2009-2018年哈尔滨市居民碘营养状况调查
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摘要
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、186.31μg/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。
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.
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.
引文
[1]国家卫生和计划生育委员会办公厅.全国碘缺乏病监测方案(2016版)[EB/OL].[2019-05-24].http://www.nhfpc.gov.cn/jkj/s5873/201604/950811922fb944b5ab3b59e4ae21a3a3.shtml.
[2]中华人民共和国卫生部.GB 26878-2011食品安全国家标准食用盐碘含量[S].北京:中国标准出版社,2012.
[3] World Health Organization.Assessment of iodine deficiency disorders and monitoring their elimination:a guide for programme managers,third edition[EB/OL].[2019-05-24]. https://www.who.int/nutrition/publications/micronutrients/iodine_deficiency/9789241595827/en/.
[4]曹建滨,高晓丽,王非非,等.2011年哈尔滨市不同人群碘营养状况调查[J].中国地方病学杂志,2012,31(3):311-314.
[5]许聪辉,刘小宁,潘志明,等.2012年广州市孕妇碘营养状况调查[J].现代预防医学,2014,41(11):1991-1992.
[6]郭晶晶,张系忠,刘玮,等.2012-2016年陕西省渭南市高水碘区富平县儿童尿碘监测结果分析[J].医学动物防制,2018,34(9):917-919.
[7]赵爱珠,侯兴佑,徐向明,等.2013-2017年渭南市重点人群尿碘检测结果分析[J].现代预防医学,2018,45(11):2077-2079,2102.
[8]王晓岑,佟丽娟.通过对食用碘盐质量的检测分析防治碘缺乏病的措施探讨[J].中国医药指南,2019,17(1):295.
[9]陈丽,张福明,杜忠华,等.碘过量与甲状腺疾病[J].中国地方病防治杂志,2010,25(2):110-112.
[10]周德梅,孟凡刚,杨宇,等.新国标碘盐浓度下贵州省儿童、孕妇碘营养状况调查[J].现代预防医学,2016,43(11):1948-1951.
[2]中华人民共和国卫生部.GB 26878-2011食品安全国家标准食用盐碘含量[S].北京:中国标准出版社,2012.
[3] World Health Organization.Assessment of iodine deficiency disorders and monitoring their elimination:a guide for programme managers,third edition[EB/OL].[2019-05-24]. https://www.who.int/nutrition/publications/micronutrients/iodine_deficiency/9789241595827/en/.
[4]曹建滨,高晓丽,王非非,等.2011年哈尔滨市不同人群碘营养状况调查[J].中国地方病学杂志,2012,31(3):311-314.
[5]许聪辉,刘小宁,潘志明,等.2012年广州市孕妇碘营养状况调查[J].现代预防医学,2014,41(11):1991-1992.
[6]郭晶晶,张系忠,刘玮,等.2012-2016年陕西省渭南市高水碘区富平县儿童尿碘监测结果分析[J].医学动物防制,2018,34(9):917-919.
[7]赵爱珠,侯兴佑,徐向明,等.2013-2017年渭南市重点人群尿碘检测结果分析[J].现代预防医学,2018,45(11):2077-2079,2102.
[8]王晓岑,佟丽娟.通过对食用碘盐质量的检测分析防治碘缺乏病的措施探讨[J].中国医药指南,2019,17(1):295.
[9]陈丽,张福明,杜忠华,等.碘过量与甲状腺疾病[J].中国地方病防治杂志,2010,25(2):110-112.
[10]周德梅,孟凡刚,杨宇,等.新国标碘盐浓度下贵州省儿童、孕妇碘营养状况调查[J].现代预防医学,2016,43(11):1948-1951.