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Article(id=1325532039671464590, tenantId=1146029695717560320, journalId=1256213402557890569, issueId=1325531848021140417, articleNumber=null, orderNo=null, doi=10.16835/j.cnki.1000-9817.2025326, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1752768000000, receivedDateStr=2025-07-18, revisedDate=1756569600000, revisedDateStr=2025-08-31, acceptedDate=null, acceptedDateStr=null, onlineDate=1793961065451, onlineDateStr=2026-11-06, pubDate=1764000000000, pubDateStr=2025-11-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793961065451, onlineIssueDateStr=2026-11-06, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793961065451, creator=13701087609, updateTime=1793961065451, updator=13701087609, issue=Issue{id=1325531848021140417, tenantId=1146029695717560320, journalId=1256213402557890569, year='2025', volume='46', issue='11', pageStart='1521', pageEnd='1672', issueExtLink='null', onlineDate='null', pubDate='1764000000000', pubDateStr='2025-11-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793961019759, creator='13701087609', updateTime=1793961019759, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=1559, endPage=1563, ext={EN=ArticleExt(id=1325532044767543951, articleId=1325532039671464590, tenantId=1146029695717560320, journalId=1256213402557890569, language=EN, title=Iodine nutrition among children aged 8-10 in Baoshan City from 2018 to 2024, columnId=1259565862625862592, journalTitle=Chinese Journal of School Health, columnName=Student Nutrition, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the iodine nutritional status of children aged 8-10 in Baoshan City, so as to comprehensively evaluate the effectiveness of eliminating and consolidating iodine deficiency disorders in Baoshan City.

Methods

From 2018 to 2024, a stratified random sampling method was used to sample 7 363 non-boarding children aged 8-10 from 35 survey sites in 5 counties of Baoshan City (Longyang County, Shidian County, Changning County, Tengchong City, Longling County).The salt iodine content and urinary iodine concentration were detected, and the thyroid volume of children was measured by ultrasound.Group comparison was conducted by using Mann-Whitney U test, Kruskal-Wallis H test, and Chi-square test.Spearman rank correlation analysis was used to investigate the correlation of salt iodine, urinary iodine and thyroid volume.

Results

A total of 7 361 samples of household edible salt for children were detected.The iodized salt coverage rate was 99.70%, the qualified iodized salt consumption rate was 97.02%.The proportion of unqualified iodized salt fluctuated and decreased from 3.14% in 2018 to 2.14% in 2024.The median iodine content of household edible salt for children was 23.70(21.60, 25.80) mg/kg.The median urinary iodine of children was 217.41(152.40, 294.59)μg/L, and the proportions of iodine deficiency, adequate iodine, and iodine excess were 9.75%, 66.66%, and 23.58%, respectively.There were statistically significant differences in the median urinary iodine of children among different years, ages, genders and before and after the supply of non-iodized salt (Z/H=134.88, 11.04, -4.28, -2.66, all P < 0.01).An average thyroid volume of children was 3.32(2.77, 3.93) mL, with a goiter rate of 1.91%.Before and after the implementation of non-iodized salt supply in Baoshan City in 2023, there were no statistically significant differences in the median iodine content of household edible salt and the goiter rate of children (Z/χ2=-1.54, 3.25, both P>0.05), but there were statistically significant differences in the qualified status of iodized salt, the median urinary iodine, and the frequency distribution of urinary iodine (χ2/Z=15.53, -2.66, 10.14, all P < 0.05).Salt iodine was positively correlated with urinary iodine (r=0.04) and negatively correlated with thyroid volume (r=-0.07), and urinary iodine was negatively correlated with thyroid volume (r=-0.03)(all P < 0.05).The thyroid volume of children consuming iodized salt was larger than that of children consuming non-iodized salt (H=9.99), and there were statistically significant differences in thyroid volume among children with different urinary iodine levels (H=15.13)(both P < 0.01).

Conclusions

From 2018 to 2024, the overall iodine nutritional level of children aged 8-10 in Baoshan City is at an adequate level.The elimination status of iodine deficiency disorders has been continuously consolidated.

, authors=Yanping LI1, Guihua LIU2, Anwei WANG3, Zengkan LIU1, Zongqi JIANG4, Dongsheng HUANG*, 2, authorsList=Yanping LI, Guihua LIU, Anwei WANG, Zengkan LIU, Zongqi JIANG, Dongsheng HUANG, authorCompany=null, correspAuthors=Dongsheng HUANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=Copyright ©2025 Chinese Journal of School 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=1325532059833483921, articleId=1325532039671464590, tenantId=1146029695717560320, journalId=1256213402557890569, language=CN, title=保山市2018—2024年8~10岁儿童碘营养状况, columnId=1259565866560119750, journalTitle=中国学校卫生, columnName=学生营养, runingTitle=null, highlight=null, articleAbstract=
目的

分析2018-2024年保山市8~10岁儿童碘营养状况, 全面评价保山市碘缺乏病消除巩固成效。

方法

2018-2024年, 采用分层随机抽样方法抽取保山市5个县(隆阳县、施甸县、昌宁县、腾冲市、龙陵县)35个调查点的7 363名8~10岁非寄宿制儿童, 检测家中盐碘含量和儿童尿碘浓度, 采用超声法测量儿童甲状腺容积。组间比较采用Mann-Whitney U检验、Kruskal-Wallis H检验、χ2检验, 采用Spearman秩相关分析盐碘、尿碘、甲状腺容积的相关性。

结果

儿童家庭食用盐共计检测7 361份, 碘盐覆盖率为99.70%, 合格碘盐食用率为97.02%。不合格碘盐占比从2018年的3.14%波动下降至2024年的2.14%。儿童家庭食用盐碘含量中位数为23.70(21.60, 25.80) mg/kg; 儿童尿碘中位数为217.41(152.40, 294.59)μg/L, 其中碘不足、碘适宜及碘过量的占比分别为9.75%, 66.66%和23.58%;不同年份、年龄、性别和未加碘食盐供应前后儿童尿碘中位数差异均有统计学意义(Z/H值分别为134.88, 11.04, -4.28, -2.66, P值均 < 0.01)。儿童甲状腺平均容积为3.32(2.77, 3.93) mL, 甲状腺肿大率为1.91%。2023年保山市实施未加碘食盐供应前后, 儿童家庭食用盐碘含量中位数及甲状腺肿大率差异无统计学意义(Z/χ2值分别为-1.54, 3.25, P值均>0.05), 但碘盐合格情况、尿碘中位数及尿碘频数分布差异均有统计学意义(χ2/Z值分别为15.53, -2.66, 10.14, P值均 < 0.05)。盐碘与儿童尿碘呈正相关(r=0.04)、与甲状腺容积呈负相关(r=-0.07), 尿碘与甲状腺容积呈负相关(r=-0.03)(P值均 < 0.05)。食用碘盐儿童甲状腺容积大于食用非碘盐儿童(H=9.99), 不同尿碘水平儿童甲状腺容积差异有统计学意义(H=15.13)(P值均 < 0.01)。

结论

2018-2024年保山市8~10岁儿童碘营养总体处于适宜水平, 持续巩固了碘缺乏病消除状态。

, authors=李艳萍1, 刘贵华2, 王安伟3, 刘增刊1, 江宗奇4, 黄东升*, 2, authorsList=李艳萍, 刘贵华, 王安伟, 刘增刊, 江宗奇, 黄东升, authorCompany=null, correspAuthors=黄东升, authorNote=

李艳萍(1984-)，女，云南腾冲人，大学本科，副主任医师，主要研究方向为传染性疾病控制和地方病防制

, correspAuthorsNote=
黄东升，E-mail:
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李艳萍(1984-)，女，云南腾冲人，大学本科，副主任医师，主要研究方向为传染性疾病控制和地方病防制

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Comparison of iodine content in household edible salt, urinary iodine content and thyroid volume of children aged 8-10 in Baoshan City from 2018 to 2024

, figureFileSmall=null, figureFileBig=null, tableContent=
变量选项统计值盐碘含量尿碘水平甲状腺容积
样本数M(P25，P75)/(mg·kg-1)样本数M(P25，P75)/(μg·L-1)人数M(P25，P75)/mL
年份20181 02024.60(22.70, 26.80)1 021215.92(157.10, 286.86)1 0223.59(3.08, 4.18)
20191 01922.90(20.70, 25.00)1 019242.22(170.20, 319.48)1 0193.22(2.54, 3.94)
20201 01723.20(21.15, 25.20)1 017232.00(170.42, 313.36)1 0173.52(3.01, 4.17)
20211 01724.11(21.60, 26.40)1 017215.22(153.62, 293.83)1 0173.12(2.65, 3.69)
20221 05623.80(22.31, 25.69)1 056187.69(121.78, 274.38)1 0563.24(2.59, 3.83)
20231 10823.72(21.43, 25.80)1 108214.30(145.00, 295.65)1 1083.31(2.92, 3.89)
20241 12423.56(21.60, 25.80)1 123214.19(151.60, 283.59)1 1243.19(2.66, 3.82)
H值192.43134.88259.36
P值＜0.01＜0.01< 0.01
未加碘食盐2018—2022年5 12923.70(21.60, 25.80)5 130219.37(154.40, 296.96)5 1313.34(2.76, 3.96)
供应前后2023—2024年2 23223.69(21.56, 25.80)2 231214.19(148.10, 288.70)2 2323.26(2.79, 3.86)
Z值-1.54-2.66-2.31
P值0.13< 0.010.02
地区分类内地县4 54123.30(21.07, 25.80)4 540217.46(151.49, 294.10)4 5413.33(2.78, 3.96)
边境县2 82024.20(22.44, 26.00)2 821217.23(154.85, 295.36)2 8223.31(2.73, 3.88)
Z值-11.37-0.04-2.75
P值＜0.010.97< 0.01
年龄/岁81 86723.69(21.54, 25.87)1 866216.44(147.15, 297.24)1 8673.06(2.52, 3.57)
92 82923.69(21.60, 25.80)2 829213.00(151.56, 286.65)2 8293.28(2.78, 3.87)
102 66523.80(21.70, 25.80)2 666222.90(156.82, 301.70)2 6673.61(2.98, 4.24)
H值2.3211.04450.70
P值0.31＜0.01< 0.01
性别男3 69623.70(21.57, 25.80)3 698223.10(156.98, 299.26)3 6983.31(2.74, 3.93)
女3 66523.70(21.60, 25.80)3 663211.79(148.70, 289.30)3 6653.33(2.79, 3.94)
Z值-0.33-4.28-1.22
P值0.75< 0.010.22
), ArticleFig(id=1325532110974632648, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325532039671464590, language=CN, label=表1, caption=

保山市2018—2024年8~10岁儿童家庭食用盐碘含量、尿碘水平及儿童甲状腺容积比较

, figureFileSmall=null, figureFileBig=null, tableContent=
变量选项统计值盐碘含量尿碘水平甲状腺容积
样本数M(P25，P75)/(mg·kg-1)样本数M(P25，P75)/(μg·L-1)人数M(P25，P75)/mL
年份20181 02024.60(22.70, 26.80)1 021215.92(157.10, 286.86)1 0223.59(3.08, 4.18)
20191 01922.90(20.70, 25.00)1 019242.22(170.20, 319.48)1 0193.22(2.54, 3.94)
20201 01723.20(21.15, 25.20)1 017232.00(170.42, 313.36)1 0173.52(3.01, 4.17)
20211 01724.11(21.60, 26.40)1 017215.22(153.62, 293.83)1 0173.12(2.65, 3.69)
20221 05623.80(22.31, 25.69)1 056187.69(121.78, 274.38)1 0563.24(2.59, 3.83)
20231 10823.72(21.43, 25.80)1 108214.30(145.00, 295.65)1 1083.31(2.92, 3.89)
20241 12423.56(21.60, 25.80)1 123214.19(151.60, 283.59)1 1243.19(2.66, 3.82)
H值192.43134.88259.36
P值＜0.01＜0.01< 0.01
未加碘食盐2018—2022年5 12923.70(21.60, 25.80)5 130219.37(154.40, 296.96)5 1313.34(2.76, 3.96)
供应前后2023—2024年2 23223.69(21.56, 25.80)2 231214.19(148.10, 288.70)2 2323.26(2.79, 3.86)
Z值-1.54-2.66-2.31
P值0.13< 0.010.02
地区分类内地县4 54123.30(21.07, 25.80)4 540217.46(151.49, 294.10)4 5413.33(2.78, 3.96)
边境县2 82024.20(22.44, 26.00)2 821217.23(154.85, 295.36)2 8223.31(2.73, 3.88)
Z值-11.37-0.04-2.75
P值＜0.010.97< 0.01
年龄/岁81 86723.69(21.54, 25.87)1 866216.44(147.15, 297.24)1 8673.06(2.52, 3.57)
92 82923.69(21.60, 25.80)2 829213.00(151.56, 286.65)2 8293.28(2.78, 3.87)
102 66523.80(21.70, 25.80)2 666222.90(156.82, 301.70)2 6673.61(2.98, 4.24)
H值2.3211.04450.70
P值0.31＜0.01< 0.01
性别男3 69623.70(21.57, 25.80)3 698223.10(156.98, 299.26)3 6983.31(2.74, 3.93)
女3 66523.70(21.60, 25.80)3 663211.79(148.70, 289.30)3 6653.33(2.79, 3.94)
Z值-0.33-4.28-1.22
P值0.75< 0.010.22
), ArticleFig(id=1325532111872213705, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325532039671464590, language=EN, label=Tab.2, caption=

Comparison of the distribution of qualified iodized salt in households of children aged 8-10 in Baoshan City by region from 2018 to 2024

, figureFileSmall=null, figureFileBig=null, tableContent=
变量选项统计值非碘盐合格碘盐不合格碘盐合计
样本数内地县边境县样本数内地县边境县样本数内地县边境县样本数内地县边境县
年份201842(50.00)2(50.00)984594(60.37)390(39.63)3212(37.50)20(62.50)1 020608(59.61)412(40.39)
201943(75.00)1(25.00)960577(60.10)383(39.90)5538(69.09)17(30.91)1 019618(60.65)401(39.35)
202032(66.67)1(33.33)991595(60.04)396(39.96)2317(73.91)6 (26.09)1 017614(60.37)403(39.63)
202133(100.00)0979587(59.96)392(40.04)3526(74.29)9 (25.71)1 017616(60.57)401(39.43)
202244(100.00)01 036638(61.58)398(38.42)1611(68.75)5 (31.25)1 056653(61.84)403(38.16)
202322(100.00)01 094697(63.71)397(36.29)129(75.00)3 (25.00)1 108708(63.90)400(36.10)
202421(50.00)1(50.00)1 098702(63.93)396(36.07)2421(87.50)3 (12.50)1 124724(64.41)400(35.59)
χ2值5.188.2019.199.67
P值0.630.22< 0.010.14
未加碘食盐供应前后2018—2022年1814(77.78)4(22.22)4 9502 991(60.42)1 959(39.58)161104(64.60)57(35.40)5 1293 109(60.59)2 022(39.41)
2023—2024年43(75.00)1(25.00)2 1921 399(63.82)793(36.18)3630(83.33)6(16.67)2 2321 432(64.16)800(35.84)
χ2值—7.414.758.36
P值1.000.010.03< 0.01
), ArticleFig(id=1325532112602022602, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325532039671464590, language=CN, label=表2, caption=

保山市2018—2024年8~10岁儿童家庭碘盐不同地区分布比较

, figureFileSmall=null, figureFileBig=null, tableContent=
变量选项统计值非碘盐合格碘盐不合格碘盐合计
样本数内地县边境县样本数内地县边境县样本数内地县边境县样本数内地县边境县
年份201842(50.00)2(50.00)984594(60.37)390(39.63)3212(37.50)20(62.50)1 020608(59.61)412(40.39)
201943(75.00)1(25.00)960577(60.10)383(39.90)5538(69.09)17(30.91)1 019618(60.65)401(39.35)
202032(66.67)1(33.33)991595(60.04)396(39.96)2317(73.91)6 (26.09)1 017614(60.37)403(39.63)
202133(100.00)0979587(59.96)392(40.04)3526(74.29)9 (25.71)1 017616(60.57)401(39.43)
202244(100.00)01 036638(61.58)398(38.42)1611(68.75)5 (31.25)1 056653(61.84)403(38.16)
202322(100.00)01 094697(63.71)397(36.29)129(75.00)3 (25.00)1 108708(63.90)400(36.10)
202421(50.00)1(50.00)1 098702(63.93)396(36.07)2421(87.50)3 (12.50)1 124724(64.41)400(35.59)
χ2值5.188.2019.199.67
P值0.630.22< 0.010.14
未加碘食盐供应前后2018—2022年1814(77.78)4(22.22)4 9502 991(60.42)1 959(39.58)161104(64.60)57(35.40)5 1293 109(60.59)2 022(39.41)
2023—2024年43(75.00)1(25.00)2 1921 399(63.82)793(36.18)3630(83.33)6(16.67)2 2321 432(64.16)800(35.84)
χ2值—7.414.758.36
P值1.000.010.03< 0.01
), ArticleFig(id=1325532113650598603, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325532039671464590, language=EN, label=Tab.3, caption=

Comparison of detection rate of urinary iodine and detection of thyroid enlargement among children aged 8-10 in Baoshan City from 2018 to 2024

, figureFileSmall=null, figureFileBig=null, tableContent=
变量选项尿碘频数甲状腺肿大
样本数< 50 μg/L50~ < 100 μg/L100~ < 200 μg/L200~ < 300 μg/L≥300 μg/Lχ2值人数检出人数χ2值
年份20181 0219(0.88)67(6.56)366(35.85)361(35.36)218(21.35)183.52**1 02227(2.64)9.82
20191 01912(1.18)54(5.30)294(28.85)359(35.23)300(29.44)1 01916(1.57)
20201 01714(1.38)65(6.39)280(27.53)379(37.27)279(27.43)1 01725(2.46)
20211 01715(1.47)64(6.29)367(36.09)331(32.55)240(23.60)1 01723(2.26)
20221 05647(4.45)126(11.93)395(37.41)285(26.99)203(19.22)1 05617(1.61)
20231 10840(3.61)104(9.39)351(31.68)350(31.59)263(23.74)1 10820(1.81)
20241 12323(2.05)78(6.95)394(35.08)395(35.17)233(20.75)1 12413(1.16)
未加碘食盐2018—2022年5 13097(1.89)376(7.33)1 702(33.18)1 715(33.43)1 240(24.17)10.14*5 131108(2.10)3.25
供应前后2023—2024年2 23163(2.82)182(8.16)745(33.39)745(33.39)496(22.23)2 23233(1.48)
地区分类内地县4 540113(2.49)357(7.86)1 467(32.31)1 526(33.61)1 077(23.72)9.98*4 54181(1.78)1.09
边境县2 82147(1.67)201(7.13)980(34.74)934(33.11)659(23.36)2 82260(2.13)
年龄/岁81 86666(3.54)145(7.77)601(32.21)603(32.32)451(24.17)37.16**1 86737(1.98)8.19*a
92 82956(1.98)231(8.17)969(34.25)961(33.97)612(21.63)2 82968(2.40)
102 66638(1.43)182(6.83)877(32.90)896(33.61)673(25.24)2 66736(1.35)
性别男3 69867(1.81)2 60(7.03)1 188(32.13)1 268(34.29)915(24.74)16.15**3 69865(1.76)0.98
女3 66393(2.54)298(8.14)1 259(34.37)1 192(32.54)821(22.41)3 66576(2.07)
合计7 361160(2.17)558(7.58)2 447(33.24)2 460(33.42)1 736(23.58)7 363141(1.91)
), ArticleFig(id=1325532115563201228, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325532039671464590, language=CN, label=表3, caption=

保山市2018—2024年8~10岁儿童尿碘频数分布及甲状腺肿大检出率比较

, figureFileSmall=null, figureFileBig=null, tableContent=
变量选项尿碘频数甲状腺肿大
样本数< 50 μg/L50~ < 100 μg/L100~ < 200 μg/L200~ < 300 μg/L≥300 μg/Lχ2值人数检出人数χ2值
年份20181 0219(0.88)67(6.56)366(35.85)361(35.36)218(21.35)183.52**1 02227(2.64)9.82
20191 01912(1.18)54(5.30)294(28.85)359(35.23)300(29.44)1 01916(1.57)
20201 01714(1.38)65(6.39)280(27.53)379(37.27)279(27.43)1 01725(2.46)
20211 01715(1.47)64(6.29)367(36.09)331(32.55)240(23.60)1 01723(2.26)
20221 05647(4.45)126(11.93)395(37.41)285(26.99)203(19.22)1 05617(1.61)
20231 10840(3.61)104(9.39)351(31.68)350(31.59)263(23.74)1 10820(1.81)
20241 12323(2.05)78(6.95)394(35.08)395(35.17)233(20.75)1 12413(1.16)
未加碘食盐2018—2022年5 13097(1.89)376(7.33)1 702(33.18)1 715(33.43)1 240(24.17)10.14*5 131108(2.10)3.25
供应前后2023—2024年2 23163(2.82)182(8.16)745(33.39)745(33.39)496(22.23)2 23233(1.48)
地区分类内地县4 540113(2.49)357(7.86)1 467(32.31)1 526(33.61)1 077(23.72)9.98*4 54181(1.78)1.09
边境县2 82147(1.67)201(7.13)980(34.74)934(33.11)659(23.36)2 82260(2.13)
年龄/岁81 86666(3.54)145(7.77)601(32.21)603(32.32)451(24.17)37.16**1 86737(1.98)8.19*a
92 82956(1.98)231(8.17)969(34.25)961(33.97)612(21.63)2 82968(2.40)
102 66638(1.43)182(6.83)877(32.90)896(33.61)673(25.24)2 66736(1.35)
性别男3 69867(1.81)2 60(7.03)1 188(32.13)1 268(34.29)915(24.74)16.15**3 69865(1.76)0.98
女3 66393(2.54)298(8.14)1 259(34.37)1 192(32.54)821(22.41)3 66576(2.07)
合计7 361160(2.17)558(7.58)2 447(33.24)2 460(33.42)1 736(23.58)7 363141(1.91)
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保山市2018—2024年8~10岁儿童碘营养状况
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李艳萍 1 , 刘贵华 2 , 王安伟 3 , 刘增刊 1 , 江宗奇 4 , 黄东升 *, 2
中国学校卫生 | 学生营养 2025,46(11): 1559-1563
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中国学校卫生 |学生营养 2025 , 46 (11) : 1559 -1563
保山市2018—2024年8~10岁儿童碘营养状况
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李艳萍1, 刘贵华2, 王安伟3, 刘增刊1, 江宗奇4, 黄东升*, 2
作者信息
  • 1保山市疾病预防控制中心地方病防制科, 云南 678000
  • 2保山市疾病预防控制中心办公室
  • 3云南省地方病防治所地方病防治科
  • 4保山市人民医院质量控制部
通讯作者:
黄东升，E-mail:
作者简介:

李艳萍(1984-)，女，云南腾冲人，大学本科，副主任医师，主要研究方向为传染性疾病控制和地方病防制

Iodine nutrition among children aged 8-10 in Baoshan City from 2018 to 2024
Yanping LI1, Guihua LIU2, Anwei WANG3, Zengkan LIU1, Zongqi JIANG4, Dongsheng HUANG*, 2
Affiliations
  • 1Endemic Disease Prevention and Control Department, Baoshan Center for Disease Control and Prevention, Baoshan 678000, Yunnan Province, China
出版时间: 2025-11-25 doi: 10.16835/j.cnki.1000-9817.2025326
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摘要
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目的

分析2018-2024年保山市8~10岁儿童碘营养状况, 全面评价保山市碘缺乏病消除巩固成效。

方法

2018-2024年, 采用分层随机抽样方法抽取保山市5个县(隆阳县、施甸县、昌宁县、腾冲市、龙陵县)35个调查点的7 363名8~10岁非寄宿制儿童, 检测家中盐碘含量和儿童尿碘浓度, 采用超声法测量儿童甲状腺容积。组间比较采用Mann-Whitney U检验、Kruskal-Wallis H检验、χ2检验, 采用Spearman秩相关分析盐碘、尿碘、甲状腺容积的相关性。

结果

儿童家庭食用盐共计检测7 361份, 碘盐覆盖率为99.70%, 合格碘盐食用率为97.02%。不合格碘盐占比从2018年的3.14%波动下降至2024年的2.14%。儿童家庭食用盐碘含量中位数为23.70(21.60, 25.80) mg/kg; 儿童尿碘中位数为217.41(152.40, 294.59)μg/L, 其中碘不足、碘适宜及碘过量的占比分别为9.75%, 66.66%和23.58%;不同年份、年龄、性别和未加碘食盐供应前后儿童尿碘中位数差异均有统计学意义(Z/H值分别为134.88, 11.04, -4.28, -2.66, P值均 < 0.01)。儿童甲状腺平均容积为3.32(2.77, 3.93) mL, 甲状腺肿大率为1.91%。2023年保山市实施未加碘食盐供应前后, 儿童家庭食用盐碘含量中位数及甲状腺肿大率差异无统计学意义(Z/χ2值分别为-1.54, 3.25, P值均>0.05), 但碘盐合格情况、尿碘中位数及尿碘频数分布差异均有统计学意义(χ2/Z值分别为15.53, -2.66, 10.14, P值均 < 0.05)。盐碘与儿童尿碘呈正相关(r=0.04)、与甲状腺容积呈负相关(r=-0.07), 尿碘与甲状腺容积呈负相关(r=-0.03)(P值均 < 0.05)。食用碘盐儿童甲状腺容积大于食用非碘盐儿童(H=9.99), 不同尿碘水平儿童甲状腺容积差异有统计学意义(H=15.13)(P值均 < 0.01)。

结论

2018-2024年保山市8~10岁儿童碘营养总体处于适宜水平, 持续巩固了碘缺乏病消除状态。

碘  /  营养状况  /  合格鉴定  /  甲状腺肿  /  儿童
Objective

To analyze the iodine nutritional status of children aged 8-10 in Baoshan City, so as to comprehensively evaluate the effectiveness of eliminating and consolidating iodine deficiency disorders in Baoshan City.

Methods

From 2018 to 2024, a stratified random sampling method was used to sample 7 363 non-boarding children aged 8-10 from 35 survey sites in 5 counties of Baoshan City (Longyang County, Shidian County, Changning County, Tengchong City, Longling County).The salt iodine content and urinary iodine concentration were detected, and the thyroid volume of children was measured by ultrasound.Group comparison was conducted by using Mann-Whitney U test, Kruskal-Wallis H test, and Chi-square test.Spearman rank correlation analysis was used to investigate the correlation of salt iodine, urinary iodine and thyroid volume.

Results

A total of 7 361 samples of household edible salt for children were detected.The iodized salt coverage rate was 99.70%, the qualified iodized salt consumption rate was 97.02%.The proportion of unqualified iodized salt fluctuated and decreased from 3.14% in 2018 to 2.14% in 2024.The median iodine content of household edible salt for children was 23.70(21.60, 25.80) mg/kg.The median urinary iodine of children was 217.41(152.40, 294.59)μg/L, and the proportions of iodine deficiency, adequate iodine, and iodine excess were 9.75%, 66.66%, and 23.58%, respectively.There were statistically significant differences in the median urinary iodine of children among different years, ages, genders and before and after the supply of non-iodized salt (Z/H=134.88, 11.04, -4.28, -2.66, all P < 0.01).An average thyroid volume of children was 3.32(2.77, 3.93) mL, with a goiter rate of 1.91%.Before and after the implementation of non-iodized salt supply in Baoshan City in 2023, there were no statistically significant differences in the median iodine content of household edible salt and the goiter rate of children (Z/χ2=-1.54, 3.25, both P>0.05), but there were statistically significant differences in the qualified status of iodized salt, the median urinary iodine, and the frequency distribution of urinary iodine (χ2/Z=15.53, -2.66, 10.14, all P < 0.05).Salt iodine was positively correlated with urinary iodine (r=0.04) and negatively correlated with thyroid volume (r=-0.07), and urinary iodine was negatively correlated with thyroid volume (r=-0.03)(all P < 0.05).The thyroid volume of children consuming iodized salt was larger than that of children consuming non-iodized salt (H=9.99), and there were statistically significant differences in thyroid volume among children with different urinary iodine levels (H=15.13)(both P < 0.01).

Conclusions

From 2018 to 2024, the overall iodine nutritional level of children aged 8-10 in Baoshan City is at an adequate level.The elimination status of iodine deficiency disorders has been continuously consolidated.

Iodine  /  Nutritional status  /  Eligibility determination  /  Goiter  /  Child
李艳萍, 刘贵华, 王安伟, 刘增刊, 江宗奇, 黄东升. 保山市2018—2024年8~10岁儿童碘营养状况. 中国学校卫生, 2025 , 46 (11) : 1559 -1563 . DOI: 10.16835/j.cnki.1000-9817.2025326
Yanping LI, Guihua LIU, Anwei WANG, Zengkan LIU, Zongqi JIANG, Dongsheng HUANG. Iodine nutrition among children aged 8-10 in Baoshan City from 2018 to 2024[J]. Chinese Journal of School Health, 2025 , 46 (11) : 1559 -1563 . DOI: 10.16835/j.cnki.1000-9817.2025326
正文
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保山市地处中缅边境，历史上是碘缺乏病流行比较广泛的地区之一，下辖5个县(市、区)(腾冲市、隆阳区、龙陵县、昌宁县和施甸县)。2007年，世界卫生组织、联合国儿童基金会/国际碘缺乏病控制理事会联合发布《碘缺乏病调查和评价指南》，将合格碘盐食用率、尿碘中位浓度以及甲状腺肿大率作为评价碘营养水平和监测碘缺乏病的重要指标[1]。多年来保山市通过实施普遍食盐加碘为主的综合防治措施，人群碘营养状况总体得到改善，碘缺乏病防治取得显著成效[2]。为满足市场需要，2016年底国家《盐业体制改革方案》[3]出台，允许跨省销售食盐，加之保山市2023年允许未加碘食盐进入市场供应患有甲状腺疾病等特殊人群，部分家庭可根据需要自由选购。为全面了解和评价保山市8~10岁儿童碘营养水平和探讨影响因素，比较评估2023年未加碘食盐供应前后儿童碘营养水平差异，本研究系统分析了2018—2024年保山市8~10岁儿童碘营养水平监测情况，结果如下。
1　对象与方法
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1.1　对象
2018—2024年间保山市按《云南省碘缺乏病监测方案(2016，2019，2023，2024版)》要求，采用分层随机抽样方法，分别以5个县(市、区)为监测点，按东、南、西、北、中划分为5个片区，在每个片区采用随机数字表法抽取1个乡镇，在每个乡镇各随机抽取1所小学，在每所小学的非寄宿制8~10岁学生中随机抽取40人(不足40人时，可在临近学校补齐)，男女各半。共调查7 363名学龄儿童，其中2名儿童盐样缺失(共采集盐样7 361份)，2名儿童尿样缺失(共采集尿样7 361份)。其中8岁组1 867名，9岁组2 829名，10岁组2 667名；男生3 698名，女生3 665名；内地县(隆阳县、施甸县、昌宁县)4 541名，边境县(腾冲市、龙陵县)2 822名。儿童平均年龄为(9.12±0.82)岁。该调查经保山市人民医院伦理委员会批准(编号：202511-LLP-002-01)，均已获得学生家长知情同意。
1.2　方法
1.2.1　盐碘监测
抽取学生家中食用盐在县级实验室开展碘含量检测。采集盐样前要清除盐中杂质，并充分混匀样品，采集至少30 g食盐，避光、避潮、避热保存。盐碘实验室检测按照《制盐工业通用试验方法碘的测定》(GB/T 13025.7—2012)[4]，碘酸钾盐采用直接滴定法，海藻碘盐及其他强化食用盐采用氧化还原法进行测定; 按照《食品安全国家标准食用盐碘含量》(GB 26878—2011)[5]，云南选择25 mg/kg±30%食盐加碘范围，碘盐含量在18~33 mg/kg为合格碘盐，5~＜18或＞33 mg/kg为不合格碘盐，＜5 mg/kg为非碘盐。
1.2.2　尿碘监测
采用聚乙烯塑料瓶收集学生当日随意1次尿样进行尿碘检测，采样量≥5 mL，尿样冷藏送往有尿碘检测资质的疾病预防控制中心，按照《尿中碘的测定第1部分：砷铈催化分光光度法》(WS/T 107.1—2016)[6]方法检测。
1.2.3　碘营养状况评价
用尿碘中位数(median of urinary iodine，MUI)进行碘营养状况评价。学龄儿童MUI＜100 μg/L为碘不足，100~ < 300 μg/L为碘适宜，≥300 μg/L为碘过量[7]。碘缺乏病消除标准：根据《重点地方病控制和消除评价办法(2019版)》进行判定[8]。
1.2.4　甲状腺肿诊断
由专业人员采用B超法，按《地方性甲状腺肿诊断标准》(WS 276—2007)[9]测量儿童甲状腺两个侧叶的最大长度L(上下直径)、宽度W(左右直径)、厚度D(前后直径)，计算甲状腺容积。8岁组甲状腺容积>4.5 mL，9岁组>5.0 mL，10岁组>6.0 mL判定为甲状腺肿大。
1.3　质量控制
每年项目开展前由省、市、县三级疾病预防控制中心分别印发《碘缺乏病监测方案》，并逐级组织对监测方案和监测技术进行培训；县级疾病预防控制中心负责具体现场监测工作的实施，市级疾病预防控制中心对部分县开展现场工作技术指导，加强采样、实验室检测、数据录入等各环节的质量控制；甲状腺超声检查由具有检查资质的专业人员完成；尿碘和盐碘检测均由通过中国疾病预防控制中心碘缺乏病参照实验室尿碘、盐碘质控考核并取得合格证的县级疾病预防控制中心实验室完成，同时市级疾病预防控制中心每年对县级检测样品的5%进行抽检复核。
1.4　统计学分析
使用SPSS 27.0.1统计软件进行数据分析。对计量资料先进行正态分布检验，本研究经检验尿碘、盐碘数值均为偏态分布，以M(P25，P75)表示，两组间比较采用Mann-Whitney U检验，多组间比较采用Kruskal-Wallis H检验；盐碘、尿碘构成比和碘盐覆盖率、碘盐合格率和合格碘盐食用率、甲状腺肿大率等计数资料的比较采用χ2检验，具有时间变化趋势性的资料分析采用χ2趋势检验。对盐碘、尿碘、甲状腺容积的相关性采用Spearman秩相关分析。以P＜0.05为有统计学意义。
2　结果
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2.1　儿童碘盐食用情况
2018—2024年共采集检测儿童家庭食用盐样7 361份，盐碘含量中位数为23.70(21.60，25.80)mg/kg，其中碘盐覆盖率为99.70%(7 339份)，碘盐合格率为97.32%(7 142/7 339)，非碘盐率为0.3%(22份)。五县(市、区)中除龙陵县无非碘盐检出外，其余各县均检出少量非碘盐。2018—2024年各年合格碘盐数分别为984，960，991，979，1 036，1 094，1 098份，非碘盐分别为4，4，3，3，4，2，2份，不合格碘盐分别为32，55，23，35，16，12，24份；不合格碘盐占比从2018年的3.14%波动下降至2024年的2.14%；未加碘食盐供应前(2018—2022年)、后(2023—2024年)合格碘盐数分别为4 950，2 192份，非碘盐分别为18，4份，不合格碘盐分别为161，36份，分布差异均有统计学意义(χ2值分别为49.32，15.53，P值均＜0.01)。不同年份、地区间儿童家庭食用盐碘含量中位数差异均有统计学意义(P值均 < 0.01)；2023年未加碘食盐供应前后及不同年龄、性别儿童家庭食用盐碘含量中位数差异均无统计学意义(P值均>0.05)。见表1。
2.2　不同地区碘盐合格情况
2018—2024年间儿童家庭合格碘盐内地县和边境县分布差异无统计学意义(P>0.05)，不合格碘盐分布差异有统计学意义(P＜0.01)。未加碘食盐供应前后儿童家庭合格碘盐内地县与边境县分布差异有统计学意义(P＜0.01)。见表2。
2.3　儿童尿碘情况
7 361份随机尿样尿碘中位数为217.41(152.40，294.59)μg/L，其中碘不足、碘适宜及碘过量的占比分别为9.75%(718例)、66.66%(4 907例)和23.58%(1 736例)，且＜50 μg/L的仅占2.17%。不同年份、年龄、性别和未加碘食盐供应前后儿童尿碘中位数差异均有统计学意义(P值均＜0.01)。见表1。不同年份、地区、年龄、性别和未加碘食盐供应前后儿童尿碘频数分布差异均有统计学意义(P值均＜0.05)。见表3。
2.4　儿童甲状腺肿情况
2018—2024年共开展超声检查7 363人，甲状腺平均容积为3.32(2.77，3.93)mL；不同年份、未加碘食盐供应前后、地区和年龄的儿童甲状腺容积差异均有统计学意义(P值均 < 0.05)。见表1。检出甲状腺肿141例，患病率为1.91%。不同年份、地区、性别及未加碘食盐供应前后儿童甲状腺肿大率差异均无统计学意义(P值均>0.05)，随着儿童年龄的增加甲状腺肿大率呈下降趋势(χ趋势2=8.19，P < 0.05)。见表3。
2.5　盐碘、尿碘、甲状腺容积的相关性
按甲状腺是否肿大进行分组，甲状腺肿大儿童家庭盐碘含量[23.69(21.57, 25.48)mg/kg]与非甲状腺肿大儿童[23.70(21.60, 25.80)mg/kg]差异无统计学意义(Z=-0.85，P>0.05)；甲状腺肿大儿童尿碘水平[223.42(163.39, 298.87)μg/L]与非甲状腺肿大的儿童[217.30(152.24, 294.48)μg/L]差异无统计学意义(Z=-0.80，P>0.05)。Spearman秩相关结果显示，盐碘与尿碘呈正相关(r=0.04)、与甲状腺容积呈负相关(r=-0.07)，尿碘与甲状腺容积呈负相关(r=-0.03)(P值均＜0.05)。按照不同食盐类型进行分组，非碘盐、不合格碘盐、合格碘盐儿童甲状腺容积中位数分别为3.16(2.66，4.03)，3.62(2.90，4.31)，3.31(2.77，3.92)mL，差异有统计学意义(H=9.99，P=0.01)。按不同尿碘水平进行分组，碘不足、碘适宜、碘过量儿童甲状腺容积中位数分别为3.35(2.80，3.92)，3.34(2.80~3.95)，3.25(2.66~3.89)mL，差异有统计学意义(H=15.13，P＜0.01)。
3　讨论
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本研究分析了2018—2024年保山市8~10岁儿童的盐碘、尿碘及甲状腺肿大状况，结果显示当地儿童碘营养相关指标均达到碘缺乏病消除标准。表明保山市碘缺乏病消除成果持续巩固，儿童总体碘营养处于适宜水平。进一步对比边境县与内地县发现，两地儿童在家庭食用盐碘含量分布、碘盐合格情况、尿碘中位数及甲状腺肿大检出率上差异均无统计学意义，提示区域间儿童碘营养状况无明显分化。
2023年保山市实施未加碘食盐供应前后，儿童家庭食用盐碘含量中位数及甲状腺肿大检出率差异无统计学意义，表明2年来实施未加碘食盐政策未对儿童核心碘营养状况及甲状腺肿大检出率带来不良影响。但碘盐合格情况、尿碘中位数及尿碘频数分布差异均有统计学意义，可能因素：(1)碘盐市场供应多元化可能影响了碘盐质量的波动；(2)极少数家庭对碘盐认知不足，可能存在误选非碘盐的情况；(3)各地区监管力度不均衡，导致政策效果存在差异。值得注意的是，尿碘水平对政策变化反应更敏感，而甲状腺肿大检出率作为长期指标尚未出现波动，提示未加碘食盐供应政策的长期效应需进一步观察，尤其要关注碘盐质量波动对儿童尿碘分布的影响。建议今后严格把控碘盐质量，开展有针对性的健康教育，完善碘营养监测体系。通过多管齐下，既能满足特殊人群需求，又能持续巩固碘缺乏病防治成效。
研究还发现，不同年份家庭食用盐碘含量差异有统计学意义，但2023年实施未加碘食盐供应前后盐碘中位数差异无统计学意义，可能与盐业市场动态调整、居民购盐渠道多样化及碘盐生产工艺批次性微调相关。值得注意的是，尽管非碘盐数量逐年下降，但仍有少量存在，提示需持续加强市场非碘盐监管。同时，未加碘食盐供应后需警惕普通人群误购风险，相关部门需规范特定食盐的人群适配性管理，卫生健康部门则应持续强化碘缺乏病监测与宣传教育工作。
从儿童尿碘水平年度变化来看，各年份波动明显，其中2022年最低。结合实际情况分析，2022年处于新型冠状病毒感染疫情防控攻坚阶段，碘缺乏病防治工作如健康教育宣传、常规监测等受限[10]，同时居民购买富碘食物的便利性下降，可能改变了儿童碘摄入方式。此外，保山市属碘缺乏地区，食盐加碘是关键防治措施，本研究发现儿童家庭盐碘含量与尿碘水平呈正相关，与吴红英等[11]研究结果一致；同时观察到食用碘盐儿童甲状腺容积大于食用非碘盐儿童，与高四海等[12]研究结论基本相符。
不同性别儿童尿碘水平差异有统计学意义，男童高于女童，与多地研究结果一致[13-15]。推测原因可能与男女童生理及行为差异相关；男童日常食盐摄入量可能高于女童[16]，且饮食量相对较大，在相同碘摄入环境下碘摄入量更多；同时男女童碘代谢速度存在差异，男童碘清除速率可能较慢[17]；加之女童生长发育早于男童，特定阶段对碘的需求更为集中，综合导致了尿碘水平的性别差异。
8~10岁儿童是碘缺乏病防治的重点人群，碘缺乏可对其智力与体格发育造成不可逆影响，而甲状腺肿大是碘缺乏病的重要表现及严重程度衡量指标。本研究显示，保山市该年龄段儿童甲状腺肿大率处于较低水平，反映儿童碘营养状况良好、碘缺乏病得到有效控制。各年份间甲状腺肿大率差异无统计学意义，表明其整体处于稳定状态；另外，尽管边境县与内地县儿童甲状腺肿大率差异无统计学意义，但边境县相对较高，仍需重点关注。
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2025年第46卷第11期
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doi: 10.16835/j.cnki.1000-9817.2025326
  • 接收时间：2025-07-18
  • 首发时间：2026-11-06
  • 出版时间：2025-11-25
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  • 收稿日期：2025-07-18
  • 修回日期：2025-08-31
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“兴保英才培养计划”医疗卫生人才专项(2023023)
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    1保山市疾病预防控制中心地方病防制科, 云南 678000
    2保山市疾病预防控制中心办公室
    3云南省地方病防治所地方病防治科
    4保山市人民医院质量控制部

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2种不同金属材料的力学参数
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Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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