Fan Lijun, Meng Fangang, Sun Qihao, Zhai Yuqian, Liu Peng
National Health Commission and Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University, Harbin, China.
Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, China.
Front Nutr. 2022 Apr 13;9:852398. doi: 10.3389/fnut.2022.852398. eCollection 2022.
Enormous efforts have been made to evaluate the worldwide prevention and control of iodine deficiency disorders (IDDs). This study evaluated China's achievements in IDD prevention and control against WHO criteria for sustainable elimination of IDD. The study sample consisted of 556,390 school-aged children and 271,935 pregnant women enrolled in the 2018 China National IDD Surveillance. As a result, at the national level, median urine iodine concentration (MUIC) was 206.1 and 163.5 μg/l in children and in pregnant women, respectively. The proportion of households consuming adequate iodized salt (PHCAIS) was 90.2%. The prevalence rates of goiter in children and thyroid disease in pregnant women were 2.0 and 0.8%, respectively. MUIC showed significant non-linear increasing trends with increasing PHCAIS in both children and pregnant women. The prevalence of thyroid disease in pregnant women had a sharp decreasing trend with increasing PHCAIS. Of note, the prevalence of goiter in children and thyroid disease in pregnant women against MUIC both presented as significant U-shaped curves, with the lowest prevalence at 100-300 μg/l of MUIC in children and 150-250 μg/l in pregnant women. PHCAIS, MUIC, and the programmatic indicators at the national level were all above their cut-offs proposed in the 2007 Criteria. Evaluation by adding the prevalence of goiter (<5%) yielded the different results at the county level. Sustainable elimination of IDD has been achieved nationally. 2018 Chinese surveillance data support the expansion of global cut-offs for optimal iodine status in school-age children from 100-199 to 100-299 μg/l as recommended by others and the lower limit of MUIC (150 μg/l) in pregnant women also seems justified. Inclusion of goiter prevalence <5% in our analysis reduced the number of municipalities and counties which had achieved sustainable elimination of IDD.
为评估全球碘缺乏病（IDD）的预防和控制情况，人们付出了巨大努力。本研究对照世界卫生组织可持续消除碘缺乏病的标准，评估了中国在碘缺乏病预防和控制方面取得的成就。研究样本包括2018年中国全国碘缺乏病监测中纳入的556,390名学龄儿童和271,935名孕妇。结果显示，在国家层面，儿童和孕妇的尿碘中位数浓度（MUIC）分别为206.1和163.5μg/L。食用合格碘盐的家庭比例（PHCAIS）为90.2%。儿童甲状腺肿患病率和孕妇甲状腺疾病患病率分别为2.0%和0.8%。儿童和孕妇的MUIC均随PHCAIS的增加呈显著非线性上升趋势。孕妇甲状腺疾病患病率随PHCAIS的增加呈急剧下降趋势。值得注意的是，儿童甲状腺肿患病率和孕妇甲状腺疾病患病率与MUIC均呈显著的U形曲线，儿童MUIC在100 - 300μg/L、孕妇在150 - 250μg/L时患病率最低。国家层面的PHCAIS、MUIC及规划指标均高于2007年标准中提出的临界值。按甲状腺肿患病率（<5%）进行评估，在县级层面得出了不同结果。中国在全国范围内已实现碘缺乏病的可持续消除。2018年中国的监测数据支持将学龄儿童最佳碘营养状态的全球临界值从100 - 199μg/L扩大至100 - 299μg/L（正如其他人所建议的），孕妇MUIC的下限（150μg/L）似乎也合理。在我们的分析中纳入甲状腺肿患病率<5%，减少了已实现碘缺乏病可持续消除的市和县的数量。
