Abstract

BackgroundIn 1996, Shanghai implemented universal salt iodization and has became the last provincial unit in China to carry out this intervention. In this study, we summarized achievements in past 20 years, to provide suggestions and evidence for the next stage of iodine supplementation.MethodsThis study summarized and analyzed monitoring data of children from 1997, 1999, 2005, 2011, 2014, and 2017 in Shanghai. In each monitoring year, 30 streets or towns were selected using the probability-proportional-to-size sampling technique. One primary school was selected from each street or town by a simple random sampling technique. From each school, 40 children aged 8 to 10 years were randomly selected. The number of children was divided equally by sex and age.ResultsIn 1997, 1999, 2005, 2011, 2014, and 2017, median urinary iodine (MUI) was 227.5 μg/L, 214.3 μg/L, 198.1 μg/L, 181.6 μg/L, 171.4 μg/L, and 183.0 μg/L, goiter rate was 3.07, 0.40, 0.08, 0.08, 0.86, and 1.90%, and median thyroid volume (MTvol) was 2.9 mL, 1.2 mL, 2.4 mL, 1.0 mL, 1.8 mL, and 2.8 mL, respectively. There was a linear correlation between goiter rate and median thyroid volume (MTvol) (r = 0.95, P = 0.014). Household salt iodine concentration (SIC) was dropping every monitoring (P < 0.05). There was a significant difference among different household SIC groups in MUI in 1999 and 2017, and in MTvol in 1999 (P < 0.05). No significant differences were detected in the other years.ConclusionsIn Shanghai, the iodine status of 8 to 10 years old children is adequate. Household SIC have little effect on iodine status of children. Future studies should analyze the dietary sources of iodine, especially from pre-packaged and prepared-away-from-home foods or meals. The regular monitoring of iodine status is important to human health.

Highlights

  • In 1996, Shanghai implemented universal salt iodization and has became the last provincial unit in China to carry out this intervention

  • Studies from the International Council for Control of Iodine Deficiency Disorders (ICCIDD), United Nations Children’s Fund (UNICEF), and World Health Organization (WHO) have revealed that the iodine concentration of a spot urine sample from a child can be used to estimate the iodine status of the population [7]

  • The results showed that mean salt iodine concentration (SIC) (MSI) was in the range of the standard household SIC each monitoring year (Table 1)

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Summary

Introduction

In 1996, Shanghai implemented universal salt iodization and has became the last provincial unit in China to carry out this intervention. We summarized achievements in past 20 years, to provide suggestions and evidence for the stage of iodine supplementation. The first iodine status monitoring in Shanghai in 1995 showed that goiter rate was low (i.e. 1.57% among urban students aged 9 to 13 years and 3.71% among adults), median urinary iodine (MUI) was 69.62 μg/L among urban students aged 9 to 13. The main indicators were urinary iodine concentration (UIC), household salt iodine concentration (SIC), and Tvol. The objectives of this study were to 1) analyze data from 1997, 1999, 2005, 2011, 2014, and 2017, 2) estimate the iodine nutritional status of Shanghai residents, 3) summarize the achievements in the prevention and treatment of IDD in the past 20 years, and 4) provide suggestions for the stages of iodine supplementation

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