【摘要】 目的:研究不同外环境碘水平地区人群碘营养状况,探讨高碘地区停供碘盐及"适碘"地区的水碘切点值,为制定预防策略提供依据。方法:沿黄河下游山东段选择不同地理位置的调查点13个,根据水碘含量分将其为0～(A)、50～(B)、100～(C)、150～(D)、300～(E)和800～μg/L(F)6个组,检测居民户饮用水和食盐碘含量,并对6～61岁居民进行尿碘测定和甲状腺肿大检查。结果:6个组的水碘中位数分别为20.3、91.4、143.2、203.6、341.9和812.3μg/L,盐碘中位数为0、25.7、25.8、30.4、36.4和33.0mg/kg,尿碘中位数为116.8、354.2、400.4、607.9、881.3和1213.8μg/L,甲状腺肿大率为10.8、8.6、15.0、14.2、14.9和25.0%。尿碘<100μg/L的样本占8.2%、100～300μg/L的占18.2%、>300μg/L的占73.6%。水碘>90μg/L的5组的尿碘频数分布都明显向高值偏移,其尿碘>300μg/L的比例随着水碘的升高而逐渐增加。水碘与尿碘的相关系数为0.449。水碘与尿碘和甲状腺肿大率均呈正相关,尿碘和甲状腺肿大率随水碘含量增加而升高,高碘地区明显高于低碘和"适碘"地区。结论:水碘20μg/L的地区须供应合格碘盐以使多数居民的碘营养水平适宜,而水碘在90μg/L以上地区居民的碘营养明显过量。建议:停供USI的水碘切点值为90μg/L,水碘在20～90μg/L之间的地区可暂界定为适碘地区。更多还原

【Abstract】 Objective:To study the master iodine nutrition status of population living in areas with different iodine in drinking water and the cut-off point of stopping iodized salt supply and the range of adequate iodine intake for the strategy of prevention from iodine deficiency or excess. Method:Thirteen townships points along the Yellow River downstream in Shandong were investigated and divided into six groups(A-F) based on water iodine concentrations of 0-50,50-100,100-150,150-300,300-800 and over 800 μg/L. The indicators of water iodine,edible salt iodine,urinary iodine(UI) and thyroid goiter were observed. Results:From A,B,C,D,E and F group,the medians of water iodine concentration were 20.3,91.4,143.2,203.6,341.9 and 812.3 μg/L,of edible salt iodine were 0,25.7,25.8,30.4,36.4 and 33.0 mg/kg,and of UI were 116.8,354.2,400.4,607.9,881.3 and 1 213.8 μg/L respectively. The goiter rates were 10.8,8.6,15.0,14.2,14.9 and 25.0 % respectively . The sample proportion of UI below 100 μg/L was 8.2%,of 100-300 μg/L was 18.2% and of over 300 μg/L was 73.6%. Frequency excursion of UI had a high trend towards water iodine concentration over 90μg/L in 5 groups. The proportion of UI over 300 μg/L increased,consistent with higher water iodine level. Median UI of all groups with iodized salt decreased significantly,especially group F. There were significant correlations between UI and water iodine. Iodine nutrition status was markedly excessive in group B,C,D,E and F. Conclusions:Iodine nutrition status of most residents consuming drinking water with iodine concentration about 20 μg/L should be adequately supplied with eligible iodized salt. Iodine intakes in groups B-F were excessive,and iodized salt supply should be stopped there. The cut-point of water iodine level where iodized salt stopped could possibly be 90 μg/L,and the range of adequate iodine intake,in terms of drinking water,could be defined at range of over 20 to 90 μg/L in iodine concentration.更多还原