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目的评价全面实行食盐加碘20年来上海市居民碘营养及膳食碘摄入状况的变化。方法采用砷铈催化分光光度法测定1995—2015年上海市学龄儿童、孕妇、乳母及成年人的尿碘水平,B超测定学龄儿童的甲状腺容积,计算甲状腺肿大率;采用直接滴定法/仲裁法定量检测居民户食盐中碘含量水平;采用3 d 24 h膳食询问调查及调味品称量方法开展膳食调查,分析全部食用碘盐及全部食用无碘盐情况下各人群碘摄入水平及来源。结果上海市学龄儿童尿碘水平1995年为72.3μg/L,1997—1999年为214~231μg/L,2002年之后稳定于100~200μg/L,儿童甲状腺肿大率均低于5%。孕妇尿碘的中位数为126.5~139.8μg/L,成年人、哺乳期妇女、婴幼儿及育龄妇女的尿碘中位数分别为138.4、123.1~131.1、150.1及125.6μg/L。2001—2009年居民合格碘盐食用率在90%以上,2010年开始逐年下降。如全部食用碘盐,总碘摄入量中位数7~10岁、11~13岁、14~18岁及18岁以上男性分别为200.3、235.5、252.7及215.4μg/L;女性分别为193.0、213.8、208.3及186.1μg/L。碘盐在男、女性膳食中贡献率分别为51.6%~54.1%和49.1%~53.0%。海带、紫菜及鱼虾类对碘的贡献率分别为7.6%~16.6%和4.5%~7.4%。结论近20年上海市居民的碘营养状况趋于稳定,总体处于适宜和安全的水平,但孕妇碘营养不足。碘盐是沿海地区膳食碘的主要来源。为保证居民碘的日常需要,控制居民的碘缺乏风险,上海地区继续实施食盐加碘的策略仍有必要。
Objective To evaluate the changes of iodine nutrition and dietary iodine intake of Shanghai residents in the past 20 years since the salt iodization was fully implemented. Methods Arsenic and cerium catalytic spectrophotometry was used to determine the level of urinary iodine in school-age children, pregnant women, nursing mothers and adults in Shanghai from 1995 to 2015. The thyroid volume of school-age children was measured by B ultrasound and the goiter rate was calculated. The titration was performed by direct titration / The method was used to measure the level of iodine in the salt of the residents. The 3 d 24 h dietary survey and the method of weighing the condiment were used to carry out the dietary survey. The iodine intake and source of all the groups . Results The urinary iodine level of school-age children in Shanghai was 72.3 μg / L in 1995, 214 ~ 231 μg / L in 1997-1999 and 100-200 μg / L in 2002. The rate of goiter in children was less than 5%. The median urinary iodine of pregnant women was 126.5 ~ 139.8μg / L, and the median urinary iodine of adults, lactating women, infants and children of childbearing age were 138.4,123.1 ~ 131.1,150.1 and 125.6μg / L, respectively. In 2001-2009, the rate of consumption of iodized salt by residents was above 90%, and decreased from 2010 onwards. The total iodine intake was 7-10 years old, 11-13 years old, and 200.3,235.5,252.7 and 215.4 μg / L for men aged 14-18 and 215.4 years old, respectively; women were 193.0 , 213.8, 208.3 and 186.1 μg / L. The contribution rates of iodized salt in male and female diets were 51.6% -54.1% and 49.1% -53.0%, respectively. The contributions of kelp, seaweed and fish and shrimp to iodine were 7.6% ~ 16.6% and 4.5% ~ 7.4%, respectively. Conclusion The iodine nutrition status of residents in Shanghai tends to be stable over the past 20 years, generally at a suitable and safe level, but pregnant women lack iodine nutrition. Iodized salt is the main source of dietary iodine in coastal areas. In order to ensure the daily needs of residents and control the residents’ risk of iodine deficiency, it is still necessary to continue the strategy of salt iodization in Shanghai.