Longitudinal Trends in Iodine Nutritional Status and Thyroid Morphology Among School-Age Children in Shenzhen,China(2021–2025)

Longitudinal Trends in Iodine Nutritional Status and Thyroid Morphology Among School-Age Children in Shenzhen,China(2021–2025) | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Longitudinal Trends in Iodine Nutritional Status and Thyroid Morphology Among School-Age Children in Shenzhen,China(2021–2025) Yuchen Xie, Xiaoheng Li, Xianru Luo, Qingshan Luo, Yan Zhou, Zhou Wang This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8578956/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 9 You are reading this latest preprint version Abstract Universal Salt Iodization(USI)has effectively eliminated iodine deficiency disorders(IDD)in China.However,the iodine landscape is shifting due to rapid urbanization,changing dietary habits,and salt reduction efforts.This study examined longitudinal trends in iodine status and thyroid morphology among 9,000 school-age children in Shenzhen from 2021 to 2025 to understand these dynamics in a post-elimination setting.Using a five-year repeated cross-sectional design,we assessed urinary iodine concentration(UIC),salt iodine content(SIC),and thyroid ultrasound( n = 3,400).The overall median UIC was 216.2µg/L,classifying as adequate.Despite general sufficiency,a clear downward trend appeared:median levels fell from 246.6µg/L in 2021 to 188.0µg/L in 2025( p < 0.001),even though household salt iodine remained stable and compliance was high(92.7%).Girls had lower urinary iodine than boys(209.6 vs.224.0µg/L)yet faced a significantly higher risk of thyroid enlargement(Adjusted OR = 1.95,95%CI:1.19–3.31).These findings suggest that relying solely on household salt monitoring may no longer fully capture total iodine intake,likely due to the increasing influence of non-household dietary sources such as processed foods and dining out. Health sciences/Diseases Health sciences/Endocrinology Health sciences/Health care Health sciences/Medical research Introduction Iodine serves as the fundamental substrate for thyroid hormone biosynthesis,governing somatic growth,neurological maturation,and metabolic regulation.Insufficient intake leads to a spectrum of disorders ranging from goiter to permanent cognitive impairment,while excessive consumption poses parallel risks for autoimmune thyroid pathologies.Achieving optimal population status requires precise equilibration.China effectively dismantled its historical burden of iodine deficiency following the 1995 enforcement of Universal Salt Iodization(USI).National surveillance over two decades confirms that the general population has sustained adequate iodine nutrition. Current urbanization trends and dietary shifts now challenge this stability.Residents increasingly rely on dining out and processed foods.The unregulated use of non-iodized salt in the food industry creates a potential gap in supplementation coverage.Evidence from Chongqing and Zhejiang indicates these lifestyle factors are already altering population iodine levels.Shenzhen occupies a distinct epidemiological niche:despite being coastal,the region suffers from water-borne iodine deficiency,and seafood consumption remains too low to serve as a primary source.School-age children possess heightened sensitivity to such environmental fluxes.Local research has yet to capture longitudinal post-elimination trends amidst these dietary transitions.This five-year analysis assesses urinary iodine,salt iodine,and thyroid morphology in Shenzhen children to characterize emerging risks. Results Participant Characteristics The study enrolled 9,000 students,split evenly between 4,519 boys(50.2%)and 4,481 girls(49.8%, p = 0.541).Most participants were 8 to 10 years old,with a small number of 11-year-olds( n = 64).Han ethnicity dominated the sample at 99.6%.A representative subset of 3,400 children received thyroid ultrasound scans.This subgroup matched the main cohort in both gender balance and age structure( p > 0.05).(See Table). Table 1 Characteristics of participants. Variables Total Boys Girls p -Value ( N = 9000) ( N = 4519) ( N = 4481) n (%) n (%) n (%) Age 0.518 8 2776(30.8%) 1401(50.5%) 1375(49.5%) 9 3214(35.7%) 1623(50.5%) 1591(49.5%) 10 2946(32.7%) 1458(49.5%) 1488(50.5%) 11 64(0.7%) 37(57.8%) 27(42.2%) Ethnicity 0.616 Han 8960(99.6%) 4501(50.2%) 4459(49.8%) Minority 40(0.4%) 18(45.0%) 22(55.0%) Annual Trends in Iodine Status Significant annual variations were observed in both median UIC( H = 241.336, p < 0.001)and median SIC( H = 180.949, p < 0.001).Notably,a distinct downward trend was observed for UIC,with the median value declining from 246.6µg/L in 2021 to 188.0µg/L in 2025.In contrast,the median SIC remained relatively stable,fluctuating slightly around 24.0 mg/kg(Table). Spearman rank correlation analysis indicated a weak but statistically significant positive correlation between SIC and UIC( rho = 0.096, p < 0.001). Table 2 Annual trends in UIC and SIC among school-age children in Shenzhen(2021–2025). Year N Median UIC (µg/L) p Median SIC (mg/kg) p Total 9000 216.2(138.6–318.0) < 0.001 24.0(22.3–22.7) < 0.001 2021 1800 246.6(161.8–361.3) 24.7(22.8–26.6) 2022 1800 235.9(150.0–341.9) 24.2(22.7–25.7) 2023 1800 223.0(142.7–328.1) 24.0(22.4–25.4) 2024 1800 196.7(123.0–294.0) 23.5(21.6–25.2) 2025 1800 188.0(125.7–267.6) 24.0(22.2–25.5) Salt Iodine Concentration(SIC) The median SIC for the entire cohort stood at 24.0 mg/kg.Compliance with the national standard was high;92.7%( n = 8,339)of households consumed qualified iodized salt.No significant disparities were found based on gender or ethnicity( p > 0.05).However,a marginal variation was observed across age groups( p = 0.0179),although the rate of qualified salt use remained uniform(Table). Urinary Iodine Concentration(UIC) The median UIC was 216.2µg/L.A significant gender disparity was evident,with boys exhibiting higher median levels(224.0µg/L)compared to girls(209.6µg/L, p < 0.01).Based on updated UNICEF guidelines,57.0%demonstrated adequate status.This gender-specific pattern persisted in the ultrasound subgroup(Table). Table 3 Salt Iodine Concentration(SIC)and coverage of iodine-qualified salt. Variables SIC(mg/kg) [M(IQR)] p -Value Qualified Salt n (%) p -Value Total 24.0(22.3–25.7) 8339(92.7%) Gender 0.747 0.961 Boy 24.0(22.3–25.7) 4186(92.6%) Girl 24.0(22.3–25.7) 4153(92.7%) Age 0.018 0.607 8 24.0(22.2–25.6) 2562(92.3%) 9 24.0(22.4–25.8) 2976(92.6%) 10 24.1(22.3–25.8) 2743(93.1%) 11 23.5(21.6–25.0) 58(90.6%) Table 4 Urinary Iodine Concentration(UIC) in Total Population and Ultrasound Group. Variables Total Population( N = 9000) Ultrasound Group( N = 3400) N UIC(µg/L) p N UIC(µg/L) p Total 9000 216.2(138.6–318) 3400 221.8(136.4–329) Gender < 0.01 0.001 Boy 4519 224.0(146.0–327) 1705 230.5(141.0–337) Girl 4481 209.6(130.6–309) 1695 212.0(132.4–320) Thyroid Morphology and Goiter Prevalence Among the 3,400 children assessed,median thyroid volumes tracked biologically with age( p < 0.001).We identified 67 cases of goiter(1.97%).A clear gender divergence emerged:girls exhibited a significantly higher goiter rate(2.60%)compared to boys(1.35%, p = 0.013).Neither UIC( p = 0.212)nor household salt iodine category( p = 1.00)successfully predicted goiter prevalence(Table). Factors Associated with Goiter Binary logistic regression identified gender as the sole determinant:girls faced significantly elevated odds of developing goiter compared to boys(Adjusted OR = 1.95,95%CI:1.19–3.31, p = 0.01).Continuous measures of urinary and salt iodine failed to show statistical correlation with goiter prevalence(Table). Discussion This five-year surveillance provides a comprehensive assessment of iodine status and thyroid health in Shenzhen children aged 8–11.The overall median urinary iodine concentration(UIC)of 216.2µg/L places this population within the adequate category(100–299µg/L)based on the updated 2018 UNICEF guidelines.This recent standard widens the previous“adequate”upper Table 6 Association analysis of iodine in salt,urinary iodine,and goiter prevalence. Variables Model 1(Unadjusted) Model 2(Adjusted) OR 95%CI p OR 95%CI p UIC(µg/L) 1.00 1.00–1.00 0.805 1.00 1.00–1.00 0.932 SIC(mg/kg) 1.00 0.97–1.04 0.862 1.00 0.97–1.04 0.855 Girl(vs.Boy) 1.95 1.18–3.29 0.010 1.95 1.19–3.31 0.010 threshold of 199µg/L set by the 2007 WHO guidelines,reclassifying the 200–299µg/L range as optimal for school-age children due to the lack of observed adverse effects.These results confirm that the Universal Salt Iodization(USI)mandate effectively maintains iodine sufficiency in this water-iodine-deficient coastal city,matching national success rates seen in over 90%of Chinese counties,. A distinct downward trend in median UIC emerged,dropping significantly from 246.6µg/L in 2021 to 188.0µg/L in 2025( p < 0.001).This decline mirrors patterns in other major cities like Chongqing,where levels fell from 303µg/L in 1997 to 226.4µg/L in 2023.Since the median salt iodine concentration(SIC)remained stable at roughly 24.0 mg/kg,the drop in urinary iodine likely stems from shifting dietary patterns.China’s Dietary Guidelines have progressively lowered daily salt targets from 6 g in 2007 to under 5 g in 2022.Reducing household salt intake benefits cardiovascular health but inherently limits the primary source of iodine.At the same time,urbanization has increased the consumption of processed foods and dining out.Research by Wang et al.shows that many processed foods use non-iodized salt,.Combined,less home cooking and more industrial salt use appear to be driving a“silent”reduction in population iodine levels. Gender Differences Boys consistently excreted more iodine than girls(224.0 vs.209.6µg/L, p < 0.01).Although the effect size was modest(Cohen’s d = 0.078),this gap mirrors findings from inland Chongqing,coastal Zhejiang,and international cohorts in Norwayand Nigeria.Dietary habits,rather than metabolism,likely explain this difference;boys generally consume larger food volumes—and by extension,more iodized salt—than girls,. Thyroid Morphology :Thyroid scans revealed a stark contrast in health outcomes:girls faced nearly double the goiter risk of boys(Adjusted OR = 1.95).This female predominance is well-documented globally.While the biological drivers in prepuberty are not fully mapped,a 2025 review points to the interaction between sex hormones(especially estrogen),X-chromosome factors,and the immune system,which predisposes females to thyroid autoimmune processes.Recent clinical data on hormone reference intervals further confirm that boys and girls follow distinct physiological trajectories even before full puberty. Salt vs.Urine Disconnect Local salt regulation appears effective,with median SIC holding steady at 24.0 mg/kg and high compliance rates(92.7%).However,salt iodine levels showed only a negligible link to urinary iodine( rho = 0.096).This decoupling—stable salt but falling urinary iodine—strongly implicates non-household sources.Catering and processed foods,which frequently use non-iodized salt,appear to be displacing household salt as drivers of iodine status,,. Goiter Risk Factors At 1.97%,the overall goiter rate sits safely below the 5%public health warning line.This is comparable to Chongqing(2.24%)and far lower than the high-iodine regions of Hebei.Surprisingly,neither UIC nor SIC predicted thyroid enlargement in our models.This likely reflects the population’s general sufficiency;the classic“U-shaped”risk curve typically only emerges at extremes of deficiency or excess,.Similarly,previous studies in Chinese children indicate that age and gender are often more potent predictors of thyroid volume than mild variations in iodine intake.Moreover,goiter develops over months or years,whereas urine samples provide only a snapshot of recent intake,a limitation that often weakens statistical associations in cross-sectional designs.A holistic monitoring approach that integrates shifting dietary patterns with biological maturation will be essential to sustain optimal thyroid health in the post-elimination era. Materials and Methods Study Design and Participants This repeated cross-sectional survey covered all 10 administrative districts of Shenzhen from January 2021 to December 2025.Using multi-stage cluster sampling,we randomly selected three townships per district followed by one primary school per township.Stratified recruitment ensured a balanced distribution of gender and age(8–11 years),yielding an annual sample of approximately 180 students per school.The final five-year cohort included 9,000 children(4,519 boys and 4,481 girls).Eligible participants were non-boarding students residing in Shenzhen for at least six months without a history of thyroid disease,recent iodine supplement use,or metabolic conditions affecting iodine processing.A randomly selected subgroup of 3,400 children(approx.680 annually)underwent thyroid ultrasound assessments.The study protocol received approval from the Ethical Review Committee of the Shenzhen Nanshan Center for Disease Control and Prevention(NSCDC),and parents or guardians were provided written informed consent. Data and Sample Collection Trained staff collected demographic details including age,gender,ethnicity,and residence via structured questionnaires.Participants provided spot midstream urine samples(8–10 mL)between 08:30 and 12:00,which were immediately aliquoted into sterile polypropylene tubes and frozen at—20◦C for analysis within one week.Households provided 50–100 g of edible salt sealed in moisture-proof bags,stored at room temperature until testing. Thyroid Ultrasound Examination Licensed radiologists performed thyroid scans using a Mindray DC-80 system with a 7.5–12 MHz linear transducer.Measure-ments included the length(L),width(W),and depth(D)of both thyroid lobes in longitudinal and transverse planes for every subject. Laboratory Measurements We quantified urinary iodine concentration(UIC)using the arsenic-cerium catalytic spectrophotometric method(WS/T 107.1–2016)on a MAPADA UV-1800 instrument.The limit of detection(LOD)was 5µg/L,with lower values assigned as LOD/√2(3.54µg/L).Salt iodine concentration(SIC)was determined by dissolving 10 g of salt for direct titration with sodium thiosulfate using a starch indicator,following the GB/T 13025.7–2012 method. Diagnostic Criteria Iodine status was classified according to the updated 2018 UNICEF guidance,which widens the adequate intake range for school-age children to 100–299µg/L.Under this framework,we defined UIC values of 100–299µg/L as adequate,<100µg/L as insufficient,and ≥ 300µg/L as excessive,.Salt quality was graded against Chinese standard GB 26878-2011as qualified(15–30 mg/kg),non-iodized( 30 mg/kg).Goiter diagnosis adhered to WS 276–2007 criteriabased on age-specific thyroid volume(Tvol)thresholds:>4.5 mL(8 years),>5.0 mL(9 years),>6.0 mL(10 years),and > 6.5 mL(11 years).Tvol was derived using the ellipsoid equation: Statistical Analysis R software(version 4.1.0)handled all statistical computations.Normality checks used the Kolmogorov–Smirnov test,with non-normal data expressed as medians and interquartile ranges(IQR).Group comparisons employed Mann–Whitney U or Kruskal–Wallis H tests for continuous variables and Chi-square tests for categorical data.Temporal trends in UIC from 2021 to 2025 were analyzed using Spearman’s rank correlation analysis.Binary logistic regression identified goiter risk factors,with significance set at a two-tailed p < 0.05. Abbreviations UIC Urinary Iodine Concentration SIC Salt Iodine Concentration USI Universal Salt Iodization IDD Iodine Deficiency Disorders Tvol Thyroid Volume Declarations Acknowledgments We express our gratitude to all students,parents,and teachers of the participating primary schools in Shenzhen for their cooperation and support during the data collection process.The publication of this paper was supported by Sanming Project of Medicine in Shenzhen(SZSM202311001)and Center for Disease Control and Prevention.During the preparation of this manuscript,the authors used deepseek(AI)for the purposes of English language editing and formatting assistance.The authors have reviewed and edited the content and take full responsibility for the content of this publication. Author contributions statem ent Conceptualization,Y.X.,X.Li.,and Z.W.;methodology,Y.X.;software,Y.X.;investigation,X.L.;data curation,Y.Z.;writing original draft preparation,Y.X.;writing review and editing,Z.W.;supervision,X.Li.;project administration,X.Li.and Q.L.All authors have read and agreed to the published version of the manuscrip Competing interests The authors declare no competing interests. Ethics approval and consent to participate The study was conducted in accordance with the Declaration of Helsinki,and approved by the Ethics Committee of the Shenzhen Nanshan District Center for Disease Control and Prevention(Protocol code SZNSCDC-LLBG-08-01). Informed consent Informed consent was obtained from all subjects involved in the study.Written informed consent has been obtained from the participants’ parents or guardians. Data availability The data presented in this study are available on request from the corresponding author. 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18:06:30","extension":"xml","order_by":5,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":73619,"visible":true,"origin":"","legend":"","description":"","filename":"78eee0e0f8f04573868ca1d2df45b06c1structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-8578956/v1/cecc9a3f2c6a83fddff53488.xml"},{"id":100821963,"identity":"3d48a15a-955c-4440-9a35-f032655f57fd","added_by":"auto","created_at":"2026-01-21 18:06:30","extension":"html","order_by":6,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":91681,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-8578956/v1/e3a28418f0fc6c9203906777.html"},{"id":100859952,"identity":"2bc9c2ce-2c5d-4e8f-9ffc-b29a388a342b","added_by":"auto","created_at":"2026-01-22 07:34:47","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":875418,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8578956/v1/03222113-85a7-4287-a64c-c452c5509f3c.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Longitudinal Trends in Iodine Nutritional Status and Thyroid Morphology Among School-Age Children in Shenzhen,China(2021–2025)","fulltext":[{"header":"Introduction","content":"\u003cp\u003eIodine serves as the fundamental substrate for thyroid hormone biosynthesis,governing somatic growth,neurological maturation,and metabolic regulation.Insufficient intake leads to a spectrum of disorders ranging from goiter to permanent cognitive impairment,while excessive consumption poses parallel risks for autoimmune thyroid pathologies.Achieving optimal population status requires precise equilibration.China effectively dismantled its historical burden of iodine deficiency following the 1995 enforcement of Universal Salt Iodization(USI).National surveillance over two decades confirms that the general population has sustained adequate iodine nutrition.\u003c/p\u003e \u003cp\u003eCurrent urbanization trends and dietary shifts now challenge this stability.Residents increasingly rely on dining out and processed foods.The unregulated use of non-iodized salt in the food industry creates a potential gap in supplementation coverage.Evidence from Chongqing and Zhejiang indicates these lifestyle factors are already altering population iodine levels.Shenzhen occupies a distinct epidemiological niche:despite being coastal,the region suffers from water-borne iodine deficiency,and seafood consumption remains too low to serve as a primary source.School-age children possess heightened sensitivity to such environmental fluxes.Local research has yet to capture longitudinal post-elimination trends amidst these dietary transitions.This five-year analysis assesses urinary iodine,salt iodine,and thyroid morphology in Shenzhen children to characterize emerging risks.\u003c/p\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eParticipant Characteristics\u003c/h2\u003e \u003cp\u003eThe study enrolled 9,000 students,split evenly between 4,519 boys(50.2%)and 4,481 girls(49.8%,\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.541).Most participants were 8 to 10 years old,with a small number of 11-year-olds(\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;64).Han ethnicity dominated the sample at 99.6%.A representative subset of 3,400 children received thyroid ultrasound scans.This subgroup matched the main cohort in both gender balance and age structure(\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05).(See Table).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCharacteristics of participants.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eBoys\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eGirls\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e-Value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e(\u003cem\u003eN\u003c/em\u003e\u0026thinsp;=\u0026thinsp;9000)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(\u003cem\u003eN\u003c/em\u003e\u0026thinsp;=\u0026thinsp;4519)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e(\u003cem\u003eN\u003c/em\u003e\u0026thinsp;=\u0026thinsp;4481)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003en\u003c/em\u003e(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003en\u003c/em\u003e(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003en\u003c/em\u003e(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.518\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2776(30.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1401(50.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1375(49.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3214(35.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1623(50.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1591(49.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2946(32.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1458(49.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1488(50.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e64(0.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e37(57.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e27(42.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEthnicity\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.616\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHan\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8960(99.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4501(50.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4459(49.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMinority\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e40(0.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18(45.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e22(55.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eAnnual Trends in Iodine Status\u003c/h3\u003e\n\u003cp\u003eSignificant annual variations were observed in both median UIC(\u003cem\u003eH\u003c/em\u003e\u0026thinsp;=\u0026thinsp;241.336,\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001)and median SIC(\u003cem\u003eH\u003c/em\u003e\u0026thinsp;=\u0026thinsp;180.949,\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001).Notably,a distinct downward trend was observed for UIC,with the median value declining from 246.6\u0026micro;g/L in 2021 to 188.0\u0026micro;g/L in 2025.In contrast,the median SIC remained relatively stable,fluctuating slightly around 24.0 mg/kg(Table). Spearman rank correlation analysis indicated a weak but statistically significant positive correlation between SIC and UIC(\u003cem\u003erho\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.096,\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAnnual trends in UIC and SIC among school-age children in Shenzhen(2021\u0026ndash;2025).\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYear\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMedian UIC\u003c/p\u003e \u003cp\u003e(\u0026micro;g/L)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMedian SIC\u003c/p\u003e \u003cp\u003e(mg/kg)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e9000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e216.2(138.6\u0026ndash;318.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e24.0(22.3\u0026ndash;22.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2021\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1800\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e246.6(161.8\u0026ndash;361.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e24.7(22.8\u0026ndash;26.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2022\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1800\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e235.9(150.0\u0026ndash;341.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e24.2(22.7\u0026ndash;25.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2023\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1800\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e223.0(142.7\u0026ndash;328.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e24.0(22.4\u0026ndash;25.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2024\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1800\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e196.7(123.0\u0026ndash;294.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e23.5(21.6\u0026ndash;25.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2025\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1800\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e188.0(125.7\u0026ndash;267.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e24.0(22.2\u0026ndash;25.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\n\u003ch3\u003eSalt Iodine Concentration(SIC)\u003c/h3\u003e\n\u003cp\u003eThe median SIC for the entire cohort stood at 24.0 mg/kg.Compliance with the national standard was high;92.7%(\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;8,339)of households consumed qualified iodized salt.No significant disparities were found based on gender or ethnicity(\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05).However,a marginal variation was observed across age groups(\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.0179),although the rate of qualified salt use remained uniform(Table).\u003c/p\u003e\n\u003ch3\u003eUrinary Iodine Concentration(UIC)\u003c/h3\u003e\n\u003cp\u003eThe median UIC was 216.2\u0026micro;g/L.A significant gender disparity was evident,with boys exhibiting higher median levels(224.0\u0026micro;g/L)compared to girls(209.6\u0026micro;g/L,\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01).Based on updated UNICEF guidelines,57.0%demonstrated adequate status.This gender-specific pattern persisted in the ultrasound subgroup(Table).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSalt Iodine Concentration(SIC)and coverage of iodine-qualified salt.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSIC(mg/kg)\u003c/p\u003e \u003cp\u003e[M(IQR)]\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e-Value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eQualified Salt\u003c/p\u003e \u003cp\u003e\u003cem\u003en\u003c/em\u003e(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e-Value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e24.0(22.3\u0026ndash;25.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8339(92.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.747\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.961\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBoy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e24.0(22.3\u0026ndash;25.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4186(92.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGirl\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e24.0(22.3\u0026ndash;25.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4153(92.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.607\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e24.0(22.2\u0026ndash;25.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2562(92.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e24.0(22.4\u0026ndash;25.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2976(92.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e24.1(22.3\u0026ndash;25.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2743(93.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e23.5(21.6\u0026ndash;25.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e58(90.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eUrinary Iodine Concentration(UIC) in Total Population and Ultrasound Group.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eTotal Population(\u003cem\u003eN\u003c/em\u003e\u0026thinsp;=\u0026thinsp;9000)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eUltrasound Group(\u003cem\u003eN\u003c/em\u003e\u0026thinsp;=\u0026thinsp;3400)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eUIC(\u0026micro;g/L)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eUIC(\u0026micro;g/L)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e9000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e216.2(138.6\u0026ndash;318)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3400\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e221.8(136.4\u0026ndash;329)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBoy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4519\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e224.0(146.0\u0026ndash;327)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1705\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e230.5(141.0\u0026ndash;337)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGirl\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4481\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e209.6(130.6\u0026ndash;309)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1695\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e212.0(132.4\u0026ndash;320)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\n\u003ch3\u003eThyroid Morphology and Goiter Prevalence\u003c/h3\u003e\n\u003cp\u003eAmong the 3,400 children assessed,median thyroid volumes tracked biologically with age(\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001).We identified 67 cases of goiter(1.97%).A clear gender divergence emerged:girls exhibited a significantly higher goiter rate(2.60%)compared to boys(1.35%,\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.013).Neither UIC(\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.212)nor household salt iodine category(\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;1.00)successfully predicted goiter prevalence(Table).\u003c/p\u003e\u003cp\u003e\u003cimg 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\" width=\"568\" height=\"369\"\u003e\u003c/p\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eFactors Associated with Goiter\u003c/h2\u003e \u003cp\u003eBinary logistic regression identified gender as the sole determinant:girls faced significantly elevated odds of developing goiter compared to boys(Adjusted OR\u0026thinsp;=\u0026thinsp;1.95,95%CI:1.19\u0026ndash;3.31,\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.01).Continuous measures of urinary and salt iodine failed to show statistical correlation with goiter prevalence(Table).\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003e This five-year surveillance provides a comprehensive assessment of iodine status and thyroid health in Shenzhen children aged 8\u0026ndash;11.The overall median urinary iodine concentration(UIC)of 216.2\u0026micro;g/L places this population within the adequate category(100\u0026ndash;299\u0026micro;g/L)based on the updated 2018 UNICEF guidelines.This recent standard widens the previous\u0026ldquo;adequate\u0026rdquo;upper\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAssociation analysis of iodine in salt,urinary iodine,and goiter prevalence.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eModel 1(Unadjusted)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eModel 2(Adjusted)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e95%CI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eOR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e95%CI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUIC(\u0026micro;g/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.00\u0026ndash;1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.805\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.00\u0026ndash;1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.932\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSIC(mg/kg)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.97\u0026ndash;1.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.862\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.97\u0026ndash;1.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.855\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGirl(vs.Boy)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.18\u0026ndash;3.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.010\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.19\u0026ndash;3.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.010\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e threshold of 199\u0026micro;g/L set by the 2007 WHO guidelines,reclassifying the 200\u0026ndash;299\u0026micro;g/L range as optimal for school-age children due to the lack of observed adverse effects.These results confirm that the Universal Salt Iodization(USI)mandate effectively maintains iodine sufficiency in this water-iodine-deficient coastal city,matching national success rates seen in over 90%of Chinese counties,.\u003c/p\u003e \u003cp\u003eA distinct downward trend in median UIC emerged,dropping significantly from 246.6\u0026micro;g/L in 2021 to 188.0\u0026micro;g/L in 2025(\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001).This decline mirrors patterns in other major cities like Chongqing,where levels fell from 303\u0026micro;g/L in 1997 to 226.4\u0026micro;g/L in 2023.Since the median salt iodine concentration(SIC)remained stable at roughly 24.0 mg/kg,the drop in urinary iodine likely stems from shifting dietary patterns.China\u0026rsquo;s Dietary Guidelines have progressively lowered daily salt targets from 6 g in 2007 to under 5 g in 2022.Reducing household salt intake benefits cardiovascular health but inherently limits the primary source of iodine.At the same time,urbanization has increased the consumption of processed foods and dining out.Research by Wang et al.shows that many processed foods use non-iodized salt,.Combined,less home cooking and more industrial salt use appear to be driving a\u0026ldquo;silent\u0026rdquo;reduction in population iodine levels.\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eGender Differences\u003c/strong\u003e \u003cp\u003eBoys consistently excreted more iodine than girls(224.0 vs.209.6\u0026micro;g/L,\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01).Although the effect size was modest(Cohen\u0026rsquo;s \u003cem\u003ed\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.078),this gap mirrors findings from inland Chongqing,coastal Zhejiang,and international cohorts in Norwayand Nigeria.Dietary habits,rather than metabolism,likely explain this difference;boys generally consume larger food volumes\u0026mdash;and by extension,more iodized salt\u0026mdash;than girls,.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eThyroid Morphology\u003c/b\u003e:Thyroid scans revealed a stark contrast in health outcomes:girls faced nearly double the goiter risk of boys(Adjusted OR\u0026thinsp;=\u0026thinsp;1.95).This female predominance is well-documented globally.While the biological drivers in prepuberty are not fully mapped,a 2025 review points to the interaction between sex hormones(especially estrogen),X-chromosome factors,and the immune system,which predisposes females to thyroid autoimmune processes.Recent clinical data on hormone reference intervals further confirm that boys and girls follow distinct physiological trajectories even before full puberty.\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eSalt vs.Urine Disconnect\u003c/strong\u003e \u003cp\u003eLocal salt regulation appears effective,with median SIC holding steady at 24.0 mg/kg and high compliance rates(92.7%).However,salt iodine levels showed only a negligible link to urinary iodine(\u003cem\u003erho\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.096).This decoupling\u0026mdash;stable salt but falling urinary iodine\u0026mdash;strongly implicates non-household sources.Catering and processed foods,which frequently use non-iodized salt,appear to be displacing household salt as drivers of iodine status,,.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eGoiter Risk Factors\u003c/strong\u003e \u003cp\u003eAt 1.97%,the overall goiter rate sits safely below the 5%public health warning line.This is comparable to Chongqing(2.24%)and far lower than the high-iodine regions of Hebei.Surprisingly,neither UIC nor SIC predicted thyroid enlargement in our models.This likely reflects the population\u0026rsquo;s general sufficiency;the classic\u0026ldquo;U-shaped\u0026rdquo;risk curve typically only emerges at extremes of deficiency or excess,.Similarly,previous studies in Chinese children indicate that age and gender are often more potent predictors of thyroid volume than mild variations in iodine intake.Moreover,goiter develops over months or years,whereas urine samples provide only a snapshot of recent intake,a limitation that often weakens statistical associations in cross-sectional designs.A holistic monitoring approach that integrates shifting dietary patterns with biological maturation will be essential to sustain optimal thyroid health in the post-elimination era.\u003c/p\u003e \u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eStudy Design and Participants\u003c/h2\u003e \u003cp\u003e This repeated cross-sectional survey covered all 10 administrative districts of Shenzhen from January 2021 to December 2025.Using multi-stage cluster sampling,we randomly selected three townships per district followed by one primary school per township.Stratified recruitment ensured a balanced distribution of gender and age(8\u0026ndash;11 years),yielding an annual sample of approximately 180 students per school.The final five-year cohort included 9,000 children(4,519 boys and 4,481 girls).Eligible participants were non-boarding students residing in Shenzhen for at least six months without a history of thyroid disease,recent iodine supplement use,or metabolic conditions affecting iodine processing.A randomly selected subgroup of 3,400 children(approx.680 annually)underwent thyroid ultrasound assessments.The study protocol received approval from the Ethical Review Committee of the Shenzhen Nanshan Center for Disease Control and Prevention(NSCDC),and parents or guardians were provided written informed consent.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eData and Sample Collection\u003c/h2\u003e \u003cp\u003eTrained staff collected demographic details including age,gender,ethnicity,and residence via structured questionnaires.Participants provided spot midstream urine samples(8\u0026ndash;10 mL)between 08:30 and 12:00,which were immediately aliquoted into sterile polypropylene tubes and frozen at\u0026mdash;20◦C for analysis within one week.Households provided 50\u0026ndash;100 g of edible salt sealed in moisture-proof bags,stored at room temperature until testing.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eThyroid Ultrasound Examination\u003c/h2\u003e \u003cp\u003eLicensed radiologists performed thyroid scans using a Mindray DC-80 system with a 7.5\u0026ndash;12 MHz linear transducer.Measure-ments included the length(L),width(W),and depth(D)of both thyroid lobes in longitudinal and transverse planes for every subject.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eLaboratory Measurements\u003c/h2\u003e \u003cp\u003eWe quantified urinary iodine concentration(UIC)using the arsenic-cerium catalytic spectrophotometric method(WS/T 107.1\u0026ndash;2016)on a MAPADA UV-1800 instrument.The limit of detection(LOD)was 5\u0026micro;g/L,with lower values assigned as LOD/\u0026radic;2(3.54\u0026micro;g/L).Salt iodine concentration(SIC)was determined by dissolving 10 g of salt for direct titration with sodium thiosulfate using a starch indicator,following the GB/T 13025.7\u0026ndash;2012 method.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eDiagnostic Criteria\u003c/h2\u003e \u003cp\u003eIodine status was classified according to the updated 2018 UNICEF guidance,which widens the adequate intake range for school-age children to 100\u0026ndash;299\u0026micro;g/L.Under this framework,we defined UIC values of 100\u0026ndash;299\u0026micro;g/L as adequate,\u0026lt;100\u0026micro;g/L as insufficient,and \u0026ge;\u0026thinsp;300\u0026micro;g/L as excessive,.Salt quality was graded against Chinese standard GB 26878-2011as qualified(15\u0026ndash;30 mg/kg),non-iodized(\u0026lt;\u0026thinsp;5 mg/kg),or non-compliant(5\u0026ndash;15 or \u0026gt;\u0026thinsp;30 mg/kg).Goiter diagnosis adhered to WS 276\u0026ndash;2007 criteriabased on age-specific thyroid volume(Tvol)thresholds:\u0026gt;4.5 mL(8 years),\u0026gt;5.0 mL(9 years),\u0026gt;6.0 mL(10 years),and \u0026gt;\u0026thinsp;6.5 mL(11 years).Tvol was derived using the ellipsoid equation:\u003c/p\u003e\u003cp\u003e\u003cimg 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\" width=\"746\" height=\"61\"\u003e\u003c/p\u003e\u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eStatistical Analysis\u003c/h2\u003e \u003cp\u003eR software(version 4.1.0)handled all statistical computations.Normality checks used the Kolmogorov\u0026ndash;Smirnov test,with non-normal data expressed as medians and interquartile ranges(IQR).Group comparisons employed Mann\u0026ndash;Whitney U or Kruskal\u0026ndash;Wallis H tests for continuous variables and Chi-square tests for categorical data.Temporal trends in UIC from 2021 to 2025 were analyzed using Spearman\u0026rsquo;s rank correlation analysis.Binary logistic regression identified goiter risk factors,with significance set at a two-tailed \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e \u003c/div\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eUIC\u0026nbsp;Urinary Iodine Concentration\u0026nbsp;SIC Salt Iodine Concentration\u003c/p\u003e\n\u003cp\u003eUSI Universal Salt Iodization\u003c/p\u003e\n\u003cp\u003eIDD Iodine Deficiency\u0026nbsp;Disorders\u0026nbsp;Tvol Thyroid Volume\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe express our gratitude to all students,parents,and teachers of the participating primary schools in Shenzhen for their cooperation and support during the data collection process.The publication of this paper was supported by Sanming Project of Medicine in Shenzhen(SZSM202311001)and Center for Disease Control and Prevention.During the preparation of this manuscript,the authors used deepseek(AI)for the purposes of English language editing and formatting assistance.The authors have reviewed and edited the content and take full responsibility for the content of this publication.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions statem\u003c/strong\u003e\u003cstrong\u003eent\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eConceptualization,Y.X.,X.Li.,and Z.W.;methodology,Y.X.;software,Y.X.;investigation,X.L.;data curation,Y.Z.;writing original draft preparation,Y.X.;writing review and editing,Z.W.;supervision,X.Li.;project administration,X.Li.and Q.L.All authors have read and agreed to the published version of the manuscrip\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to\u003c/strong\u003e\u003cstrong\u003eparticipate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was conducted in accordance with the Declaration of Helsinki,and approved by the Ethics Committee of the Shenzhen Nanshan District Center for Disease Control and Prevention(Protocol code SZNSCDC-LLBG-08-01).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInformed consent\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInformed consent was obtained from all subjects involved in the study.Written informed consent has been obtained from the participants’ parents or guardians.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data presented in this study are available on request from the corresponding author.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAdditional information\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eCorrespondence and requests for materials should\u0026nbsp;be addressed to Z.W.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eTriggiani,V.\u003cem\u003eet al.\u003c/em\u003eRole of Iodine,Selenium and Other Micronutrients in Thyroid Function and Disorders.\u003cem\u003eEndocr.Metab.Immune Disord.Drug Targets\u003c/em\u003e 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children.\u003cem\u003eEur.J.Clin.Nutr.\u003c/em\u003e67,1138\u0026ndash;1141(2013).\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-8578956/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8578956/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eUniversal Salt Iodization(USI)has effectively eliminated iodine deficiency disorders(IDD)in China.However,the iodine landscape is shifting due to rapid urbanization,changing dietary habits,and salt reduction efforts.This study examined longitudinal trends in iodine status and thyroid morphology among 9,000 school-age children in Shenzhen from 2021 to 2025 to understand these dynamics in a post-elimination setting.Using a five-year repeated cross-sectional design,we assessed urinary iodine concentration(UIC),salt iodine content(SIC),and thyroid ultrasound(\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;3,400).The overall median UIC was 216.2\u0026micro;g/L,classifying as adequate.Despite general sufficiency,a clear downward trend appeared:median levels fell from\u003c/p\u003e \u003cp\u003e246.6\u0026micro;g/L in 2021 to 188.0\u0026micro;g/L in 2025(\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001),even though household salt iodine remained stable and compliance was high(92.7%).Girls had lower urinary iodine than boys(209.6 vs.224.0\u0026micro;g/L)yet faced a significantly higher risk of thyroid enlargement(Adjusted OR\u0026thinsp;=\u0026thinsp;1.95,95%CI:1.19\u0026ndash;3.31).These findings suggest that relying solely on household salt monitoring may no longer fully capture total iodine intake,likely due to the increasing influence of non-household dietary sources such as processed foods and dining out.\u003c/p\u003e","manuscriptTitle":"Longitudinal Trends in Iodine Nutritional Status and Thyroid Morphology Among School-Age Children in Shenzhen,China(2021–2025)","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-21 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2026","published":true,"recentEditorialEvents":[{"type":"editorInvitedReview","content":"","date":"2026-05-18T14:54:51+00:00","index":57,"fulltext":""},{"type":"reviewerAgreed","content":"117241616610824360174048572023904817135","date":"2026-05-03T20:44:03+00:00","index":55,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[{"id":61458655,"name":"Health sciences/Diseases"},{"id":61458656,"name":"Health sciences/Endocrinology"},{"id":61458657,"name":"Health sciences/Health care"},{"id":61458658,"name":"Health sciences/Medical research"}],"tags":[],"updatedAt":"2026-01-21T18:06:26+00:00","versionOfRecord":[],"versionCreatedAt":"2026-01-21 18:06:25","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8578956","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8578956","identity":"rs-8578956","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}