碘營養的過去，現在，與未來

Iodine Nutrition in the Past, Present, and Future

10.6200/TCMJ.2015.12.2.03

王繁棻

碘 ； 甲狀腺 ； 碘缺乏 ； 加碘鹽 ； iodine ； thyroid gland ； iodine deficiency ； iodized salt

北市醫學雜誌

12卷2期（2015 / 06 / 30）

14 - 21

繁體中文

碘是製造甲狀腺素的必要元素，碘不足在人生的每個階段都會造成影響。1993年世界衛生組織（WHO）建議食鹽加碘為消除碘營養缺乏疾病之主要政策。台灣過去許多地區有相當高之甲狀腺腫盛行率，自1967年起實施全面食鹽加碘，1971年甲狀腺腫盛行率降至4.3%為碘營養充足範圍。而以尿液碘濃度評估碘營養則是近年才發展；由2001－2002國民營養調查抽樣檢體之尿碘檢測，6－12歲學童尿碘中位數為123微克／升，35.2%尿碘濃度小於100微克／升，屬WHO定義之碘營養充足；但在2004－2008年，19歲以上成人全體尿碘中位數為正常值下限之100微克／升，尿碘濃度小於100微克／升為50.1%。2003年正是台灣由全面加碘鹽轉變為非強制性食鹽加碘之年份，是否食鹽加碘政策、現代飲食習慣的改變對民眾碘營養造成影響值得密切注意。雖然對大部分民眾適當的碘攝取是重要的課題，仍需提醒若本身為甲狀腺疾病患者，應避免大量攝取含碘食物，以免引發甲狀腺功能惡化。

Iodine is a trace element required for the thyroid hormone synthesis and is essential in the development of every stages of human life. In 1993, the World Health Organization (WHO) recommended salt iodization as the central strategy to eliminate iodine deficiency disorder. Taiwan was an area of endemic goiter in the past. Mandatory salt iodization in Taiwan started in 1967, and a survey in 1971 revealed that the goiter rate had reduced from 21.6% to 4.3%. The technique of urinary iodine (UI) measurement was developed in recent years. Urinary iodine measurement from samples collected in the Nutrition and Health Survey in Taiwan (NAHSIT) 2001-2002 showed that the median UI concentration among 6-12 year old schoolchildren was 123 μg/L, and the percentage of the population with UI levels below 100 μg/L was 35.2%, indicated that the iodine status was adequate according to the WHO criteria. However, in 2004-2008, the median UI concentration was 100 μg/L among adults older than 19 years old, which was the lowest limit of normal range, and the percentage of the population with UI levels below 100 μg/L was 50.1%. The national salt iodization program had been changed from mandatary to voluntary in 2003. The change of salt iodization policy and subsequent dietary habits might have altered the iodine status in the Taiwanese population. Close monitoring of iodine status is important. Adequate iodine intake is important for a healthy life. Ingestion of large amount of iodine containing food is not recommended in individuals with thyroid diseases to avoid iodine induced thyroid dysfunction.