Study on iodine nutrition and related influencing factors of children aged 8-10 in Wuhan
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摘要:
目的 了解武汉市学龄儿童碘营养状况及其相关因素,为调整儿童碘缺乏病防治策略提供依据。 方法 2019年在武汉市5个区(洪山、汉阳、汉南、江夏、东西湖)按东、西、南、北、中各抽取1所小学的8~10岁儿童,采集儿童随机一次尿样、家庭食用盐样进行检测,同时进行身高、体重测量及自填式问卷调查。共收集有效问卷942份,其中男生484名,女生458名。 结果 儿童家庭食用盐碘含量中位数为23.20 mg/kg,儿童尿碘中位数为251.00 μg/L,儿童随机一次尿碘与性别、调查前1天是否食用海带、食用牛奶频次及是否接受过放射检查相关(P值均 < 0.05)。性别为男生(OR=1.38,95%CI=1.04~1.82)、调查前1天食用海带(OR=1.67,95%CI=1.13~2.47)及接受过放射检查(OR=1.26,95%CI=1.05~1.52)与儿童尿碘水平高于适宜值上限均呈正相关(P值均 < 0.05)。全市儿童碘缺乏病防治知识知晓率为69.64%。 结论 武汉市8~10岁儿童碘营养状况高于国际组织推荐的适宜量水平,儿童随机一次尿碘水平受多种因素影响,且儿童碘缺乏病知识知晓率偏低。应加强儿童及居民碘缺乏病健康教育,确保在防止发生碘缺乏的同时也避免碘过量。 Abstract:Objective To understand the status of iodine nutrition and its related influencing factors of school-age children in Wuhan, so as to provide the basis for adjusting the strategies of IDD prevention and control. Methods In 5 districts of Wuhan (Hongshan, Hanyang, Hannan, Jiangxia, Dongxihu), non-boarding students aged 8-10 years old were selected from each of the five sample areas in the east, west, south, north and middle. Samples of urine and the cooking salt from their home were randornly colleted among children. Height, weight measurement and a self-administered questionnaire were conducted at the same time. A total of 942 valid questionnaires were collected, including 484 boys and 458 girls. Results The median of iodine content of children's household salt was 23.20 mg/kg, the median of urinary iodine of children in the city was 251.00 μg/L. Children's random urine iodine concentration was related to gender, whether kelp was consumed the day before the survey, the frequency of consuming milk, and whether they received radiological examinations(P < 0.05). Male (OR=1.38, 95%CI=1.04-1.82), consumption of kelp the day before the survey (OR=1.67, 95%CI=1.13-2.47) and radiological examination (OR=1.26, 95%CI=1.05-1.52) were risk factors for children with urinary iodine concentration higher than the upper limit of the appropriate value(P < 0.05). The awareness rate of children's iodine deficiency disease prevention knowledge in Wuhan was 69.64%. Conclusion The iodine nutritional status of children aged 8-10 years in Wuhan was higher than the appropriate level recommended by international organizations. The random urine iodine concentration of children was affected by many factors and the awareness rate of children's iodine deficiency disease knowledge in Wuhan was low. Therefore, health education for children and residents on iodine deficiency disorders should be strengthened, and they should be properly guided and intervened to ensure that iodine deficiency is prevented while iodine excess is avoided. -
Key words:
- Iodine /
- Nutritional status /
- Regression analysis /
- Child
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表 1 武汉市不同地区儿童家庭食用盐碘水平/(mg·kg-1)
Table 1. Iodine levels of salt in children's families in different regions of Wuhan/(mg·kg-1)
地区 检测份数 碘含量分布 中位数 < 5 5~ < 18 18~33 > 33 汉阳 196 0 0 196 0 23.02 洪山 194 2 7 184 1 25.15 东西湖 165 5 3 156 1 22.36 汉南 189 5 9 171 4 23.60 江夏 198 1 8 189 0 21.60 合计 942 13 27 896 6 23.20 表 2 武汉市不同组别儿童尿碘水平分布/(μg·L-1)
Table 2. Distribution of urinary iodine levels in different groups of children in Wuhan/(μg·L-1)
组别 选项 样品份数 < 100 100~ < 200 200~ < 300 ≥300 地区 汉阳 196 53(27.04) 59(30.10) 46(23.47) 38(19.39) 洪山 194 11(5.67) 36(18.56) 63(32.47) 84(43.30) 东西湖 165 37(22.42) 45(27.27) 45(27.27) 38(23.03) 汉南 189 12(6.35) 27(14.29) 47(24.87) 103(54.50) 江夏 198 14(7.07) 37(18.69) 54(27.27) 93(46.97) 性别 男 484 57(11.78) 97(20.04) 127(26.24) 203(41.94) 女 458 70(15.28) 107(23.36) 128(27.95) 153(33.41) 年龄/岁 8 197 22(11.17) 36(18.27) 57(28.93) 82(41.62) 9 263 40(15.21) 58(22.05) 63(23.95) 102(38.78) 10 482 65(13.49) 110(22.82) 135(28.01) 172(35.68) 合计 942 127(13.48) 204(21.66) 255(27.07) 356(37.79) 注: ()内数字为构成比/%。 表 3 儿童随机一次尿碘水平影响因素
Table 3. Influencing factors of random urine iodine level in children
组别 选项 人数 尿碘中位数/(μg·L-1) χ2/Z值 P值 性别 男 484 263.66 -2.89 0.00 女 458 235.40 年龄/岁 8 197 274.00 3.81 0.15 9 263 242.00 10 482 242.15 BMI 正常 778 245.50 4.11 0.13 超重 97 280.00 肥胖 67 255.72 盐碘含量/(mg·kg-1) < 5 13 258.20 0.18 0.98 5~ < 18 27 221.11 18~33 896 251.81 ≥33 6 232.78 调查前1天是否食用海带 是 135 299.12 -2.95 0.00 否 807 245.00 食用海带、紫菜、海苔等食品频次 每天都吃 27 335.00 1.66 0.65 ≥1次/周 323 251.00 每两周1次 245 251.00 每两周小于1次 347 248.47 食用鱼、虾、蟹、贝类等海产品频次 每天都吃 52 248.55 2.00 0.57 ≥1次/周 349 237.00 每两周1次 235 247.00 每两周小于1次 306 262.04 食用肉蛋类食品的频次 每天都吃 423 244.00 3.34 0.34 ≥1次/周 281 255.72 每两周1次 190 260.50 每两周小于1次 48 202.82 食用牛奶或奶制品的频次 每天都吃 436 228.71 9.54 0.02 ≥1次/周 260 272.15 每两周1次 162 251.31 每两周小于1次 84 271.90 吃海产品制成的零食频次 经常吃 40 265.50 1.08 0.58 偶尔吃 617 250.00 基本不吃 285 256.00 直系亲属是否患有甲状腺疾病 是 25 276.00 1.42 0.49 否 642 255.76 不知道 275 244.00 家庭成员是否抽烟 是 605 250.00 -0.77 0.44 否 337 251.00 是否接受过放射检查 是 289 257.00 13.67 0.00 否 420 270.50 不知道 233 217.00 参加体育锻炼频次 每天都参加 322 266.58 4.54 0.21 3~6次/周 301 249.00 1~2次/周 252 248.65 < 1次/周 67 200.00 儿童防治知识知晓率 < 60% 259 237.00 4.63 0.10 60%~80% 419 260.50 > 80% 264 252.05 表 4 尿碘水平高于适宜值上限影响因素的Logistic回归分析(n=942)
Table 4. Logistic regression analysis of influencing factors of urine iodine level above the upper limit of the appropriate value (n=942)
自变量 β值 标准误 Wald χ2值 P值 OR值(OR值95%CI) 性别 0.32 0.14 5.12 0.02 1.38(1.04~1.82) 调查前1天是否食用海带 0.51 0.20 6.72 0.01 1.67(1.13~2.47) 是否接受过放射检查 0.23 0.10 5.89 0.02 1.26(1.05~1.52) -
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