Postgraduate Program in Public Health, Faculty of Medicine, Universidade Federal do Rio Grande, Rua Visconde de Paranaguá, 102, 4o Piso, Rio Grande RS 96210.900, Brazil.
Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Rua Marechal Deodoro, 1160 - 3° Piso, Pelotas RS 96020.220, Brazil.
Nutrients. 2020 Apr 13;12(4):1077. doi: 10.3390/nu12041077.
Salt iodization is the main public health policy to prevent and control iodine deficiency disorders. The National Salt Iodization Impact Assessment Survey (PNAISAL) was conducted to measure iodine concentration among Brazilian schoolchildren. A survey including 6-14-year-old schoolchildren from public and private schools from all 26 Brazilian states and the Federal District was carried out in the biennia 2008-2009 and 2013-2014. Municipalities, schools, and students were randomly selected. Students were interviewed at school using a standard questionnaire, which included the collection of demographic, educational, weight, height, and 10 mL non-fasting urine collection information. The analyses were weighted according to the population of students per federative unit. The median urinary iodine concentration (MUIC) for the entire sample by region, federative unit per school, and student characteristics, was described from the cutoff points defined by the World Health Organization (severe disability: <20 µg/L, moderate: 20-49 µg/L, mild: 50-99 µg/L, adequate: 100-199 µg/L, more than adequate: 200-299 µg/L, and excessive: >300 µg/L). In total, 18,864 students (95.9% of the total) from 818 schools in 477 municipalities from all federative units were included in this study. Almost 70% were brown skin color, nine-years-old or older, studied in urban schools, and were enrolled in elementary school. The prevalence of overweight/obesity, as measured by body mass index (BMI) for age, was about twice as high compared to nutritional deficits (17.3% versus 9.6%). The MUIC arrived at 276.7 µg/L (25th percentile = 175.5 µg/L and 75th percentile = 399.71 µg/L). In Brazil as a whole, the prevalence of mild, moderate, and severe deficit was 6.9%, 2.6%, and 0.6%, respectively. About one-fifth of the students (20.7%) had adequate iodine concentration, while 24.9% and 44.2% had more than adequate or excessive concentration, respectively. The prevalence of iodine deficits was significantly higher among younger female students from municipal public schools living in rural areas with the lowest BMI. The median urine iodine concentration showed that Brazilian students have an adequate nutritional intake, with a significant proportion of them evidencing overconsumption of this micronutrient.
盐碘强化是预防和控制碘缺乏症的主要公共卫生政策。开展了国家盐碘强化影响评估调查（PNAISAL），以测量巴西学童的碘浓度。这项调查涵盖了来自巴西所有 26 个州和联邦区的公立和私立学校的 6-14 岁学童，在 2008-2009 年和 2013-2014 年两年间进行。采用随机抽样的方法选取了市县和学生。在学校，学生们通过标准问卷接受了采访，问卷内容包括人口统计学、教育、体重、身高和 10 毫升非禁食尿液采集信息。根据每个联邦单位的学生人数对分析结果进行了加权。根据世界卫生组织（严重残疾：<20μg/L、中度：20-49μg/L、轻度：50-99μg/L、充足：100-199μg/L、过多：200-299μg/L、过多：>300μg/L）的定义，按地区、每个市县的学校和学生特征，对整个样本的中位数尿碘浓度（MUIC）进行了描述。共有来自所有联邦单位的 477 个市县的 818 所学校的 18864 名学生（占总数的 95.9%）纳入了本研究。近 70%的学生是棕色皮肤，9 岁或以上，在城市学校学习，且在小学就读。与营养不足（9.6%）相比，超重/肥胖（用年龄体重指数衡量）的患病率要高近两倍（17.3%）。MUIC 达到 276.7μg/L（25%分位数=175.5μg/L，75%分位数=399.71μg/L）。在巴西全国范围内，轻度、中度和重度碘缺乏症的患病率分别为 6.9%、2.6%和 0.6%。约五分之一的学生（20.7%）碘摄入量充足，而 24.9%和 44.2%的学生碘摄入量过多或过量。在来自农村地区、公立市立学校的年轻女学生中，碘缺乏症的患病率明显更高，这些学生的 BMI 最低。尿碘中位数表明，巴西学生的营养摄入充足，其中相当一部分学生存在这种微量营养素摄入过量的情况。
