摘要
目的了解烟台市8~10岁儿童碘营养状况,为因地制宜科学补碘提供依据。方法采用多阶段分层整群随机抽样方法,2022年在烟台市每个县(市、区,以下简称县)按东、西、南、北、中划分为5个片区,每个片区抽取1个乡镇(街道)作为调查地,每个调查地抽取1所小学校,每所小学抽取40名8~10岁非寄宿儿童作为调查对象,采集其家中食用盐盐样和随机1次尿样,测定盐碘、尿碘含量。抽取部分儿童,使用B超检测其甲状腺情况。每个调查地以行政村(社区)为单位,集中供水的行政村采集1份末梢水水样;分散供水的行政村则按东、西、南、北、中5个方位,每个方位抽取2口井(少于10口井则全部抽取),采集井水水样,检测水碘含量。芝罘区和招远市各抽取2个企事业单位食堂和5家中型、5家小型餐馆,采集食用盐盐样,检测盐碘含量。并进一步对不同地理环境划分区域(海岛、沿海、次沿海、内陆)的监测结果进行比较分析。结果共对2343名儿童进行尿碘、盐碘检测,尿碘中位数为147.10μg/L,不同区域儿童尿碘中位数分别为173.96、148.20、148.05、136.04μg/L,差异有统计学意义(H=15.55,P=0.001);盐碘中位数为17.81 mg/kg,不同区域盐碘中位数分别为0.00、0.00、20.02、22.48 mg/kg,差异有统计学意义(H=263.48,P<0.001);不同区域的碘盐覆盖率(15.34%、48.37%、69.63%、76.69%)和合格碘盐食用率(13.50%、39.14%、61.86%、69.17%)比较,差异均有统计学意义(χ^(2)=257.65、235.64,均P<0.001)。共对1419名儿童进行甲状腺B超检查,不同区域儿童的甲状腺肿大率(2.44%、2.18%、3.04%、3.12%)和结节检出率(3.90%、4.90%、5.89%、2.18%)比较,差异均无统计学意义(χ^(2)=0.85、6.69,均P>0.05)。共监测水样2488份,水碘中位数为3.70μg/L,不同区域水碘中位数比较,差异有统计学意义(H=141.21,P<0.001)。共检测餐饮单位食用盐盐样120份,合格碘盐食用率为62.50%。结论烟台市儿童合格碘盐食用率低于90%,但其碘营养处于适宜水平,这提示烟台市儿童的碘摄入可能并不完全依赖于碘盐。
Objective To understand the iodine nutrition status of 8-10 years old children in Yantai City,and to provide a scientific basis for scientific iodine supplementation according to local conditions.Methods Using multi-stage stratified cluster random sampling method,each county(city and district,hereinafter referred to as county)in Yantai City in 2022 was divided into 5 areas according to east,west,south,north and center,and 1 township(street)was selected as the survey site for each area,and 1 school was selected for each survey site,and 40 non-residential children aged 8-10 years old in each elementary school were selected as the target respondents,and the salt samples of edible salt in their homes were collected,and the urine samples of salt iodine and urinary iodine content were measured at random.A sample of salt and a random sample of urine were collected from the children's homes,and the salt iodine and urine iodine content were measured.Some of the children were sampled and their thyroid gland was tested using ultrasound.Each survey site is based on administrative villages(communities);administrative villages with centralized water supply collect one sample of terminal water;administrative villages with decentralized water supply take two wells(or all of them if there are fewer than 10 wells)in each of the five directions:east,west,south,north,and central,and collect water samples from the wells to test the iodine content of the water.Zhifu District and Zhaoyuan City each took 2 canteens of enterprises and institutions and 5 medium-sized and 5 small restaurants to collect salt samples of edible salt and test the salt iodine content.Results A total of 2343 children were tested for urinary iodine and salt iodine;the median urinary iodine was 147.10μg/L,and the median urinary iodine in children from different regions was 173.96,148.20,148.05,and 136.04μg/L,respectively,with statistically significant differences(H=15.55,P=0.001);the median salt iodine was 17.81 mg/kg,and the different regional The median salt iodine was 0.00,0.00,20.02,and 22.48 mg/kg,respectively,and the difference was statistically significant(H=263.48,P<0.001);the iodized salt coverage rate(15.34%,48.37%,69.63%,and 76.69%)and the consumption rate of qualified iodized salt(13.50%,39.14%,61.86%,and 69.17%)were compared in different regions were compared,and the differences were statistically significant(χ^(2)=257.65,235.64,P<0.001).A total of 1419 children underwent ultrasound examination of the thyroid gland,and there were no statistically significant differences when comparing the rates of goiter(2.44%,2.18%,3.04%,and 3.12%)and nodule detection(3.90%,4.90%,5.89%,and 2.18%)among the children in different regions(χ^(2)=0.85,6.69,P>0.05).A total of 2488 water samples were monitored,and the median water iodine was 3.70μg/L.When comparing the median water iodine in different regions,the difference was statistically significant(H=141.21,P<0.001).A total of 120 salt samples of edible salt from catering units were tested,and the consumption rate of qualified iodized salt was 62.50%.Conclusion The consumption rate of qualified iodized salt among children in Yantai was below 90%,but their iodine nutrition was at an appropriate level,suggesting that the iodine intake of children in Yantai may not be entirely dependent on iodized salt.
作者
李悦
向继平
张茗媛
刘靖宇
林荣
Li Yue;Xiang Jiping;Zhang Mingyuan;Liu JingYu;Lin Rong(Department of Endemic and Parasitic Disease Prevention,Yantai Center for Disease Control and Prevention,Yantai 264003,China)
出处
《中华地方病学杂志》
北大核心
2024年第10期818-822,共5页
Chinese Journal of Endemiology
基金
烟台市科技计划项目(2022YD109)
山东省学校卫生协会项目(JKZX2023214)
关键词
碘
儿童
盐类
尿
营养
Iodine
Children
Salts
Urine
Nutrition
