Fujian Center for Disease Control and Prevention, Department of Endemic Diseases, Fujian, No. 76 Jintai Road, Fujian, 350001, Fuzhou, People's Republic of China.
Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18, 17165, Solna, Sweden.
Nutr J. 2021 Feb 23;20(1):17. doi: 10.1186/s12937-021-00676-7.
Universal salt iodization program was introduced to China to eliminate iodine deficiency disorders in 1995. In 2012, Fujian Province decreased the concentration of iodized table salt according to the national unified requirement. This study aimed to assess the effect on iodine status after the adjustment, providing evidence for further adjustment in Fujian Province.
Sampling units were selected by multistage cluster sampling method. In each sampling unit, table salt was collected from 30 households. A total of 2,471 people in 2009 and 4,806 people in 2017 provided urine samples and were included in this cross-sectional analysis. Median iodized salt concentration and median urine iodine concentration were present by median and interquartile range.
Median iodized salt decreased from 29.8 mg/kg in 2009 to 23.9 mg/kg in 2017. The median urinary iodine concentrations for school-age children in 2017 in coastal urban area, non-coastal urban area, coastal rural area and non-coastal rural area were 163.6µg/L (interquartile range = 100.1-252.0µg/L), 198.9µg/L (interquartile range = 128.0-294.0µg/L), 181.8µg/L (interquartile range = 114.1-257.0µg/L) and 218.2µg/L (interquartile range = 148.1-306.5µg/L), respectively. The median urinary iodine concentrations for adults in 2017 in these areas were 151.1µg/L (interquartile range = 98.3-231.7µg/L), 168.7µg/L (interquartile range = 109.6-242.0µg/L), 167.7µg/L (interquartile range = 105.7-245.7µg/L) and 182.7µg/L (interquartile range = 117.1-258.9µg/L). The median urinary iodine concentrations for pregnant women in 2017 in these areas were 157.7µg/L (interquartile range = 106.9-223.8µg/L), 141.5µg/L (interquartile range = 97.7-207.6µg/L), 127.3µg/L (interquartile range = 90.0-184.5µg/L) and 144.8µg/L (interquartile range = 99.9-184.5µg/L). The median urinary iodine concentrations for lactating women in 2017 in these areas were 122.7µg/L (interquartile range = 84.1-172.0µg/L), 123.7µg/L (interquartile range = 70.7-184.7µg/L), 105.8µg/L (interquartile range = 67.1-152.3µg/L) and 110.2µg/L (interquartile range = 74.1-170.3µg/L).
The overall urinary iodine concentrations among school-age children, adults and lactating women dramatically decreased after implementing the new standard. Almost all of them were iodine adequate, suggesting we reached the expected aim of iodized salt adjustment. However, pregnant women were iodine insufficient after adjustment. Therefore, we should continue the surveillance of iodine status of populations and focus on the additional iodine supplement strategies for pregnant women.
1995 年，中国引入了全民食盐碘化计划，以消除碘缺乏症。2012 年，根据国家统一要求，福建省降低了碘盐浓度。本研究旨在评估调整后的效果，为福建省进一步调整提供依据。
采用多阶段整群抽样方法抽取采样单位。在每个采样单位，从 30 户家庭中采集食盐。共有 2009 年 2471 人和 2017 年 4806 人提供了尿液样本，进行了这项横断面分析。用中位数和四分位数间距表示碘盐浓度和尿碘中位数。
2009 年碘盐中位数为 29.8mg/kg，2017 年降至 23.9mg/kg。2017 年沿海城区、非沿海城区、沿海农村和非沿海农村学龄儿童的尿碘中位数分别为 163.6µg/L（四分位间距 100.1-252.0µg/L）、198.9µg/L（四分位间距 128.0-294.0µg/L）、181.8µg/L（四分位间距 114.1-257.0µg/L）和 218.2µg/L（四分位间距 148.1-306.5µg/L）。2017 年这些地区成人的尿碘中位数分别为 151.1µg/L（四分位间距 98.3-231.7µg/L）、168.7µg/L（四分位间距 109.6-242.0µg/L）、167.7µg/L（四分位间距 105.7-245.7µg/L）和 182.7µg/L（四分位间距 117.1-258.9µg/L）。2017 年这些地区孕妇的尿碘中位数分别为 157.7µg/L（四分位间距 106.9-223.8µg/L）、141.5µg/L（四分位间距 97.7-207.6µg/L）、127.3µg/L（四分位间距 90.0-184.5µg/L）和 144.8µg/L（四分位间距 99.9-184.5µg/L）。2017 年这些地区哺乳期妇女的尿碘中位数分别为 122.7µg/L（四分位间距 84.1-172.0µg/L）、123.7µg/L（四分位间距 70.7-184.7µg/L）、105.8µg/L（四分位间距 67.1-152.3µg/L）和 110.2µg/L（四分位间距 74.1-170.3µg/L）。
实施新标准后，学龄儿童、成人和哺乳期妇女的总体尿碘浓度显著下降。他们几乎都处于碘充足状态，表明我们达到了调整碘盐的预期目标。然而，调整后孕妇碘摄入不足。因此，我们应继续监测人群的碘营养状况，并关注孕妇的额外碘补充策略。
