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Article(id=1321170801215263725, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1321170720168726830, articleNumber=null, orderNo=null, doi=10.11847/zgggws1146376, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1731254400000, receivedDateStr=2024-11-11, revisedDate=1739116800000, revisedDateStr=2025-02-10, acceptedDate=1744387200000, acceptedDateStr=2025-04-12, onlineDate=1792921265176, onlineDateStr=2026-10-25, pubDate=1754755200000, pubDateStr=2025-08-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1792921265176, onlineIssueDateStr=2026-10-25, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1792921265176, creator=13701087609, updateTime=1792921265176, updator=13701087609, issue=Issue{id=1321170720168726830, tenantId=1146029695717560320, journalId=1319373219989389464, year='2025', volume='41', issue='8', pageStart='897', pageEnd='1024', issueExtLink='null', onlineDate='null', pubDate='1754755200000', pubDateStr='2025-08-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1792921245852, creator='13701087609', updateTime=1792921245852, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=1001, endPage=1004, ext={EN=ArticleExt(id=1321170801437561838, articleId=1321170801215263725, tenantId=1146029695717560320, journalId=1319373219989389464, language=EN, title=Influence of iodine intake on thyroid volume among students aged 8–10 years in a district of Beijing from 2022 to 2024 based on a generalized estimating equation model, columnId=1320427686514770171, journalTitle=Chinese Journal of Public Health, columnName=Survey and Report, runingTitle=null, highlight=null, articleAbstract=
Objective

To assess iodine intake levels and their impact on thyroid volume in children aged 8–10 years in a district of Beijing city from 2022 to 2024.

Methods

From 2022 to 2024, 200 non-boarding students aged 8–10 years were randomly selected annually from five townships in the district, totaling 600 participants over the three years. Urine samples, household salt samples, and ultrasound-measured thyroid volumes were collected. Generalized estimating equations (GEE) models were used to analyze annual trends and conduct sensitivity analyses by sex.

Results

The median urinary iodine concentrations (UICs) in children aged 8–10 years from 2022 to 2024 were 170.96, 157.35, and 163.10 µg/L, respectively, indicating overall stability in UICs. However, a slight increasing trend in UICs was observed in boys over the years (P = 0.032). The mean salt iodine content (SIC) from 2022 to 2024 was (17.76 ± 7.96), (16.78 ± 11.48), and (16.27 ± 9.08) mg/kg, respectively, showing slight variations across the years. GEE model results showed that, after controlling for other factors, boys had larger thyroid volumes than girls (β = 0.32, 95%CI: 0.10–0.49); increasing age had a positive and significant effect on thyroid volume (β = 0.56, 95%CI: 0.46–0.64). Compared to girls, boys had higher mean UICs (β = 5.68, 95%CI: 3.10–7.79); SIC had a significant positive effect on UICs (β = 0.08, 95%CI: 0.02–0.14). Sensitivity analyses by sex revealed that the effect of SIC on UICs was significant and positive in both boys (β = 0.56, 95%CI: 0.27–0.86) and girls (β = 1.20, 95%CI: 0.01–0.80), while the direct effect of SIC on thyroid volume was not significant in either boys (β = 0.17, 95%CI: –0.40–0.60) or girls (β = 0.19, 95%CI: –0.50–0.80).

Conclusions

In iodine-sufficient environments, thyroid volume is primarily influenced by physiological factors such as age and sex, with salt iodine intake having no significant effect on thyroid volume. However, SIC is positively correlated with UIC. Iodine monitoring can focus on UIC measurements, as changes in thyroid volume are relatively small under iodine-sufficient conditions.

, authors=Zhilin WU, Yubin ZHANG, Chao HE, Wenzeng ZHANG, authorsList=Zhilin WU, Yubin ZHANG, Chao HE, Wenzeng ZHANG, authorCompany=null, correspAuthors=Wenzeng ZHANG, authorNote=null, correspAuthorsNote=
ZHANG Wenzeng, E-mail:
, copyrightStatement=Copyright © 2025 Chinese Journal of Public Health. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1321170802825876475, articleId=1321170801215263725, tenantId=1146029695717560320, journalId=1319373219989389464, language=CN, title=基于GEE模型的2022—2024年北京市某区8～10岁在校小学生碘摄入水平及其对甲状腺容积影响, columnId=1320427686770622717, journalTitle=中国公共卫生, columnName=调查报告与分析, runingTitle=null, highlight=null, articleAbstract=
目的

评估2022—2024年北京市某区8～10岁儿童碘摄入水平及其对甲状腺容积的影响。

方法

于2022—2024年，每年从当地随机抽取5个乡镇中8～10岁非寄宿学生200人，3年共计600人，收集其尿样、家庭食盐样本、B超测定的甲状腺容积等相关信息，通过广义估计方程（GEE）模型分析其年度变化趋势并按性别进行敏感性分析。

结果

2022—2024年8～10岁儿童平均尿碘浓度中位数分别为170.96、157.35、163.10 g/L，尿碘浓度总体稳定，但男童尿碘随年度略有增加趋势（P=0.032）。2022—2024年盐碘含量均值分别为（17.76±7.96）、（16.78±11.48）、（16.27±9.08）mg/kg，含量均值不同年度略有差异。GEE模型结果显示，在控制其他因素后，男童的甲状腺容积大于女童（β=0.32，95%CI=0.10～0.49）；年龄增加对甲状腺容积的影响为正向且显著（β=0.56，95%CI=0.46～0.64）。相比女童，男童的平均尿碘浓度高于女童（β=5.68，95%CI=3.10～7.79）；盐碘含量对尿碘浓度的影响显著且为正向（β=0.08，95%CI=0.02～0.14）；不同性别敏感性分析显示，盐碘含量对尿碘浓度的影响在男童组（β=0.56，95%CI=0.27～0.86）和女童组（β=1.20，95%CI=0.01～0.80）均显著且为正向，而盐碘对甲状腺容积的直接影响在男童组（β=0.17，95%CI= – 0.40～0.60）和女童组（β=0.19，95%CI= – 0.50～0.80）均不显著。

结论

在碘营养充足的环境中，甲状腺容积主要受年龄和性别等生理性因素影响，盐碘摄入对甲状腺容积无显著影响，但盐碘含量与尿碘浓度正相关。碘监测可侧重于尿碘浓度的测定，而甲状腺容积在碘充足条件下的变化相对较小。

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武之琳（1996—），医师，硕士，研究方向：传染病与地方病预防与控制

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张文增，E-mail：
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武之琳（1996—），医师，硕士，研究方向：传染病与地方病预防与控制

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Effect of various factors on children′s thyroid volume from 2022 to 2024 (GEE model analysis results)

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变量β $ S_{\overline{x}} $Z值P值95%CI
截距4.200.2021.0<0.0013.80～4.60
年份0.210.0127.43<0.0010.20～0.23
盐碘5.994.881.230.220−3.59～15.57
年龄0.560.0512.19<0.0010.46～0.64
性别0.320.093.230.0030.10～0.49
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2022—2024年各因素对儿童甲状腺容积的影响（GEE模型分析结果）

, figureFileSmall=null, figureFileBig=null, tableContent=
变量β $ S_{\overline{x}} $Z值P值95%CI
截距4.200.2021.0<0.0013.80～4.60
年份0.210.0127.43<0.0010.20～0.23
盐碘5.994.881.230.220−3.59～15.57
年龄0.560.0512.19<0.0010.46～0.64
性别0.320.093.230.0030.10～0.49
), ArticleFig(id=1321170806713995294, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170801215263725, language=EN, label=Tab.2, caption=

Effects of various factors on urinary iodine concentration in children from 2022 to 2024 (GEE model results)

, figureFileSmall=null, figureFileBig=null, tableContent=
变量β $ S_{\overline{x}} $Z值P值95%CI
截距18030.006.000.001120～240
年份1.711.531.120.270–1.29～4.72
盐碘0.080.032.670.0080.02～0.14
年龄3.151.053.000.0031.07～5.23
性别5.681.124.73<0.0013.10～7.79
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2022—2024年各因素对儿童尿碘浓度的影响（GEE模型结果）

, figureFileSmall=null, figureFileBig=null, tableContent=
变量β $ S_{\overline{x}} $Z值P值95%CI
截距18030.006.000.001120～240
年份1.711.531.120.270–1.29～4.72
盐碘0.080.032.670.0080.02～0.14
年龄3.151.053.000.0031.07～5.23
性别5.681.124.73<0.0013.10～7.79
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Effect of iodized salt on children′s thyroid volume: Generalized estimating equation (GEE) model results stratified by sex

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性别变量β $ S_{\overline{x}} $Z值P值95%CI
男童截距0.250.0216.34<0.0010.22～0.28
年份0.320.0215.69<0.0010.28～0.36
盐碘0.170.250.680.348−0.4～0.6
年龄0.520.0140.32<0.0010.50～0.55
女童截距0.110.0110.78<0.0010.10～0.12
年份0.110.00813.73<0.0010.09～0.12
盐碘0.190.300.630.407−0.50～0.80
年龄0.580.01345.31<0.0010.55～0.60
), ArticleFig(id=1321170806919516193, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170801215263725, language=CN, label=表3, caption=

盐碘对儿童甲状腺容积的影响：按性别分组的GEE模型结果

, figureFileSmall=null, figureFileBig=null, tableContent=
性别变量β $ S_{\overline{x}} $Z值P值95%CI
男童截距0.250.0216.34<0.0010.22～0.28
年份0.320.0215.69<0.0010.28～0.36
盐碘0.170.250.680.348−0.4～0.6
年龄0.520.0140.32<0.0010.50～0.55
女童截距0.110.0110.78<0.0010.10～0.12
年份0.110.00813.73<0.0010.09～0.12
盐碘0.190.300.630.407−0.50～0.80
年龄0.580.01345.31<0.0010.55～0.60
), ArticleFig(id=1321170807028568098, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170801215263725, language=EN, label=Tab.4, caption=

Effect of iodized salt on urinary iodine concentration in children: Generalized estimating equation (GEE) model results stratified by sex

, figureFileSmall=null, figureFileBig=null, tableContent=
性别变量β $ S_{\overline{x}} $Z值P值95%CI
男童截距180.0020.009.000.001140～220
年份1.200.412.960.0050.45～2.04
盐碘0.560.153.710.0010.27～0.86
年龄0.140.220.630.610−0.32～0.55
女童截距170.0025.006.800.002120～220
年份0.870.312.640.0200.22～1.51
盐碘1.200.205.940.0050.01～0.80
年龄0.050.250.200.840−0.43～0.57
), ArticleFig(id=1321170807150202915, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170801215263725, language=CN, label=表4, caption=

盐碘对儿童尿碘浓度的影响：按性别分组的GEE模型结果

, figureFileSmall=null, figureFileBig=null, tableContent=
性别变量β $ S_{\overline{x}} $Z值P值95%CI
男童截距180.0020.009.000.001140～220
年份1.200.412.960.0050.45～2.04
盐碘0.560.153.710.0010.27～0.86
年龄0.140.220.630.610−0.32～0.55
女童截距170.0025.006.800.002120～220
年份0.870.312.640.0200.22～1.51
盐碘1.200.205.940.0050.01～0.80
年龄0.050.250.200.840−0.43～0.57
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基于GEE模型的2022—2024年北京市某区8～10岁在校小学生碘摄入水平及其对甲状腺容积影响
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武之琳 , 张煜彬 , 何朝 , 张文增 *, *
中国公共卫生 | 调查报告与分析 2025,41(8): 1001-1004
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中国公共卫生 |调查报告与分析 2025 , 41 (8) : 1001 -1004
基于GEE模型的2022—2024年北京市某区8～10岁在校小学生碘摄入水平及其对甲状腺容积影响
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武之琳, 张煜彬, 何朝, 张文增*, *
作者信息
  • 北京市顺义区疾病预防控制中心，北京 101300
通讯作者:
张文增，E-mail：
作者简介:

武之琳（1996—），医师，硕士，研究方向：传染病与地方病预防与控制

Influence of iodine intake on thyroid volume among students aged 8–10 years in a district of Beijing from 2022 to 2024 based on a generalized estimating equation model
Zhilin WU, Yubin ZHANG, Chao HE, Wenzeng ZHANG
Affiliations
  • Institute for Communicable Disease Control and Prevention, Beijing Shunyi Center for Disease Control and Prevention, Beijing, 101300, China
    • Corresponding Author:
    ZHANG Wenzeng, E-mail:
出版时间: 2025-08-10 doi: 10.11847/zgggws1146376
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摘要
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目的

评估2022—2024年北京市某区8～10岁儿童碘摄入水平及其对甲状腺容积的影响。

方法

于2022—2024年，每年从当地随机抽取5个乡镇中8～10岁非寄宿学生200人，3年共计600人，收集其尿样、家庭食盐样本、B超测定的甲状腺容积等相关信息，通过广义估计方程（GEE）模型分析其年度变化趋势并按性别进行敏感性分析。

结果

2022—2024年8～10岁儿童平均尿碘浓度中位数分别为170.96、157.35、163.10 g/L，尿碘浓度总体稳定，但男童尿碘随年度略有增加趋势（P=0.032）。2022—2024年盐碘含量均值分别为（17.76±7.96）、（16.78±11.48）、（16.27±9.08）mg/kg，含量均值不同年度略有差异。GEE模型结果显示，在控制其他因素后，男童的甲状腺容积大于女童（β=0.32，95%CI=0.10～0.49）；年龄增加对甲状腺容积的影响为正向且显著（β=0.56，95%CI=0.46～0.64）。相比女童，男童的平均尿碘浓度高于女童（β=5.68，95%CI=3.10～7.79）；盐碘含量对尿碘浓度的影响显著且为正向（β=0.08，95%CI=0.02～0.14）；不同性别敏感性分析显示，盐碘含量对尿碘浓度的影响在男童组（β=0.56，95%CI=0.27～0.86）和女童组（β=1.20，95%CI=0.01～0.80）均显著且为正向，而盐碘对甲状腺容积的直接影响在男童组（β=0.17，95%CI= – 0.40～0.60）和女童组（β=0.19，95%CI= – 0.50～0.80）均不显著。

结论

在碘营养充足的环境中，甲状腺容积主要受年龄和性别等生理性因素影响，盐碘摄入对甲状腺容积无显著影响，但盐碘含量与尿碘浓度正相关。碘监测可侧重于尿碘浓度的测定，而甲状腺容积在碘充足条件下的变化相对较小。

儿童  /  碘  /  甲状腺  /  广义估计方程  /  北京市
Objective

To assess iodine intake levels and their impact on thyroid volume in children aged 8–10 years in a district of Beijing city from 2022 to 2024.

Methods

From 2022 to 2024, 200 non-boarding students aged 8–10 years were randomly selected annually from five townships in the district, totaling 600 participants over the three years. Urine samples, household salt samples, and ultrasound-measured thyroid volumes were collected. Generalized estimating equations (GEE) models were used to analyze annual trends and conduct sensitivity analyses by sex.

Results

The median urinary iodine concentrations (UICs) in children aged 8–10 years from 2022 to 2024 were 170.96, 157.35, and 163.10 µg/L, respectively, indicating overall stability in UICs. However, a slight increasing trend in UICs was observed in boys over the years (P = 0.032). The mean salt iodine content (SIC) from 2022 to 2024 was (17.76 ± 7.96), (16.78 ± 11.48), and (16.27 ± 9.08) mg/kg, respectively, showing slight variations across the years. GEE model results showed that, after controlling for other factors, boys had larger thyroid volumes than girls (β = 0.32, 95%CI: 0.10–0.49); increasing age had a positive and significant effect on thyroid volume (β = 0.56, 95%CI: 0.46–0.64). Compared to girls, boys had higher mean UICs (β = 5.68, 95%CI: 3.10–7.79); SIC had a significant positive effect on UICs (β = 0.08, 95%CI: 0.02–0.14). Sensitivity analyses by sex revealed that the effect of SIC on UICs was significant and positive in both boys (β = 0.56, 95%CI: 0.27–0.86) and girls (β = 1.20, 95%CI: 0.01–0.80), while the direct effect of SIC on thyroid volume was not significant in either boys (β = 0.17, 95%CI: –0.40–0.60) or girls (β = 0.19, 95%CI: –0.50–0.80).

Conclusions

In iodine-sufficient environments, thyroid volume is primarily influenced by physiological factors such as age and sex, with salt iodine intake having no significant effect on thyroid volume. However, SIC is positively correlated with UIC. Iodine monitoring can focus on UIC measurements, as changes in thyroid volume are relatively small under iodine-sufficient conditions.

children  /  iodine  /  thyroid  /  generalized estimating equations  /  Beijing city
武之琳, 张煜彬, 何朝, 张文增. 基于GEE模型的2022—2024年北京市某区8～10岁在校小学生碘摄入水平及其对甲状腺容积影响. 中国公共卫生, 2025 , 41 (8) : 1001 -1004 . DOI: 10.11847/zgggws1146376
Zhilin WU, Yubin ZHANG, Chao HE, Wenzeng ZHANG. Influence of iodine intake on thyroid volume among students aged 8–10 years in a district of Beijing from 2022 to 2024 based on a generalized estimating equation model[J]. Chinese Journal of Public Health, 2025 , 41 (8) : 1001 -1004 . DOI: 10.11847/zgggws1146376
正文
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在全球范围内，碘缺乏是影响人类健康的一个重要公共卫生问题，特别是在儿童群体中[1]。碘是人体合成甲状腺激素的重要元素，甲状腺激素在儿童的生长发育中起关键作用，尤其对神经系统的正常发育和新陈代谢的调节作用不可或缺，缺碘不仅会导致甲状腺肿大，还会对儿童的智力发育和生长产生长期影响[2]。我国自20世纪90年代起实施了普遍碘盐政策，主要通过向食盐中添加碘来保障居民的日常碘摄入。政策实施后，我国的碘缺乏状况得到显著改善，尤其是在儿童和青少年群体中[3]。随着社会的发展，生活方式和饮食结构发生了巨大变化，儿童的碘营养状况也受到多方面因素影响，因此在政策实施多年后，仍有必要对当前儿童的碘摄入情况和甲状腺容积状况进行定期评估。本研究于2022—2024年对北京市某区8～10岁儿童碘摄入水平进行检测并评估其对甲状腺容积的影响，为完善儿童碘营养干预措施和碘监测策略提供依据。
1　对象与方法
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1.1　对象
为2022—2024年北京市某区8～10岁非寄宿在校学生。采用分层随机抽样法，根据辖区地理特征及行政分区将研究区域划分为5个抽样片区，每年在每个片区随机抽取1个乡镇/街道，并在该乡镇/街道随机选取1所小学，从每所小学中随机抽取40名8～10岁非寄宿学生（共200人，性别均衡，男女各半），3年累计调查600名学生。所有参与者及其家长均签署知情同意书，有效率为100%。
1.2　方法
采用问卷调查与生物指标检测相结合的方式。调查问卷为自行设计，内容包括年龄、性别、碘盐使用情况等，由当地社区卫生人员通过面对面询问的方式调查；生物指标包含尿样、盐样检测及甲状腺容积测量。尿样、盐样的采集均按照统一要求由当地社区卫生人员规范操作采样。盐碘含量作为衡量家庭碘摄入水平的重要连续变量[4]，其检测依据WS/T 107.1—2016《尿中碘的测定 第1部分：砷铈催化分光光度法》进行[5]；尿碘浓度用于评估儿童短期碘摄入量[6]，依据GB/T 13025.7—2012《制盐工业通用试验方法 碘的测定》进行检测[7]，其正常范围为100～199 μg/L[6]；甲状腺容积作为评估学生长期碘营养状态重要指标[8]，由2名专业医师采用超声波检查法进行，并参考WS 276—2007《地方性甲状腺肿诊断标准》，标准通过公式（1）计算甲状腺容积[9]，8、9和10岁儿童的甲状腺容积上限值分别为4.2、5.0、6.0 mL。当测量结果超过相应年龄的上限值时，提示可能存在碘营养不良或其他甲状腺相关问题[9]。
$ \text{甲状腺容积}({\mathrm{mL}})= \frac{\text{π} }{6} \times \text{长度}({\mathrm{cm}})\times\text{宽度}({\mathrm{cm}})\times \text{厚度}{\mathrm{(cm)}} $
1.3　统计分析
使用R.3.5.1完成。本研究具体分析步骤分为3步，首先对连续性变量（包含年龄、盐碘含量和尿碘浓度）进行描述性统计，对正态分布数据以（$ \overline{x}\pm s $）表示，对非正态分布数据以中位数和四分位数间距表示；分类变量（包含性别、是否使用碘盐）则以频数和百分比表示。其次，考虑到本研究为纵向研究涉及多个时间点的重复测量，故采用GEE（generalized estimating equations）模型进行分析，并使用QIC（quasi-likelihood under the independence model criterion）值来评估模型拟合效果，QIC值越小表明模型拟合效果越好[10]。在使用GEE模型前，本研究已对数据的分布特性进行了前期检查以确认自变量（盐碘含量）与因变量（尿碘浓度、甲状腺容积）之间存在线性关系。数据的相关结构经过检验采用交换型相关结构。分类变量（性别、是否使用碘盐）经过哑变量编码处理后纳入模型。最后，本研究建立了2个GEE模型，分别以尿碘浓度和甲状腺容积为因变量，自变量为盐碘含量，协变量包括年龄、是否使用碘盐、性别及年份。此外，为进一步验证结果的稳健性，通过性别分组进行敏感性分析，以探讨盐碘含量对尿碘浓度和甲状腺容积的性别差异影响。P<0.05为差异有统计学意义。
2　结　果
收起
2.1　调查对象基本情况及碘盐使用情况
2022—2024年共调查8～10岁儿童600人（每年200人），其中每年男童占比分别为51.00%（102/200）、52.00%（104/200）和50.50%（101/200）。2022—2024年调查对象平均年龄分别为（9.14±0.63）、（9.10±0.31）和（8.80±0.41）岁；2022—2024年使用碘盐的家庭分别占88.50%（177/200）、78.50%（157/200）和79.50%（159/200）。
2.2　盐碘含量、尿碘浓度检测及甲状腺容积测量结果
2022—2024年盐碘含量分别为（17.76±7.96）、（16.78±11.48）、（16.27±9.08）mg/kg，含量均值在各年度略有差异，但整体变化幅度较小，表明食盐碘强化政策的实施效果总体稳定。2022—2024年尿碘浓度总体稳定，其尿碘浓度中位数（四分位数间距）分别为170.96（116.90～236.22）、157.35（122.90～194.23）、163.10（121.20～222.40）µg/L，均处于适宜碘营养范围内。甲状腺容积检测结果略有波动，2022年和2023年的均值分别为（3.59±1.04）和（3.59±1.15） mL，而2024年略增至（3.83±1.14） mL，均未超过《中国地方性甲状腺肿诊断标准》建议的正常范围。
2.3　2022—2024年各因素对儿童甲状腺容积的影响（表1）
本研究使用GEE模型（交换型相关结构；QIC=429.93）评估2022—2024年各因素对儿童甲状腺容积的影响，结果表明，在控制其他因素后，男童的甲状腺容积大于女童（β=0.32，95%CI=0.10～0.49）。盐碘含量变化与甲状腺容积之间无明显相关性（β=5.99，95%CI= – 3.59～15.57）。年龄对甲状腺容积的影响显著（β=0.56，95%CI=0.46～0.64），表明甲状腺容积随着儿童生长发育逐渐增大，符合儿童在生长发育期器官随身体增长而增大的规律。
2.4　2022—2024年各因素对儿童尿碘浓度的影响（表2）
本研究使用GEE模型（交换型相关结构；QIC=433.32）评估2022—2024年各因素对儿童尿碘浓度的影响，研究结果显示，男童的尿碘浓度平均高于女童（β=5.68，95%CI=3.10～7.79）；随着盐碘含量的增加，儿童尿碘浓度显著增加（β=0.08，95%CI=0.02～0.14），表明食用盐中碘含量是尿碘浓度的影响因素之一。此外，年龄对尿碘浓度也有显著影响（β=3.15，95%CI=1.07～5.23），这可能与年龄增长带来的体格增大导致碘需求增加，以及饮食摄入量随年龄增长而增加有关。
2.5　性别敏感性分析
2.5.1　各因素对不同性别儿童甲状腺容积的敏感性分析（表3）
GEE模型分析结果显示，无论男童还是女童，均随着年份的增加儿童甲状腺容积均显著增大（男童组：β=0.32，95%CI=0.28～0.36；女童组：β=0.11，95%CI=0.09～0.12），同时年龄对儿童甲状腺容积也具有显著正向影响（男童组：β=0.52，95%CI=0.50～0.55；女童组：β=0.58，95%CI=0.55～0.60）。盐碘水平对甲状腺容积的直接影响在不同性别中均不显著（男童组：β=0.17，95%CI= – 0.40～0.60；女童组：β=0.19，95%CI= – 0.50～0.80）。2组模型均采用交换型相关结构，其中男童组QIC值为465.3，女童组QIC值为470.0，2组模型拟合效果良好且差异较小。
2.5.2　各因素对不同性别儿童尿碘浓度的敏感性分析（表4）
GEE模型分析结果表明，无论男童还是女童，盐碘含量对尿碘浓度均表现出显著的正相关性（男童组：β=0.56，95%CI=0.27～0.86；女童组：β=1.20，95%CI=0.01～0.80），盐碘含量的增加显著提高尿碘浓度，且尿碘浓度随着年份的增加逐年升高（男童组：β=1.20，95%CI=0.45～2.04；女童组：β=0.87，95%CI=0.22～1.51）。2组模型均采用交换型相关结构，其QIC值分别为男童组450.1，女童组448.8，2组模型拟合效果良好且差异较小。
3　讨　论
收起
本研究对2022—2024年北京市某区8～10岁儿童的碘摄入水平及其对甲状腺容积的影响进行分析，结果表明，该区儿童尿碘浓度总体稳定，这与现行碘营养干预措施的效果相符[11–12]。GEE模型分析表明，年龄和性别是影响甲状腺容积的主要因素。其中，年龄对甲状腺容积的正向作用在男童和女童中均一致，表明甲状腺容积随儿童生长发育和体格增长自然增大[13]。此外，男童甲状腺容积大于女童，这可能与男童更高的代谢需求和青春期生长特性有关[13]。盐碘含量对甲状腺容积的影响在整体模型及敏感性分析中未显示显著作用，表明在碘营养充足地区，盐碘对甲状腺容积的直接影响较弱，这可能与北京市长期实施的碘盐政策确保了儿童适宜的碘营养水平有关，额外盐碘摄入对甲状腺容积并未产生显著影响[14]，提示在碘摄入充足的背景下，甲状腺容积可能主要受年龄和性别等生理因素调控。
此外，性别敏感性分析显示，男童尿碘浓度高于女童，这可能反映生长发育过程中男童对甲状腺激素需求的增加[15]。盐碘对尿碘浓度的显著正向作用进一步证明，尿碘浓度可以有效反映儿童碘摄入水平，可作为评估碘营养状态的可靠指标。这一结果支持了碘盐政策在维持儿童适宜碘营养水平中的重要作用，表明通过尿碘浓度的监测，可对个体和群体的碘营养状况进行动态评估[15]。
本研究具有一定的局限性。首先，本研究人群限于北京市某区的8～10岁儿童，结果推广性受限，需在不同地区和年龄段儿童中进一步验证。其次，盐碘含量的测定基于家庭采样，可能无法完全代表儿童实际摄入的碘水平。最后，本研究未纳入其他可能影响甲状腺容积的因素，如饮食结构、遗传背景或环境暴露，这可能导致部分结果的解释存在一定局限。本研究提示在碘营养充足地区，应进一步突出尿碘浓度监测作为评估碘营养状况的核心指标，而甲状腺容积的变化主要受到生理性因素的影响，因此可作为辅助指标。未来建议采取尿碘浓度与其他生物标志物（如血清甲状腺激素水平）检测相结合的方式综合评估儿童碘营养状态，以优化公共卫生政策并提高其实际干预效果。

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doi: 10.11847/zgggws1146376
  • 接收时间：2024-11-11
  • 首发时间：2026-10-25
  • 出版时间：2025-08-10
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  • 收稿日期：2024-11-11
  • 修回日期：2025-02-10
  • 录用日期：2025-04-12
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    北京市顺义区疾病预防控制中心，北京 101300

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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
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