Objective: To identify children's iodine nutrition and goitre status in areas with mildly excessive iodine in drinking water. Design: A cross-sectional survey. Probability proportional to size sampling was employed to randomly select children from thirty townships where the median iodine content in drinking water ranged from 150 to 300 mg/l; their urinary iodine concentrations were determined and their thyroid volumes were measured by ultrasound. Drinking water samples and salt samples from the villages where the children lived were collected using a systematic sampling method. Setting: Hebei Province of China. Subjects: A total of 1259 children aged 8-10 years (621 boys and 638 girls). Results: Children's median urinary iodine concentration was found to be 418?8 mg/l, and the iodine concentration was .300 mg/l for 68?3 % (248/363) of the urine samples. Children's median urinary iodine concentration in villages with median salt iodine .10 mg/kg was significantly higher than that in villages with median salt iodine ,5 mg/kg (442?9 mg/l v. 305?4 mg/l, P E 0). The goitre rate of 1259 children examined by ultrasound was 10?96 %. Conclusions: The iodine intake of children living in areas with mildly excessive iodine in drinking water in Hebei Province was found to be excessive. The measured iodine excess in the sampled children is exacerbated by consumption of iodized salt. Goitre was identified in these areas; however, due to the limitation of the current criteria for children's thyroid volume, a comprehensive assessment of the prevalence of goitre in these regions could not be made and further study is required.
The prevalence of goitre in areas with mildly excessive iodine in drinking-water is still under debate. The aim of the present study was to explore the prevalence of goitre and its epidemiological characteristics in these areas using WHO criteria. To this end, three towns with a median water iodine (MWI) of 150 -300 mg/l were selected randomly in Hengshui City of Hebei Province of China, and one town with a MWI of 105 mg/l was chosen as a control. A total of 452 children in the three towns and 120 children in the control town were randomly selected to measure thyroid volume (T vol ) by ultrasound. The goitre status of these children was judged using the criteria recommended by the WHO. The overall goitre prevalences in the three towns were 24·6 % (111/452) by age-specific T vol and 33·0 % (149/452) by body surface area (BSA)-adjusted T vol , which were significantly higher than that in the control town by both age-specific T vol (14·0 % (17/120), P¼ 0·015) and BSA-adjusted T vol (17·5 % (21/120), P¼ 0·001). Significant differences were found neither in goitre prevalences across sex by both age-specific T vol (P¼ 0·078) and BSA-adjusted T vol (P¼ 0·692) nor in that across age group by both BSA-adjusted T vol (P¼0·461) and age-specific T vol (P¼ 0·183). The present study found a high prevalence of goitre in children living in areas with mildly excessive iodine in drinking-water in Hebei Province. No significant differences were found in goitre prevalences across sex and age group. These results suggest that the T vol reference values recommended by the WHO could be too low for Chinese children.
Iodine in drinking water was identified to be the key contributor to this excessive iodine in children indicating that in these areas, intervention should focus on providing alternative drinking water supplies.
Sufficient iodine intake by pregnant and lactating women is crucial to their offspring's cognitive development. The aim of the present study was to explore the impact of iodised salt intake on the iodine status of pregnant and lactating women. Thirty towns were selected from 211 towns in the rural areas of Shijiazhuang city using probability proportionate to size sampling in this cross-sectional survey. In each selected town, forty pregnant women and forty lactating women were randomly selected to contribute urine samples to determine iodine content. The median urinary iodine content (UIC) of 1200 pregnant women in all was 146 (interquartile range (IQR) 88-239) mg/l. The median UIC in the first, second and third trimesters were 166 (IQR 92-276) mg/l, 145 (IQR 83-248) mg/l and 134 (IQR 79 -221) mg/l, respectively. The median UIC in the first trimester was significantly higher than that in the third trimester (P¼ 0·04). The median UIC of 1200 lactating women in all was 120 ) mg/l. Their median UIC in every 4-week block was higher than the WHO criteria except in weeks 25-28 and weeks 33-36 of lactation. Pregnant women's median UIC did not correlate with median salt iodine (MSI) (P¼ 0·402); however, there was a linear correlation between MSI and the lactating women's median UIC (P¼ 0·007). Iodised salt failed to provide adequate iodine to pregnant women possibly due to limited intake of iodised salt during pregnancy, though it was found to provide adequate iodine to lactating women in the rural areas of Shijiazhuang city.
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