目的 调查评估福建省育龄妇女、孕妇和乳母碘营养状况,并分析其影响因素,旨在为精准补碘提供一定科学指导。方法 采用多阶段分层整群抽样方法共抽取1452名育龄妇女、2749名孕妇和1397乳母进行问卷调查,采集其家中盐样检测盐碘,采集其尿样检测尿碘。应用χ2检验、多因素Logistic回归模型对影响福建省育龄妇女、孕妇和乳母碘营养水平的人口学特征因素进行分析。结果 育龄妇女、孕妇和乳母合格碘盐覆盖率分别为89.9%、92.5%、93.4%,尿碘中位数分别为128.9、130.2、106.0 μg/L。多因素Logistic回归分析显示,沿海的育龄妇女、孕中期、孕晚期、沿海的孕妇及纯母乳喂养、沿海、食用未加碘盐的乳母碘营养不足风险更高（分别OR=1.351,1.231、1.389、1.289,1.414、1.313、2.171,均P<0.05）;而文化程度、人均年收入、城乡分布、身高质量指数对上述3类妇女碘营养水平的影响无统计学意义（P>0.05）结论 福建省育龄妇女、乳母碘营养适宜,而孕妇碘营养轻度不足。
Abstract
Objective To investigate the iodine nutritional status of childbearing aged, pregnant and breastfeeding in Fujian Province, and analyze its influencing factors, to provide some scientific guidance for precision iodine supplementation. Methods A total of 1452 women of childbearing age, 2749 pregnant women and 1397 lactating women were selected by a multi-stage stratified random sampling method. A questionnaire survey was conducted. Salt samples were collected from their households to detect salt iodine, and urine samples to detect urinary iodine. The χ2 test and multivariate logistic regression model were used to analyze the demographic characteristics and factors affecting the iodine nutrition level. Results The consumption rates of qualified iodized salt for women of childbearing age, pregnant women and lactating mothers were 89.9%, 92.5% and 93.4%, and the median urinary iodine concentrations were 128.9, 130.2 and 106.0μg/L, respectively. Multivariate logistic regression model analysis showed that women of childbearing age in coastal areas, pregnant women in the second and third trimesters of pregnancy, and coastal areas, and lactating mothers with exclusive breastfeeding, in coastal areas, and consuming non-iodized salt had a higher risk of iodine deficiency ( OR = 1.351; 1.231, 1.389, 1.289; 1.414, 1.313, 2.171, respectively, all P<0.05 ). However, the effects of education level, per capita annual income, urban and rural distribution, and body mass index on the iodine nutrition level among the women were not statistically significant (P>0.05 ). Conclusion The iodine nutrition of women of childbearing age and lactating mothers in Fujian Province is sufficient, while the iodine nutrition of pregnant women is mildly deficient.
关键词
育龄妇女 /
孕妇 /
乳母 /
尿碘 /
影响因素
Key words
women of child-bearing age /
pregnant women /
breastfeeding women /
influencing factors /
urinary iodine
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参考文献
[1] Zimmermann MB,Jooste PL,Pandav CS.Iodine-deficiency disorders[J]. Lancet,2008,372:1251–1262.
[2] WHO/UNICEF/ICCIDD. Assessment of iodine deficiency disorders and monitoring their elimination[M]// A guide for programme managers.3 ed. Geneva: World Health Organization,2007.
[3] Hynes KL, Otahal P, Hay I, et al. Mild iodine deficiency during pregnancy is associated with reduced educational outcomes in the offspring: 9-year follow-up of the gestational iodine cohort[J]. J Clin Endocrinol Metab,2013,98:1954–1962.
[4] Chen D,Ye Y,Lan Y,et al. Adequate iodine nutrition and higher salt intake in Chinese adults aged 18-59 years recommended by international organizations[J]. Sci Rep,2024,14:6993.
[5] 陈迪群,张小珍,兰莺,等. 减盐对福建省成人膳食碘摄入和碘营养状况的影响[J]. 营养学报,2023,45:431–435.
[6] Lin Y,Chen D,Wu J,et al. Iodine status five years after the adjustment of universal salt iodization:a cross-sectional study in Fujian Province, China[J]. Nutr J,2021,20:1–8.
[7] Bath SC,Steer CD,Golding J,et al. Effect of inadequate iodine status in UK pregnant women on cognitive outcomes in their children: results from the Avon Longitudinal Study of Parents and Children (ALSPAC)[J]. Lancet,2013,382:331–337.
[8] Chen D,Ye Y,Wu J,et al. Comparison of thyroglobulin and thyroid function in pregnant women between counties with a median urinary iodine concentration of 100-149 µg/L and 150-249 µg/L[J]. Biomed Environ Sci,2023,36:917–929.
[9] Li C,Peng S,Zhang X,et al. The urine iodine to creatinine as an optimal index of iodine during pregnancy in an iodine adequate area in China[J]. J Clin Endocrinol Metab,2016,101:1290–1298.
[10] Lopes CA,Duarte M,Prazeres S,et al. Maternal urinary iodine concentration during pregnancy and its impact on child growth and neurodevelopment: an 11-year follow-up study[J]. Nutrients,2023,15:4447.
[11] 吴晓燕,陈迪群,吴佳妮,等.福建省孕妇膳食碘摄入与碘营养状况分析[J].营养学报,2023,45:354–358.
[12] Sun R,Fan L,Du Y,et al. The relationship between different iodine sources and nutrition in pregnant women and adults[J]. Front Endocrinol (Lausanne),2022,13:924990.
[13] Dold S, Zimmermann MB, Aboussad A, et al. Breast milk iodine concentration is a more accurate biomarker of iodine status than urinary iodine concentration in exclusively breastfeeding women[J]. J Nutr,2017,147:528–537.
[14] Rohner F,Nizamov F,Petry N,et al. Household coverage with adequately iodized salt and iodine status of nonpregnant and pregnant women in Uzbekistan[J]. Thyroid,2020,30:898–890.
基金
国家卫生健康委病因流行病学重点实验室（哈尔滨医科大学）开放课题（No.NHCKLEE20230907）
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