Deng Jing, Xu Wei-min, Zhu Xiao-xia, Jin Quan, Huang Yang-mei, Liu Hui, Jin Xing-yi
Hangzhou Center for Disease Control and Prevention, Hangzhou, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2011 Oct;32(10):1009-13.
To explore the iodine level in the environment and the iodine status among the general population as well as the prevalence of thyroid nodules in Hangzhou city. Relationship between the prevalence of thyroid nodules and the policy of universal salt iodization in Hangzhou was also analyzed.
Questionnaire, a 3-day weighed dietary record method, and 3 days' 24-hour dietary recall method were used to understand the iodine nutrition status and dietary intake of iodine among the general population in the city. Drinking water, edible salt and morning urine were collected to determine iodine content. All objects under survey underwent the thyroid B ultrasonic examination. Statistical analysis was done by SPSS 13.0 and SAS 9.1.
(1) In total, 12 620 effective questionnaires were available, with 221 water samples, 12 730 urine samples, and 3593 salt samples collected. 12 515 objects underwent B ultrasonic examination, and 1848 received dietary investigation. (2) Water iodine level of Hangzhou was in the range of 0.20 - 5.99 µg/L, with the median level as 2.58 µg/L. (3) Average daily dietary intake of iodine for adult males in Hangzhou was 289.2 µg/d. The contribution of iodine intake from iodized salt was 74.4%. (4) The median of Hangzhou residents' urinary iodine was 178.80 µg/L, with the urinary iodine levels at 100 µg/L-, 200 µg/L-, < 100 µg/L, and ≥ 300 µg/L groups were 37.14%, 23.11%, 21.05%, and 18.69% respectively. Urinary iodine of pregnant women was 141.0 µg/L. (5) Incidence of thyroid nodules in females (28.6%) was higher than that of males (20.1%). The detection rate increased with age (6.4% at group 6-, 10.9% at 12-, 12.0% at 18-, 24.4% at 40-, and 38.8% at 65-); with the highest in urban area (29.8%), followed by suburbs (23.3%) and in rural area it showed the least (20.3%). Urinary iodine level was found lower among the population who had been detected with thyroid nodules (160.36 µg/L) than those among the undetected population (182.00 µg/L).
Hangzhou appeared to be an area where the environmental was iodine deficient. Iodized salt was the major source of iodine intake. The iodine status among the general population seemed to be safe and suitable, but the iodine level for pregnant women was not sufficient. There was still no evidence indicating that the universal salt iodization policy in Hangzhou was associated with the prevalence of thyroid nodules.
了解杭州市环境碘水平、人群碘营养状况及甲状腺结节患病情况,并分析甲状腺结节患病率与食盐加碘政策的关系。
采用问卷调查、3天膳食称重法和3天24小时膳食回顾法,了解杭州市居民碘营养状况及碘膳食摄入情况。采集饮用水、食用盐和晨尿测定碘含量。对所有调查对象进行甲状腺B超检查。采用SPSS 13.0和SAS 9.1软件进行统计分析。
(1)共获得有效问卷12620份,采集水样221份、尿样12730份、盐样3593份。12515人接受B超检查,1848人接受膳食调查。(2)杭州市水碘含量范围为0.20~5.99μg/L,中位数为2.58μg/L。(3)杭州市成年男性碘膳食摄入量平均为289.2μg/d,碘盐对碘摄入的贡献率为74.4%。(4)杭州市居民尿碘中位数为178.80μg/L,尿碘水平在100μg/L~、200μg/L~、<100μg/L和≥300μg/L组的构成比分别为37.14%、23.11%、21.05%和18.69%。孕妇尿碘为141.0μg/L。(5)女性甲状腺结节发病率(28.6%)高于男性(20.1%)。检出率随年龄增长而升高(6~岁组为6.4%,12~岁组为10.9%,18~岁组为12.0%,40~岁组为24.4%,65~岁组为38.8%);城区最高(29.8%),其次为郊区(23.3%),农村最低(20.3%)。甲状腺结节检出人群尿碘水平(160.36μg/L)低于未检出人群(182.00μg/L)。
杭州市为环境碘缺乏地区,碘盐是碘摄入的主要来源。人群碘营养状况总体处于安全适宜水平,但孕妇碘营养不足。尚无证据表明杭州市食盐加碘政策与甲状腺结节患病率有关。