Wang Zhengyuan, Luo Baozhang, Zang Jiajie, Shi Zehuan, Cui Xueying, Song Qi, Jin Wei, Guo Changyi, Liu Shoujun
Division of Health Risk Factors Monitoring and Control, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China.
General office, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China.
Thyroid. 2020 Oct;30(10):1535-1540. doi: 10.1089/thy.2019.0813. Epub 2020 May 12.
The appropriate range of median urinary iodine concentration (MUI) in children has always been controversial. To prevent the occurrence of a goiter epidemic in Shanghai, we explored the appropriate range of MUI by integrating multiple monitoring results. This study summarized and analyzed the monitoring data from 1997, 1999, 2011, 2014, and 2017 of children living in Shanghai. In each monitoring year, the probability-proportional-to-size sampling technique was used to select 30 sampling units. In each sampling unit, one primary school was randomly selected. From each selected school, 40 children 8- to 10-year-old were randomly recruited to measure thyroid volume (Tvol) and their household salt iodine intake. In 1997, 1999, 2011, 2014, and 2017, MUI of 8- to 10-year-old children was 228, 214, 182, 171, and 183 μg/L, and median Tvol (MTvol) was 2.9, 1.2, 1.0, 1.8, and 2.8 mL, respectively. There was a linear correlation between goiter rate and MTvol ( = 0.95, = 0.014; 100 × goiter rate = 1.314 × MTvol -1.287). Generalized additive model (GAM) was used to predict MTvol as follows, MTvol = 0.60689 + 0.00302 MUI +0.999928 s (MUI) -0.05172 mean salt iodized concentrations (MSIs) +0.03481 × 100 × iodized salt coverage rate +0.00000969 per capita disposable income +0.271422 s (per capita disposable income) -0.38772 × monitoring year gap. The results revealed that the average relative error between predicted and actual value was 15.2%. GAM results showed that at 27-277 μg/L MUI, the goiter rate was <5%. Iodine status is appropriate in Shanghai. Under the existing economy and MSI, the optimal range of MUI should be 70-277 μg/L in 8- to 10-year-old children living in Shanghai.
儿童尿碘中位数（MUI）的适宜范围一直存在争议。为预防上海地区甲状腺肿流行的发生，我们通过整合多项监测结果来探索MUI的适宜范围。本研究总结并分析了1997年、1999年、2011年、2014年和2017年上海儿童的监测数据。在每个监测年份，采用按规模大小成比例的概率抽样技术选取30个抽样单元。在每个抽样单元中，随机选择一所小学。从每所选定的学校中，随机招募40名8至10岁的儿童测量甲状腺体积（Tvol）及其家庭盐碘摄入量。1997年、1999年、2011年、2014年和2017年，8至10岁儿童的MUI分别为228、214、182、171和183μg/L，甲状腺体积中位数（MTvol）分别为2.9、1.2、1.0、1.8和2.8mL。甲状腺肿患病率与MTvol之间存在线性相关性（r = 0.95，P = 0.014；100×甲状腺肿患病率 = 1.314×MTvol - 1.287）。采用广义相加模型（GAM）预测MTvol如下：MTvol = 0.60689 + 0.00302MUI + 0.999928s（MUI） - 0.05172平均盐碘浓度（MSIs） + 0.03481×100×碘盐覆盖率 + 0.00000969人均可支配收入 + 0.271422s（人均可支配收入） - 0.38772×监测年份间隔。结果显示，预测值与实际值之间的平均相对误差为15.2%。GAM结果表明，当MUI为27 - 277μg/L时，甲状腺肿患病率<5%。上海地区碘营养状况适宜。在现有经济水平和MSI条件下，上海地区8至10岁儿童MUI的最佳范围应为70 - 277μg/L。
