Department of Endocrinology and Metabolism, The Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Disease, The First Hospital of China Medical University, Shenyang, P.R. China.
Department of Endocrinology and Metabolism, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, P.R. China.
Thyroid. 2021 Dec;31(12):1858-1867. doi: 10.1089/thy.2021.0301. Epub 2021 Dec 2.
Despite the implementation of the universal salt iodization (USI) program for correction of iodine deficiency in China for ∼20 years, the actual iodine nutrition status of Chinese residents and the prevalence of iodine deficiency and iodine excess are issues that need to be addressed. This nationally representative cross-sectional study was conducted across all 31 provinces of mainland China to gather extensive data on iodine nutrition status and the influential factors. This study included 78,470 participants, aged 18 years or older, who were interviewed and asked to answer a questionnaire. Urine iodine concentration (UIC) was measured by the inductively coupled plasma mass spectrometry method, and goiter was examined by thyroid ultrasonography. In addition, sixty 9-11 years old school children in each province were randomly selected to evaluate the UIC and thyroid ultrasonography. The iodine nutrition status was determined according to the World Health Organization guidelines. The iodized salt coverage was 95.37%. The median urine iodine (MUI) was 177.89 μg/L (interquartile range [IQR], 117.89-263.90 μg/L) and goiter prevalence was 1.17% (confidence interval [95% CI 0.95-1.43]) in the adult population. The MUI was 199.75 μg/L (IQR, 128.41-303.37 μg/L) in school-age children, and goiter prevalence was 3.50% [95% CI, 2.93-4.13]. The percentage of individuals with UIC <50 μg/L was 3.43%, <20%. Analysis indicated that sex, age, geographic factors, body mass index, and smoking habits influence the iodine nutrition level. The mandatory USI program has successfully eliminated iodine deficiency disorders, and the findings indicate that the iodine nutrition level in the general population is within the safe range.
尽管中国已经实施了普遍食盐碘化（USI）计划来纠正碘缺乏症约 20 年，但中国居民的实际碘营养状况以及碘缺乏和碘过量的流行仍然是需要解决的问题。这项全国性的代表性横断面研究覆盖了中国大陆的 31 个省，以收集广泛的碘营养状况和影响因素数据。该研究纳入了 78470 名年龄在 18 岁及以上的参与者，通过问卷调查对他们进行了访谈。尿碘浓度（UIC）采用电感耦合等离子体质谱法测量，甲状腺超声检查甲状腺肿。此外，每个省还随机选择 60 名 9-11 岁的在校儿童，以评估 UIC 和甲状腺超声检查。根据世界卫生组织的指导原则确定碘营养状况。碘盐覆盖率为 95.37%。成年人的中位数尿碘（MUI）为 177.89μg/L（四分位距[IQR]，117.89-263.90μg/L），甲状腺肿患病率为 1.17%（95%可信区间[95%CI]：0.95-1.43）。在校儿童的 MUI 为 199.75μg/L（IQR：128.41-303.37μg/L），甲状腺肿患病率为 3.50%（95%CI：2.93-4.13）。UIC<50μg/L 的个体百分比为 3.43%，<20μg/L 的个体百分比为 0.50%。分析表明，性别、年龄、地理因素、体重指数和吸烟习惯影响碘营养水平。强制性 USI 计划成功消除了碘缺乏症，研究结果表明，普通人群的碘营养水平处于安全范围。
