合肥市四类人群碘营养水平的研究

发布时间：2018-05-01 15:11

本文选题：四类人群 + 碘营养　；参考：《安徽医科大学》2013年硕士论文

【摘要】：目的了解在当前食用盐加碘浓度（35±15mg/kg）下，合肥市四类人群0-2岁婴幼儿、8-10岁学龄儿童、哺乳期妇女和孕妇的碘营养水平现状，评价8-10岁学龄儿童碘营养水平能否代表合肥市四类人群的碘营养水平，以及孕期及哺乳期妇女碘营养水平对垂体-甲状腺功能以及其子代碘营养水平的影响，探讨8-10岁学龄儿童和0-2岁婴幼儿的碘营养水平与其生长发育指标的关系，为科学防治碘缺乏病提供理论依据。方法整群抽取合肥市包河区和长丰县，按照东南西北中5个方位抽取5个乡，每乡随机抽取2所小学，在每所小学随机抽取40名以上8-10岁学龄儿童（数量不足可从最临近的学校补足），年龄组8，9，10岁均衡分布，男女各半。在每所抽样小学附近的街道、乡村分别抽取10名以上孕妇、哺乳期妇女及其0-2岁婴幼儿、18-45岁育龄妇女（对照人群）。采集四类人群一次性随机尿样，8-10岁儿童、孕妇和哺乳期妇女家庭食用盐样、水样，孕妇和哺乳期妇女血样以及哺乳期妇女乳汁样，并对8-10岁学龄儿童和0-2岁婴幼儿生长发育指标进行测量。对碘盐合格率、水碘浓度、尿碘浓度、乳碘浓度、甲状腺功能指标（TSH、FT4、TT4和TT3）以及生长发育指标等进行分析。结果合肥市居民户盐碘中位数为28.3mg/kg，碘盐覆盖率98.2%，居民户合格碘盐食用率95.1%，城区高于农村，城乡居民户合格碘盐食用率差异有统计学意义（χ2=6.172，P=0.013）；饮用水水碘浓度7.7μg/L，农村高于城区，差异有统计学意义（Z＝-8.276，P0.001）；四类人群0-2岁婴幼儿、8-10岁学龄儿童、哺乳期妇女和孕妇尿碘中位数分别为303.7μg/L,358.1μg/L,209.1μg/L和161.8μg/L，哺乳期妇女和0-2岁婴幼儿尿碘处于良好和适宜的水平，孕妇尿碘处于不足水平，8-10岁学龄儿童尿碘超过适宜水平，8-10岁学龄儿童尿碘明显高于其他三类人群，四类人群尿碘水平组间差异有统计学意义（χ2=211.857，P0.001）；城区8-10岁儿童尿碘中位数明显高于农村，而城区孕妇尿碘中位数显著低于农村，，城乡尿碘水平差异均有统计学意义（Z=-1.990和-3.192，P0.05）；18-45岁育龄妇女尿碘中位数高于哺乳期妇女和孕妇，差异有统计学意义（χ2=55.435P0.001）；高尿碘组和适宜尿碘组8-10岁学龄儿童身高和体重都大于低尿碘组，其差异有统计学意义（F=8.115和4.544，P0.05），低尿碘组婴幼儿体重和头围均小于适宜尿碘组和高尿碘组，三组之间头围差异有统计学意义（F=3.313,P 0.05）；城乡孕妇FT4、TT4和TT3差异均有统计学意义（t=5.28、6.49和9.99，P0.001），不同尿碘水平FT4和TT3组间差异均有统计学意义（χ2=6.14和7.64，P0.05）；城乡哺乳期妇女TT4和TT3差异均有统计学意义（t=-10.627和2.548，P0.05），不同尿碘水平TSH和FT3组间差异均有统计学意义（χ2=10.155和29.900，P0.05）；哺乳期妇女尿碘水平与其婴幼儿尿碘水平相关性有统计学意义（r尿-尿＝0.466，P0.001）。结论合肥市四类人群中孕妇碘营养处于不足水平，8-10岁学龄儿童超过适宜水平；8-10岁学龄儿童碘营养水平不能完全代表其他三类人群的碘营养水平，孕期及哺乳期妇女碘营养水平对其垂体-甲状腺功能有一定的影响，哺乳期妇女尿碘水平与其婴幼儿尿碘水平之间呈相关性，8-10岁学龄儿童和0-2岁婴幼儿碘营养水平对其生长发育指标有影响。建议今后碘缺乏病防治监测应综合考虑以上四类人群的碘营养水平，以便更好地预防和控制碘缺乏病。
[Abstract]:Objective to understand the status of iodine nutrition level of 0-2 year old children, 8-10 year old school age children, lactating women and pregnant women under the current salt iodine concentration (35 + 15mg/kg), and to evaluate iodine nutrition level of four class of people in Hefei city and the iodine nutrition water of pregnant and lactating women in 8-10 year old children. The relationship between the iodine nutrition level of 8-10 year old children and 0-2 year old infants and their growth and development indexes was discussed in order to provide a theoretical basis for the scientific prevention and treatment of iodine deficiency.
Methods a group of Hefei and Changfeng counties were selected to extract 5 townships in 5 places in the Middle East and West. 2 primary schools were randomly selected from each township in each township. At each primary school, 40 or more 8-10 year old school-age children were randomly selected. The age group was in a balanced distribution of 8,9,10 years old. In the streets and villages, 10 or more pregnant women, breast-feeding women and their 0-2 year old infants and 18-45 year old women of childbearing age (control crowd) were collected, and four groups of people were collected for one time random urine sample, 8-10 year old children, pregnant women and lactation women's families to eat salt samples, water samples, pregnant women and lactation women's blood samples and lactating women's milk samples, and 8-10 year old school age. The growth and development indexes of children and 0-2 year old infants were measured. The qualification rate of iodized salt, iodine concentration, iodine concentration, iodine concentration, thyroid function index (TSH, FT4, TT4 and TT3), and growth and development indexes were analyzed.
Results the median of salt iodine was 28.3mg/kg, the coverage rate of iodized salt was 98.2%, the consumption rate of qualified iodized salt was 95.1%, and the urban area was higher than that in the rural area. The difference of the qualified iodized salt consumption rate of urban and rural residents was statistically significant (x 2=6.172, P=0.013); the iodine concentration of drinking water was 7.7 g/L, and the difference was statistically significant (Z = -8.276, P0.0). 01); four groups of 0-2 year old children, 8-10 year old school age children, breast-feeding women and pregnant women urine iodine median of 303.7 mu g/L, 358.1 mu g/L, 209.1 g/L and 161.8 mu g/L, breast-feeding women and 0-2 years of infant urine iodine in good and appropriate level, pregnant women's urine iodine is not at the level, 8-10 years of school age children urine iodine exceeds the appropriate level, 8-10 iodine level, 8-10. The urine iodine of school age children was significantly higher than that of the other three groups, and the difference of urine iodine level between the four groups was statistically significant (2=211.857, P0.001); the median urine iodine number of 8-10 year old children in the urban area was significantly higher than that in the rural areas, while the median urine iodine in the urban areas was significantly lower than that in the rural areas. The difference in the level of urine iodine in urban and rural areas was statistically significant (Z=-1.990 and -3.192, P0.0 5): the median urine iodine number of women of childbearing age at 18-45 years was higher than that of lactating women and pregnant women, the difference was statistically significant (x 2=55.435P0.001). The height and weight of the high urine iodine group and the suitable iodine group at 8-10 year old school age children were higher than those of the low urinary iodine group. The difference was statistically significant (F=8.115 and 4.544, P0.05), and the weight and head circumference of the low urinary iodine group were less than those of the low urine iodine group. The difference in head circumference between the three groups was statistically significant (F=3.313, P 0.05). The differences in FT4, TT4 and TT3 between urban and rural pregnant women were statistically significant (t=5.28,6.49 and 9.99, P0.001), and there were significant differences between the groups of FT4 and TT3 (x 2=6.14 and 7.64, P0.05). There were statistical significance (t=-10.627 and 2.548, P0.05). There was significant difference between TSH and FT3 in different levels of urine iodine (x 2=10.155 and 29.900, P0.05), and the correlation between urine iodine level and urine iodine level in breast feeding women was statistically significant (r urine - urine = 0.466, P0.001).
Conclusion the iodine nutrition of pregnant women in the four groups of Hefei is inadequate, and the 8-10 year old school age children exceed the appropriate level. The iodine nutrition level of 8-10 year old children can not fully represent the iodine nutrition level of the other three groups. The iodine nutrition level of the pregnant and lactation women has certain influence on the pituitary thyroid gland function and the lactation period women's urine. Iodine level is related to the level of urine iodine in infants and young children. Iodine nutrition levels of 8-10 year old children and 0-2 year old children have an impact on their growth and development. It is suggested that iodine deficiency in the prevention and control of iodine deficiency diseases should be taken into consideration in order to prevent and control iodine deficiency.

【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R151.41

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