云南省大理市人群碘营养及孕妇、乳妇等重点人群甲状腺功能调查研究

发布时间：2018-04-16 20:03

本文选题：碘缺乏病 + 碘营养　；参考：《大理大学》2017年硕士论文

【摘要】：目的:本课题拟调查新标准碘盐全面覆盖后,云南省大理市外环境碘含量、居民户碘盐食用情况、不同人群尿碘水平、重点人群碘营养来源等,重点了解人群的甲状腺功能和甲状腺疾病流行情况。探索甲状腺球蛋白作为孕妇碘营养生物标记物的可行性,以及尿碘孕妇中位数在100~150μg/L时,能否满足母体的需要。以评估目前云南省不同人群的碘营养水平及防治碘缺乏病的科学性和有效性,为全省碘缺乏病监测和防治提供科学依据。方法:1.以行政村为单位,在大理市每个行政村调查一个饮用人数最多水源的水碘含量;调查2012-2015年居民户食用碘盐情况;计算水碘、盐碘中位数,碘盐覆盖率、碘盐合格率、合格碘盐食用率等。2.在大理市抽取孕妇、乳妇、学龄儿童、普通成年人群、0~4岁婴幼儿和儿童,对研究对象进行问卷调查、尿碘浓度检测、甲状腺B超、甲状腺功能、甲状腺球蛋白等内容的横断面调查。计算大理市不同人群尿碘中位数以及甲状腺疾病的患病率。分析甲状腺球蛋白(Tg)),促甲状腺激素(TSH)作为孕妇碘营养生物标记物的可行性。结果:1.大理市饮用水碘含量中位数为0.62μg/L,水碘含量范围为0~9.92μg/L,所有饮用水碘含量10μg/L。2.大理市2012-2015年居民户食盐合格碘盐食用率每年在90%以上,盐碘中位数由2012年的29.38mg/kg下降至2015年的24.96mg/kg。3.不同人群的尿碘中位数,孕妇为136.85μg/L,乳妇102.63μg/L,普通成年人群164.03μg/L,8~10岁儿童209.61μg/L,2岁儿童157.27μg/L,2~4岁儿童134.08μg/L。4.孕、乳妇富碘海产品的平均摄入频次为1.1次/月,仅有1.99%的人群通过多维元素制剂来补碘。5.孕妇、乳妇、育龄妇女TSH中位数分别为1.995、2.345、2.565m IU/L;孕早、中、晚期TSH中位数分别为1.850、2.030、2.235 mIU/L。6.大理市成年人群甲状腺结节总检出率为14.70%,甲肿率为1.6%,甲亢、亚甲亢的患病率分别为0.16%、0.47%,甲减、亚甲减的患病率分别为0.47%、7.09%,成年人群TPOAb、TgAb阳性率都为9.22%。7.孕妇、乳妇、育龄妇女Tg中位数分别为10.49、9.28、9.66μg/L,均小于13μg/L;大于40μg/L的比例分别为1.90%、1.79%、2.08%,均小于3%。8.孕早、中、晚期Tg中位数分别为10.56、10.78、10.08μg/L,均小于13μg/L,大于40μg/L的比例分别为0、2.38%、3.28%,孕晚期的比例3%。结论:1.大理市外环境普遍缺碘,人群碘摄入主要依赖于加碘食盐。2.大理市按期实现了盐碘含量的下调。3.盐碘含量下调后,大理市乳妇、育龄妇女、普通成年人群、2岁儿童都处于碘营养适宜水平,学生处于高于适宜量水平。4.作为孕妇碘营养评价指标,Tg好于TSH。5.以Tg来评价,结合近年来90%以上的合格碘盐食用率,大理市孕妇尿碘中位数在100-150μg/L之间,孕妇总体碘营养缺乏的风险不大。但近几年大理市非碘盐冲销和盐业体制改革,需关注孕、乳妇个体碘营养状况。6.碘含量下调后,大理市处于持续消除碘缺乏病状态,人群甲状腺疾病总体处于较低水平。
[Abstract]:Objective: to investigate the content of iodine in the environment of Dali, Yunnan Province, the consumption of iodized salt in households, the level of urinary iodine in different population groups, and the sources of iodine nutrition of the key population after the comprehensive coverage of the new standard iodized salt.Focus on the thyroid function of the population and the prevalence of thyroid diseases.To explore the feasibility of using thyroglobulin as a biomarker of iodine nutrition in pregnant women and whether the maternal needs can be satisfied when the median of pregnant women with urinary iodine is 100 ~ 150 渭 g / L.In order to evaluate the iodine nutrition level of different population in Yunnan Province and to provide scientific basis for the monitoring and prevention of iodine deficiency disorders in Yunnan province.Method 1: 1.Take the administrative village as the unit, investigate the water iodine content of one of the most potable water sources in each administrative village in Dali city; investigate the consumption of iodized salt by households from 2012 to 2015; calculate the water iodine, salt iodine median, iodized salt coverage rate and iodized salt qualified rate.Qualified iodized salt consumption rate, etc.Pregnant women, breast-wives, school-age children and children were selected from Dali city. The subjects were investigated by questionnaire, urinary iodine concentration, thyroid B ultrasound, thyroid function.Cross-sectional investigation of thyroid globulin and other contents.The median urinary iodine and the prevalence of thyroid disease were calculated in Dali.To analyze the feasibility of thyroglobulin (TG) and thyrotropin (TSH) as biological markers of iodine nutrition in pregnant women.The result is 1: 1.The median iodine content in drinking water in Dali is 0.62 渭 g / L, the iodine content in water is in the range of 0 ~ 9.92 渭 g / L, and the iodine content in all drinking water is 10 渭 g / L 路L. 2.In Dali City, the annual consumption rate of household salt qualified iodized salt was more than 90% between 2012 and 2015, and the median salt iodine consumption rate fell from 2012 to 24.96 mg / kg 路3 in 2015.The median urinary iodine was 136.85 渭 g / L for pregnant women, 102.63 渭 g / L for nursing women, 209.61 渭 g / L / L for children aged 10 years, 209.61 渭 g / L / L for children aged 2 to 2 years old, 134.08 渭 g / L 路L / L for children of 4 years old.During pregnancy, the average intake frequency of iodine rich seafood was 1.1 times per month. Only 1.99% of the population supplemented iodine by multi-dimensional preparation.The median TSH of pregnant women, nursing women and women of childbearing age were 1.995U 2.345v 2.565m IUs / L and 1.850,2.030m / 2.235m / L 路L ~ (-1) of TSH in early, middle and late pregnancy, respectively.The total detection rate of thyroid nodules in adult population of Dali was 14.70, the rate of thyroid swelling was 1.6, the prevalence of hyperthyroidism and subthyroidism was 0.16, the prevalence of hypothyroidism and subthyroidism was 0.477.09, and the positive rate of TPOAb-TgAb was 9.22.The median TG of pregnant women, breast-wives and women of childbearing age was 10.49 / 9.280.66 渭 g / L, respectively, and the proportion of pregnant women > 40 渭 g / L was 1.90 and 1.79 / L, respectively.The median of TG in the early, middle and late trimester of pregnancy was 10.56 卤10.78 卤10.08 渭 g / L, respectively, which were less than 13 渭 g / L, and the proportion greater than 40 渭 g / L was 0.2.38 / L and 3.28, respectively.Conclusion 1.Iodine deficiency is common in the outside environment of Dali, and iodine intake mainly depends on iodized salt. 2.In Dali City, the iodine content of salt has been reduced by 3. 3 on schedule.After the decrease of salt iodine content, the suckling women, women of childbearing age, and general adults were all in the suitable level of iodine nutrition, and the students were above the appropriate level. 4.As an evaluation index of iodine nutrition in pregnant women, TG was better than that of TSH.5.According to TG, combined with the consumption rate of 90% of qualified iodized salt in recent years, the median urinary iodine of pregnant women in Dali was between 100-150 渭 g / L, and the risk of total iodine deficiency of pregnant women was not significant.However, in recent years, the non-iodized salt sterilisation and salt industry system reform in Dali city need to pay attention to the iodine nutrition status.After the decrease of iodine content, Dali is in the condition of eliminating iodine deficiency disorders, and the thyroid diseases in the population are generally at a low level.
【学位授予单位】：大理大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R599

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