Health Research and Development Center.
J Nutr Sci Vitaminol (Tokyo). 2020;66(Supplement):S468-S473. doi: 10.3177/jnsv.66.S468.
Iodine deficiency affects people of all age groups and yields detrimental health effects known as Iodine Deficiency Disorders (IDD). Universal Salt Iodization (USI) where above 90% household use iodized salt became the main program to optimized population iodine status. This study aimed to analyze iodine in salt, iodine status and thyroid functions from three different IDD endemic regions.
This was a cross-sectional study, with women of reproductive age (15 to 45 y old) as subjects, conducted in plain area (Yogyakarta) city (n=250), mountainous area (Bukit Tinggi city) (n=249), and combination of mountaneous and plain area (Purworejo regency) (n=249). Urinary iodine (UIE), prevalence of hyperthyroidism, and hypothyroidism (diagnostic based on combination of TSH and fT4 level), also the presence or absence and level of iodine in salt were assessed.
Iodized salt coverage have reached >90% household in all three region, while titration found 75.6% with adequate level of iodine in salt (>30 ppm), with wide range of iodine level in salt (0.00-218.2 ppm). With that condition, population in plain and combination of plain and mountainous area have more than adequate iodine status (218 μg/L and 224 μg/L), while population in mountaneous area still in mild iodine deficiency status (UIE median of 88 μg/L). Most population is in euthyroid condition. Hyperthyroidism, subclinical hyperthyroidism, secondary hyperthyroidism, subclinical hypothyroidism, and hypothyroidism were found in 0.7%, 4.8%, 0.4%, 8.9%, and 0.9% population consecutively. There were no relationship between iodine status and prevalence of hyperthyroidism and hypothyroidism, but subclinical hypothyroidism most prevalent in excess UIE population (12.5% vs 8.3%).
All three regions have achieved USI target. But the risk of iodine deficiency still found in mountaneous area. Household iodized salt coverage discrepancy between rapid test and titration strengthen the need of more accurate but efficient test of iodine level in salt.
碘缺乏影响所有年龄段的人群，并产生碘缺乏疾病（IDD）等有害健康影响。全民食盐碘化（USI），即 90%以上的家庭使用碘盐，成为优化人群碘营养状况的主要方案。本研究旨在分析三个碘缺乏病流行地区的盐碘、碘营养状况和甲状腺功能。
这是一项横断面研究，以 15-45 岁的育龄妇女为研究对象，分别在平原地区（日惹）、山区（武吉丁宜）和山区和平原混合区（普沃勒佐摄政区）进行（n=250、n=249、n=249）。检测尿碘（UIE）、甲亢和甲减（根据 TSH 和 fT4 水平联合诊断）的患病率，以及盐碘的存在和含量。
三个地区的家庭碘盐覆盖率均>90%，而滴定发现 75.6%的盐碘含量充足（>30ppm），盐碘含量范围广泛（0.00-218.2ppm）。在这种情况下，平原和山区混合地区的人群碘营养状况充足（218μg/L 和 224μg/L），而山区人群仍处于轻度碘缺乏状态（UIE 中位数为 88μg/L）。大多数人群处于甲状腺功能正常状态。甲亢、亚临床甲亢、继发甲亢、亚临床甲减和甲减的患病率分别为 0.7%、4.8%、0.4%、8.9%和 0.9%。碘营养状况与甲亢和甲减的患病率之间无相关性，但亚临床甲减在 UIE 水平较高的人群中更为常见（12.5%vs8.3%）。
三个地区均已达到 USI 目标。但山区仍存在碘缺乏风险。快速检测和滴定法之间的家庭碘盐覆盖率差异表明，需要更准确但更有效的盐碘含量检测方法。
