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Spatial–Temporal Analysis of Factors Influencing the Median Urine Iodine Concentration of 8–10-year-old Children in Xinjiang, China 25 Years after Implementation of the Salt Iodization Policy

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Abstract

The iodine status of children has improved and stabilized since China implemented salt iodization measures 25 years ago, but routine monitoring of iodine cannot reflect regional factors that influence the iodine level in children. Therefore, we conducted a regional spatial–temporal analysis of children’s median urinary iodine concentration (MUIC) and searched for possible factors that might affect children’s iodine levels by mining monitoring data. We analyzed data from Xinjiang collected as part of the “Iodine Deficiency Disease National Monitoring Program” from 2017 to 2020. The study population consisted of 76,268 children who participated in the study. We used global autocorrelation analysis to determine whether the MUIC of children was spatially clustered, local autocorrelation analysis to identify specific clustering areas, local cold and hot spot analysis to verify the reliability of the local autocorrelation results, and a spatial lag model to identify factors affecting the children’s MUIC. The MUIC values were 217.70, 227.00, 230.67, and 230.67 µg/L in 2017, 2018, 2019, and 2020, respectively. Global autocorrelation analysis showed that the MUIC of all children in the study was significantly related to region (Z scores all > 1.96, P values all < 0.05) from 2017 to 2020. Partial auto-correlation analysis showed that counties with clusters of high values were mostly concentrated in the southwestern region of Xinjiang, whereas counties with clusters of low values were located in the northern part of Xinjiang. Partial cold spot and hot spot analysis showed the same trend, and there are more overlapping districts and counties in 4 years. Three-dimensional trend analysis indicated that children from the western part of Xinjiang had high levels of urinary iodine. According to spatial lag model, urine iodine concentration level is positively correlated with thyroid volume, average salary, and urbanization rate classification. The MUIC of 8–10-year-old children in Xinjiang was spatially clustered and related to geographic region. Our results show that spatial analysis of survey data combined with geographic technology and public health data can accurately identify areas with abnormal iodine concentrations in children. Additionally, understanding the factors that influence iodine levels in the human population is conducive to improving monitoring methods.

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Acknowledgements

We thank all of the children who participated in this study and the physicians involved in data collection and testing of the urine samples. We also thank the Department of Endemic Diseases, Center for Disease Control and Prevention of Xinjiang Autonomous Region, and the Department of Endemic Diseases, College of Medical Engineering and Technology at Xinjiang Medical University for their help with analysis and forecast data.

Funding

This work was supported by the State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia Fund (SKL-HIDCA-2020–9), and the National Natural Science Foundation of China (Grant Nos. 72163033, 72064036, 72174175).

Author information

Author notes

  1. Chenchen Wang, Yuhua Ma, and Yuxia Zhang contributed equally to this work.

Authors and Affiliations

  1. Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi, 830002, People’s Republic of China

    Chenchen Wang

  2. Department of Oncology, East Hospital Affiliated to Tongji University, Shanghai, 200092, People’s Republic of China

    Yuhua Ma

  3. Department of Pathology, Karamay Central Hospital, Karamay, 834099, People’s Republic of China

    Yuhua Ma

  4. Division of Clinical Nutrition, Maternal and Child Health Hospital of Urumqi, Urumqi, 830011, People’s Republic of China

    Yuxia Zhang

  5. National Institute of Environmental Health, China CDC, 100021, Beijing, People’s Republic of China

    Wei Zhang

  6. State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Xinjiang Medical University, Urumqi, 830011, People’s Republic of China

    Liping Zhang

  7. College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, 830011, People’s Republic of China

    Liping Zhang

Authors
  1. Chenchen Wang
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  2. Yuhua Ma
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  4. Wei Zhang
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Contributions

Chenchen Wang and Liping Zhang made substantial contributions to the study concept and design; Chenchen Wang was responsible for data collection and collation; Yuxia Zhang and Yuhua Ma conducted data analysis and visual processing; Yuhua Ma and Wei Zhang sorted the research results; Chenchen Wang and Liping Zhang wrote the manuscript; and Chenchen Wang and Liping Zhang critically revised the manuscript for important intellectual content. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Liping Zhang.

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Ethics approval and consent to participate

The study was approved by the Medical Science Research Ethics Committee of Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, and was in accordance with the Declaration of Helsinki. All participants provided written informed consent for inclusion in the study and could withdraw from the study at any time.

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The authors declare no competing interests.

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Wang, C., Ma, Y., Zhang, Y. et al. Spatial–Temporal Analysis of Factors Influencing the Median Urine Iodine Concentration of 8–10-year-old Children in Xinjiang, China 25 Years after Implementation of the Salt Iodization Policy. Biol Trace Elem Res 201, 1648–1658 (2023). https://doi.org/10.1007/s12011-022-03307-2

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  • DOI: https://doi.org/10.1007/s12011-022-03307-2

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