=-12.049,P＜0.001)。全市碘盐覆盖率94.44%(391/414),非碘盐率为5.56%(23/414),合格碘盐食用率为81.40%(337/414),碘盐合格率为86.19%(337/391)。腾冲市碘盐覆盖率、合格碘盐食用率和碘盐合格率均高于隆阳区(χ²=10.668、46.087、35.542,均P＜0.001),隆阳区非碘盐率高于腾冲市(χ²=9.616,P=0.002)。儿童甲状腺肿大率为2.17%(9/414),隆阳区甲状腺肿大率(4.39%)高于腾冲市(0.00%)(χ²=7.249,P=0.006)。甲状腺结节检出率为6.28%(26/414),隆阳区甲状腺结节检出率(12.68%)高于腾冲市(0.00%)(χ²=321.498,P＜0.001);8~10岁儿童甲状腺结节检出率分别为2%、3.52%、11.05% (χ²=11.588,P=0.003)。 结论 2016年保山市两县8~10岁学龄儿童尿碘处于略超过适宜量,处于可接受水平,今后应进一步加强以儿童为主的重点人群碘营养水平监测

Surveillance results of iodine nutrition among school children aged 8-10 years after implementing the new standard of salt iodine content in Baoshan city

Objective To investigate the iodine nutrition condition among school children aged 8-10 years after implementation of the new standard of salt iodine content in Baoshan city, and to provide references for prevention and control of iodine deficiency disorders. Methods According to Surveillance Program on Iodine Deficiency Disorders in Yunan province, a stratified cluster random sampling method was used to select 414 school children aged 8-10 years in Tengcheng city and Longyang district in 2016. The method for measuring iodine in urine by As3+-Ce4+ catalytic spectrophotometry was used for determining the urine iodine, and thyroid volumes in children were detected by B ultrasound. At the same time, the methods of oxidation-reduction and direct titration were used to detect the iodine content of edible salt collected from the children’s homes. SPSS software was employed to analyze the level of urine iodine and thyroid abnormal situation in the children and iodine content of edible salt in their families. Results A total of 414 children aged 8-10 years in Baoshan city in 2016 were surveyed, and 414 urine samples were detected. The median urine iodine (MUI) was 250.60 μg/L (195.86 μg/L-329.76 μg/L). The MUI in Tengchong city and Longyang district was 258.26 μg/L and 250.27 μg/L respectively, without statistically significant differences(Z=-1.071,P=0.284). The MUI was higher in urban children than in rural ones, with a statistically significant difference (Z=-3.303, P=0.001). A total of 414 samples of edible salt were detected, and the median salt iodine (MSI) was 23.26 mg/kg. The MSI was higher in Tengchong city than in Longyang district (25.38 mg/kg vs. 20.07 mg/kg), with a statistically significant difference (Z=-12.049,P<0.001). The coverage rate of iodized salt, the rate of non-iodized salt, the utilization rate of qualified iodized salt and the qualified rate of iodized salt were 94.44% (391/414), 5.56% (23/414), 81.40% (337/414) and 86.19% (337/391) respectively. The coverage rate of iodized salt, the utilization rate of qualified iodized salt and the qualified rate of iodized salt were higher in Tengchong city than in Longyang district (χ²=10.668, χ²=46.087, χ²=35.542, all P<0.001), while the rate of non-iodized salt was higher in Longyang district than in Tengchong city(χ²=9.616,P=0.002).The thyrocele rate was 2.17% (9/414), and the rate was higher in Longyang district than in Tengchong city (4.39% vs. 0.00%, χ²=7.249, P=0.006). The detection rate of thyroid nodule was 6.28%(26/414), and this rate was higher in Longyang district than in Tengchong city (12.68% vs. 0.00%, χ²=321.498, P<0.001). The detection rate of thyroid nodule in 8-10 years old children were 2%, 3.52% and 11.05% (χ²=11.588, P=0.003). Conclusions Urine iodine of the school children aged 8-10 years in Tengchong city and Longyang district of Baoshan city was slightly more than the adequate level, but remained at an acceptable level. It is necessary to further strengthen the surveillance of iodine nutrition among the key population, especially in children