ABSTRACT
Objective:To evaluate the current situation of prevention and control of iodine deficiency disorders (IDD), and to describe the iodine nutrition level of pregnant women in key population in Zhejiang Province.Methods:In 2021, a cross-sectional survey on iodine nutrition status of the population was conducted in all 90 counties (cities, districts) in Zhejiang Province. Each county (city, district) was divided into five districts: east, west, south, north, and central. One township (street) was selected from each district, and 20 pregnant women were selected from each township (street) to collect edible salt samples and one random urine sample for salt and urinary iodine testing. The above indicators were stratified and analyzed according to urban, rural, coastal, inland, early pregnancy, mid pregnancy, and late pregnancy.Results:A total of 9 679 pregnant women's salt samples were tested, with a salt iodine content of (20.2 ± 9.2) mg/kg, an iodized salt coverage rate of 84.2% (8 153/9 679), and a qualified iodized salt consumption rate of 80.4% (7 785/9 679). Among them, the qualified iodized salt consumption rate of pregnant women in coastal areas was 69.4% (3 175/4 575), significantly lower than that in inland areas [90.3% (4 610/5 104)]; and the proportion of non iodized salt consumption in coastal areas [25.8% (1 181/4 575)] was significantly higher than inland areas [6.8% (345/5 104)]. A total of 9 679 pregnant women's urine samples were tested, with a median urinary iodine of 133.0 μg/L ( < 150 μg/L). In urban areas, the median urinary iodine (129.8 μg/L) was lower than that in rural areas (135.0 μg/L). Likewise, the median urinary iodine was 126.0 μg/L, lower than inland areas (140.3 μg/L). And as pregnancy progressed, the iodine nutrition level of pregnant women gradually decreased (the median urinary iodine: 137.0 μg/L in early pregnancy, 134.1 μg/L in mid pregnancy, and 129.4 μg/L in late pregnancy).Conclusion:In 2021, pregnant women in Zhejiang Province are in a state of iodine deficiency, and there is a greater risk in urban areas compared to rural areas and coastal areas compared to inland areas.
ABSTRACT
At present, Chinese residents have three iodine nutritional states: iodine deficiency, iodine appropriate and iodine excess. Appropriate iodine nutrition is crucial to the growth, development, and metabolic regulation of the body. Accurate assessment of individual iodine nutrition level is helpful to accurately understand the iodine status of the body and prevent iodine deficiency or excess. Previous indexes for assessing iodine nutrition include urinary iodine, thyroid stimulating hormone, goiter rate and so on, but these indexes have different degrees of shortcomings in individual iodine nutrition evaluation. This paper reviews the commonly used individual iodine nutrition evaluation indexes, and discusses the possibility of combined application of multiple indexes.
ABSTRACT
Objective@#To investigate the status of iodine nutrition and prevalence of goiter among children at ages of 8 to 10 years in Zhejiang Province in 2021, so as to provide insights into the management of iodine deficiency in children.@*Methods @#A total of 90 counties (districts) were sampled as field survey sites from 11 cities of Zhejiang Province using a multi-stage stratified random sampling method in 2021, and non-residential children at ages of 8 to 10 years in these sites were sampled as study subjects. Subjects' household edible salt samples and random urine samples were collected. The iodine content in salt and urinary iodine level were determined using the direct titration method and arsenic-cerium catalytic spectrophotometry for evaluation of iodine nutrition among children. In addition, the lateral lobe of the thyroid gland was measured using ultrasound, and the prevalence of goiter was estimated. @*Results@#A total of 19 363 children were recruited, including 9 710 male children and 9 653 female children, with a male to female ratio of 1.01︰1, and there were 10 704 urban children (55.28%) and 8 659 rural children (44.72%), 9 149 children living in coastal areas (47.25%) and 10 214 children in inland regions (52.75%). The mean iodine content was (19.79±9.25) mg/kg in salt, and the coverage of qualified iodized salt (15 252) was 78.77%. The coverage of qualified iodized salt was significantly lower in urban children than in rural children (76.70% vs. 81.21%; χ2=68.301, P<0.001), and was lower in children living in coastal regions than in inland regions (68.05% vs. 88.27%; χ2=1 270.769, P<0.001). The median urinary iodine concentration was 195.1 μg/L, and the household iodine content in salt correlated positively with urinary iodine concentration in children (rs=0.383, P<0.001). There were 2 885 children with iodine deficiency (14.90%), 7 137 children with adequate iodine (36.86%), 5 414 children with excessive iodine intake (27.96%), and 3 927 children with iodine overdose (20.28%), and the distribution of iodine nutrition in children varied significantly in regions (χ2=283.277, P<0.001) and gender (χ2=126.349, P<0.001). The prevalence of goiter was 2.45% among 7 195 children receiving ultrasound examinations, and a higher prevalence rate of goiter was detected in urban children than in rural children (2.76% vs. 2.00%; χ2=3.962, P=0.047). @*Conclusions @#The overall urinary iodine nutrition was adequate among children at ages of 8 to 10 years in Zhejiang Province in 2021, and the prevalence of goiter in children fell within the threshold defined in the criteria of elimination of iodine deficiency. However, the supervision of the iodized salt quality remains to be improved and iodine deficiency control remains to be reinforced.
ABSTRACT
Objective To set up the reference ranges of thyroid hormones for pregnant and lactating woman in Zhejiang.Methods A total of 338 pregnancy,322 lactating women and 139 non-pregnant women (as a control) were selected from 1 079 women in 13 survey sites of Zhejiang as survey subjects,through the questionnaire survey and thyroid B-ultrasound tests from June 2010 to September 2010.The level of urinary iodine was measured by spectrophotometer,and the thyroid hormone [free triiodothyronine (FT3),free (unbound) thyroxin (FT4),triiodothyronine (T3),tetraiodothyronine (T4),thyroid stimulating hormone (TSH)] was measured by automated chemiluminescence immunoassay.Analysis of thyroid hormone 95％ in pregnant women and lactating women.Results The median urinary iodine of all women investigated were in optimal urine levels (150-249 μg/L),which indicated they were in iodine sufficient status.The FT3 index of lactating women was higher than that of pregnant women and non pregnant women (Zlactating-pregnant =3.98,Zlactating-pregnant =2.46,all P ＜ 0.05);the FT4 index level of lactating women was higher than that of pregnant women and non pregnant women (Zlactating-pregnant =2.68,Zlactating-non-pregnant =2.25,all P ＜ 0.05);the T3 index level of lactating women was higher than that of pregnant women and non pregnant women (Zlactating-pregnant =3.51,Zlactating-non pregnant =2.41,all P ＜ 0.05);levels of T4 in lactating women was the highest (Zlactating-pregnant =2.30,Zlactating-pregnant =4.90,Zlactating-non pregnant =1.57,all P ＜ 0.05);TSH index of lactating women and non pregnant women were higher than that of pregnant women (Zlactating-pregnant =2.81,Zlactating-non pregnant =1.68,all P ＜ 0.05).And in pregnant,the 95％ medical reference interval of FT3 was 3.37-6.53 pmol/L,FT4 was 10.68-20.85 pmol/L,T3 was 1.40-2.79 nmol/L,T4 was 72.72-166.41 nmol/L,and TSH was 0.15-4.44 mU/L;in lactating woman,FT3 was 3.39-6.44 pmol/L,FT4 was 10.81-20.33 pmol/L,T3 was 1.44-2.77 nmol/L,T4 was 71.94-164.61 nmol/L,and TSH was 0.25-4.47 mU/L.Conclusion The thyroid hormone levels of pregnant and lactating women are different from those of non-pregnant women,therefore establishing reference data of thyroid hormones for pregnant and lactating women may be a very important step for clinical practice.
ABSTRACT
Objective To learn the status of iodine nutrition and the goiter of children and pregnant woman in Zhejiang Province after the iodine salt concentration adjustment.Methods The proportionate to population size sampling was applied to select 30 surveillance areas in Zhejiang Province,and iodine nutritional status were evaluated by 4 indicators that include goiter rate in 8 -10 years old children,urine iodine,iodized salt and water iodine.Results The iodine content of 1 565 edible salt samples collected from the above children was measured,and the iodine median(P25 -P75 )was 23.30 (21.00 -25.80)mg/kg.The coverage of iodized salt rate was 88.43%,and 95.88% iodized salts was qualified.The qualified iodized -salt ingesting rate was 84.79%.The iodine content of children aged 8 -10 years old and pregnant woman was tested,and iodine median (P25 -P75 )was 171.99 (113.00 -243.89 ),134.14 (82.10 -202.98)g/L respectively.The iodine content of 66 water samples were randomly collected from the surveillance areas to be tested,and iodine median(P25 -P75 )was 2.42(1.17 -6.28)μg/L.The proportion less than 10 g/L was 87.9%.The goiter status of 1 565 children were examined by B -type of ultrasonic,and the prevalence of goiter was 4.98%.Conclusion After the iodine salt concentration adjustment,the status of iodine nutrition in children was in optimum level,but the level of iodine nutrition in pregnant women was less than the state,which should be paid more attention.
ABSTRACT
Objective To find out the status of iodine nutrition and the goiter of population in Zhejiang Province after adjustment of salt iodine concentration.Methods From April to June 2013,the probability proportionate to size sampling method was applied in 31 countries in Zhejiang Province to select 1 650 school-age children aged 8-10 to examine thyroid by B ultrasound,to collect urine and salt samples,and to test the iodine level using the colorimetric titration method and the spectrophotometer method.Six hundred and twenty pregnant women were selected to collect urine samples and urinary iodine was tested by the spectrophotometer method.Results The coverage rate of iodized salt and the consumption rate of qualified iodized salt in Zhejiang Province after adjustment of salt iodine concentration were 93.20％ (1 521/1 632) and 89.71％ (1 464/1 632),respectively;and the medians urinary iodine in children and pregnant women were 178.40 μg/L and 127.23 μg/L,respectively;and the goiter and median thyroid volume were 5.27％ (87/1 650) and 3.45 ml,respectively;the P97 thyroid volume of children in Zhejiang Province in the 8,9 and 10 years old groups (4.76,5.29,6.36 ml) were higher than those (4.5,5.0,6.0 ml) in the thyroid volume reference (WS 276-2007);and the correlations between thyroid volume,goiter and urinary iodine were not found.Conclusions After adjustment of salt iodine concentration,the status of iodine nutrition in Zhejiang Province in general is down to optimum level,which indicates that it is appropriate for this adjustment,but the level of iodine nutrition in pregnant women is less than appropriate,which should be pay attention to.
ABSTRACT
Objective To understand the current status of iodine nutrition among the community residents to compare the level of iodine nutrition in different areas and groups of populations in Zhejiang province.Methods Stratified cluster sampling method was adopted and residents from twenty-two communities in Zhejiang province were selected.A cross-sectional survey was conducted,using questionnaires,laboratory tests,on urinary iodine,water iodine and the concentration of the iodine in salt,which had played positive roles in the calculation of the level of iodine nutrition.Results Results of the iodine nutrition in this cross-sectional survey were as follows:the median water iodine and salt iodine of Zhejiang were 2.42 μg/L and 28.8 mg/kg,respectively.The coverage of iodized salts was 79.54％,with the ingesting rate of qualified iodized-salt as 76.65％ and the median content of urinary iodine in the population of Zhejiang was 161 μg/L.The average iodine content among pregnant women was 138 μg/L,with the percentage of samples less than 100 μg/L as 25.92％,more than 300 μg/L as 15.30％.The proportions of iodine intake through water,salt and other foods were 1.70％,76.41％ and 21.89％,respectively.Conclusion The status of iodine nutrition in Zhejiang province in general seemed to be appropriate,but the level of iodine nutrition in pregnant women was less than the requirement,which should call for attention.
ABSTRACT
<p><b>OBJECTIVE</b>To assess the level of dietary iodine intake and its contribution in Zhejiang.</p><p><b>METHODS</b>A total of 9798 subjects were recruited in this survey with multi-stage stratified cluster random sampling method in April, 2010, the 24-hours dietary recall method and the "food composition table" were used to obtain the dietary iodine intake, and edible salt and drinking water samples were collected to detect the content of iodine.</p><p><b>RESULTS</b>A total of 9798 subjects were included in this survey. The mean intake of dietary iodine in Zhejiang residents per standard man-days was (395.13 ± 78.16) µg/d, which in between of Recommended Nutrient Intake (RNI) 150 µg/d and Tolerable Upper Intake Level (UL) 1000 µg/d; the iodine intake of 18.40% (1803/9798) subjects was lower than estimated average requirement of iodine (EAR), 4.68% (459/9798) subjects was higher than the UL. The means of dietary iodine intake in various areas were (498.85 ± 96.77) µg/d, (384.50 ± 88.76) µg/d and (326.33 ± 78.32)µg/d in inland areas, sub-coastal areas and coastal areas, successively (F = 27.17, P < 0.05); the proportions of dietary iodine intake lower than EAR were 34.89% (1239/3551), 10.48% (370/3530) and 7.14% (197/2717) in coastal areas, sub-coastal area and inland areas, successively (χ(2) = 62.87, P < 0.01) , while those higher than UL were 5.10% (180/3530), 4.86% (132/2717) and 4.14% (147/3551) in sub-coastal area, inland areas and coastal areas.In the condition of ignoring cooking loss, the mean contribution of dietary iodine intake in edible salt, all kinds of food and drinking water were 74.92% (296.03/395.13), 23.85% (94.24/395.13) and 1.23% (4.86/395.13), successively; the contributions of edible salt in inland areas, sub-coastal areas and coastal areas were 83.72% (417.64/498.85), 73.05% (280.88/384.50) and 66.83% (280.09/326.33), successively; the contributions of drinking water in sub-coastal areas, coastal areas and inland areas were 1.61% (6.19/384.50) , 1.44% (4.70/326.33) and 0.65% (3.24/498.85) , successively (χ(2) = 7.24, P = 0.032) ; the contribution of laver in coastal areas, sub-coastal areas and inland areas were 22.57% (73.65/326.33), 17.11% (65.79/384.50) and 8.09% (40.36/498.85), successively (χ(2) = 82.17, P < 0.01) ; the contribution of sea fish in coastal areas, sub-coastal areas and inland areas were 2.38% (7.77/326.33), 0.72% (2.77/384.50) and 0.68% (3.39/498.85) (χ(2) = 19.47, P = 0.012).</p><p><b>CONCLUSIONS</b>The dietary iodine intake of Zhejiang residents was at recommended intake levels; the iodized salt turns out to be the main source, the iodine nutrition level was relatively low in coastal areas of Zhejiang, which the coverage of iodized salt should be improved.</p>
Subject(s)
Female , Humans , Male , China , Diet Surveys , Drinking Water , Iodine , Nutritional Status , Rural Population , Sodium Chloride, Dietary , Urban PopulationABSTRACT
<p><b>OBJECTIVE</b>To evaluate the iodine nutrition level of population in Zhejiang province and to analyze the relevant influencing factors from 2009 to 2011.</p><p><b>METHODS</b>From October 2009 to October 2011, a total of 19 517 subjects were recruited in this cross sectional survey, by multistage stratified cluster random sampling method. The subjects were all living over three years in Zhejiang province. The basic information and life styles were interviewed by questionnaires; and the samples of drinking water, edible salt and urines were separately collected from the subjects to test the content of iodine. In total, 16 228 subjects answered the questionnaire, and 265 samples of drinking water, 7811 samples of edible salt and 19 517 samples of urine were collected. Then, we analyzed the distribution of iodine in water, edible salt and urine samples, as well as the relevance.</p><p><b>RESULTS</b>The median (25% - 75% percentile) of water iodine was 2.42 (1.17 - 6.28) µg/L in drinking water among Zhejiang residents; while separately 2.79 (1.60 - 6.87) µg/L in city and 2.04 (1.03 - 5.29) µg/L in country side (Z = 2.07, P < 0.05). The figures turned out to be 2.17 (1.22 - 5.73) µg/L, 2.77 (1.88 - 6.87) µg/L, and 1.40 (0.77 - 5.65) µg/L, respectively, in coastal areas, coastal periphery areas and inland areas (χ(2) = 11.16, P < 0.05). The median (25% - 75% percentile) of salt iodine was 28.80 (22.93 - 32.40) mg/kg; while separately 29.00 (24.50 - 32.60) mg/kg and 28.50 (13.90 - 32.29) mg/kg in city and country side (Z = 6.32, P < 0.05). The figures turned out to be 25.19 (0.00 - 30.20) mg/kg, 29.00 (26.60 - 31.70) mg/kg and 32.40 (28.94 - 36.30) mg/kg, respectively, in coastal areas, coastal periphery areas and inland areas (χ(2) = 1581.62, P < 0.05). The coverage rate of iodized salt was 79.54% (6213/7811) in all province. The urinary iodine median was 160.74(97.20 - 247.00) µg/L, while the urinary iodine median in pregnant women was 137.99 (82.40 - 215.30) µg/L, lower than the recommended optimal levels, which was 150 - 249 µg/L. The figures turned out to be 153.45(92.00 - 237.50) µg/L in city and 168.00 (102.18 - 257.00) µg/L in country side (Z = -9.25, P < 0.05); while in coastal, coastal periphery place and inland areas, the median were separately 156.00 (94.29 - 242.80) µg/L, 150.14 (94.70 - 227.00) µg/L and 187.70 (109.00 - 276.80) µg/L (χ(2) = 194.12, P < 0.05). The analysis of relevance between urine iodine, water iodine and iodized salt showed that the urine iodine would increase as long as the iodized salt increased; and the difference had statistical significance (χ(2) = 440.88, P < 0.01). And there were no relevance between urine iodine level and the water iodine level (χ(2)cmh = 0.57, P = 0.45). The analysis of the influencing factors showed that education background (χ(2) = 14.17, P < 0.05), different styles of career (χ(2) = 16.15, P < 0.01) and diet habits (χ(2) = 108.63, P < 0.01) could influence the level of urine iodine.</p><p><b>CONCLUSION</b>Iodine was deficient in Zhejiang province. The nutrition level of iodine was fine in Zhejiang in 2009, however, the coverage rate of iodine was commonly low in coastal areas, especially the pregnant women suffered from iodine deficiency. In our study, the factors influencing the urine iodine level included iodized salt, age, education background and diet habits.</p>
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Pregnancy , Young Adult , China , Epidemiology , Cross-Sectional Studies , Drinking Water , Goiter, Endemic , Epidemiology , Iodine , Urine , Sodium Chloride, Dietary , UrineABSTRACT
<p><b>OBJECTIVE</b>To evaluate the status of diffuse goiter of population in Zhejiang Province and to analyze the relevant influencing factors.</p><p><b>METHODS</b>A total of 18 188 subjects were recruited in the cross sectional survey, by multistage stratified cluster random sampling method. B ultrasound measurement were carried among the subjects to detect the thyroid volume, and the basic information and life styles were interviewed by questionnaires. Then, we analyzed the distribution and its influencing factors of diffuse goiter.</p><p><b>RESULTS</b>The ratio of diffuse goiter among the surveyed population was 2.2% (403/18 188), the difference showed statistical significance (χ(2) = 267.11, P < 0.05). The ratio among the group aged 6-7 years old and 8-10 years old was comparatively high, separately 10.3% (27/262) and 9.8% (51/519). The ratio among women (2.9%, 305/10 470) was higher than it among men (1.3%, 97/7672) (χ(2) = 55.55, P < 0.05). The residents from inland areas had the highest prevalence (3.2%, 138/4374), followed by residents from sub-coastal areas (2.0%, 131/6411), coastal areas minimum (1.8%, 138/4374) (χ(2) = 24.31, P < 0.05). The content of water iodine and salt iodine among people with symptoms of goiter had statistical difference with it among ordinary population (water iodine:χ(2) = 4.95, P = 0.026; salt iodine: χ(2) = 11.03, P < 0.01). The median(quartile) of water iodine in ordinary population was 2.41 (1.96-6.15) µg/L and among people with symptoms of goiter was 1.88 (1.49-5.15) µg/L. The median(quartile) of salt iodine in ordinary population was 30.18 (24.69-32.65) mg/kg and among people with symptoms of goiter was 29.1 (24.70-31.95) mg/kg. The influential factors of goiter were as follows: the family income, the education degree, the job and profession status, the diet character, the habitual sea food consumption, the alcohol intake status (χ(2) were separately 8.08, 37.85, 98.78, 68.69, 10.91, 12.21, 26.94, P < 0.05). Multi-factor analysis showed the results as follows: female (OR = 0.27 95%CI:0.18-0.39), school students (OR = 8.05, 95%CI:3.87-16.73), vegetarian (OR = 1.60, 95%CI:1.15-2.22) took a higher risk of getting pathogenic goiter; while the group of those who had university degree or above (OR = 0.84, 95%CI: 0.73-0.97), ate sea food frequently (OR = 0.62, 95%CI:0.44-0.88) took a lower risk.</p><p><b>CONCLUSIONS</b>The ratio of diffuse goiter in the group aged among 6-7 years old and 8-10 years old was comparatively high. The ratio was influenced by many factors.</p>
Subject(s)
Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Young Adult , China , Epidemiology , Cross-Sectional Studies , Feeding Behavior , Goiter , Epidemiology , Prevalence , Surveys and QuestionnairesABSTRACT
Objective To evaluate the dietary iodine intake level of population in coastal and inland areas of Zhejiang province.Methods The cluster sampling method was applied to select Zhoushan,Ningbo and Taizhou cities from Zhejiang province as coastal areas,to select Jinhua,Quzhou and Lishui cities from Zhejiang province as inland areas,and two counties(districts) were randomly selected in each chosen city,three sub-districts(towns) were randomly selected in each chosen counties (districts),then one community (village) was randomly selected in each chosen sub-districts(towns).Adult residents aged greater than 18 were selected as investigation subjects,their dietary iodine intake in the past 24 hours was investigated,and the Food composition table” was inquired to get the data of dietary iodine intake.One hundred copies of residential edible salt samples and drinking water samples in each of the selected community (village) were collected to detect salt iodine and water iodine by direct titrimetric and spectrophotometric method,respectively.Results The mean of adult residents' dietary iodine intake in Zhejiang coastal area was 267.76 μg/d,which was less than that in inland area (429.05 μg/d,t =- 6.90,P ＜0.05),and the means of adult residents' dietary iodine intake from drinking water,laver and fish(5.75,69.72,5.61 μg/d,respectively) in coastal area were higher than those in inland areas(3.25,35.27,3.43 μg/d,respectively,t =21.73,3.92,4.08,all P ＜ 0.05),however,the means of adult residents' dietary iodine intake from salt,kelp and other food (166.81,3.04,16.82 μg/d,respectively) in coastal areas were less than those in inland areas (355.15,6.14,25.81 μg/d,respectively,t =- 8.76,- 5.49,- 18.56,all P ＜ 0.05).In coastal areas,the proportion which was less than estimated average requirement of iodine(EAR,120 μg/d) was 46.48％ (1029/2214),the ratio which was higher than the maximum tolerable intake of iodine(UL,1000 μg/d) was 3.34％ (74/2214),and the average contribution rate of dietary intake of iodine in salt was 62.30％(166.81/267.76).While in inland areas,the corresponding proportions were 7.61％ (171/2246),2.80％ (63/2246) and 82.78％ (355.15/429.05),respectively.Conclusions The dietary iodine intake in Zhejiang inland areas has reached the recommended nutrient intake levels of the Chinese Nutrition Society,but there is a certain degree of insufficient iodine intake in population of the coastal areas.
ABSTRACT
Objective To evaluate the nutritional status of iodine of pregnant and lactating women in coastal and inland areas of Zhejiang province,and to provide scientific basis for iodine supplementation.Methods In 2009,five coastal cities,five coastal counties and three inland areas from Zhejiang province were selected by the cluster sampling method,and one sub-district(township) was randomly selected in each city (county),then one community (village) was randomly selected in each sub-district (township).Thirty pregnant women,thirty lactating women and fifty children aged 8 - 10,were randomly selected in each community(village) as the investigation objects to collect instant urine samples to detect urine iodine,and to collect thirty resident edible salt and some water samples to detect salt iodine and water iodine,if the numbers of water source were more than 5 then 1 water sample was collected by their location of east,south,west,north and center in each community(village),otherwise,the numbers of water samples collected were equal to the number of community (village).Results The medians of salt iodine of coastal city,coastal county and inland area were 28.42,25.29,and 33.24 mg/kg,respectively,and the medians of water iodine correspondingly were 5.41,11.52,and 2.80 μg/L,respectively.The medians of urinary iodine of pregnant and lactating women in Zhejiang province were 148.72 and 161.34 μg/L,respectively,which were less than that of children aged 8 - 10(231.02 μg/L,Z =8.57,8.24,all P ＜ 0.017).The medians of urinary iodine in pregnant women from different areas were ranked in order as inland areas(211.42 μg/L),coastal counties (150.51 μg/L) and coastal cities (123.33 μg/L,Z =2.80,5.31,2.42,all P ＜ 0.017),and in lactating women,the medians of urinary iodine in inland areas( 197.43 μg/L) was higher than that in coastal cities( 139.64 μg/L,Z =4.03,P ＜ 0.017).Conclusions The overall levels of iodine nutrition in lactating and pregnant women in Zhejiang province are in the appropriate level,but that of the pregnant women in the coastal cities is inadequate.