Iodine and selenium deficiencies are common worldwide. We assessed the iodine and selenium status of Gilgit-Baltistan, Pakistan. We determined the elemental composition (ICP-MS) of locally grown crops (n = 281), drinking water (n = 82), urine (n = 451) and salt (n = 76), correcting urinary analytes for hydration (creatinine, specific gravity). We estimated dietary iodine, selenium and salt intake. Median iodine and selenium concentrations were 11.5 (IQR 6.01, 23.2) and 8.81 (IQR 4.03, 27.6) µg/kg in crops and 0.24 (IQR 0.12, 0.72) and 0.27 (IQR 0.11, 0.46) µg/L in water, respectively. Median iodised salt iodine was 4.16 (IQR 2.99, 10.8) mg/kg. Population mean salt intake was 13.0 g/day. Population median urinary iodine (uncorrected 78 µg/L, specific gravity-corrected 83 µg/L) was below WHO guidelines; creatinine-corrected median was 114 µg/L but was unreliable. Daily selenium intake (from urinary selenium concentration) was below the EAR in the majority (46–90%) of individuals. Iodine and selenium concentrations in all crops were low, but no health-related environmental standards exist. Iodine concentration in iodised salt was below WHO-recommended minimum. Estimated population average salt intake was above WHO-recommended daily intake. Locally available food and drinking water together provide an estimated 49% and 72% of EAR for iodine (95 µg/day) and selenium (45 µg/day), respectively. Low environmental and dietary iodine and selenium place Gilgit-Baltistan residents at risk of iodine deficiency disorders despite using iodised salt. Specific gravity correction of urine analysis for hydration is more consistent than using creatinine. Health-relevant environmental standards for iodine and selenium are needed.

碘和硒缺乏在世界范围内很常见。我们评估了巴基斯坦吉尔吉特-巴尔蒂斯坦的碘和硒状况。我们测定了当地种植的作物 ( n  = 281)、饮用水 ( n  = 82)、尿液 ( n  = 451) 和盐 ( n = 76），校正尿液分析物的水合作用（肌酐，比重）。我们估计了膳食碘、硒和盐的摄入量。作物中碘和硒的中位数浓度分别为 11.5 (IQR 6.01, 23.2) 和 8.81 (IQR 4.03, 27.6) µg/kg，水中的中位数分别为 0.24 (IQR 0.12, 0.72) 和 0.27 (IQR 0.11, 0.46) µg/L。碘盐碘中位数为 4.16 (IQR 2.99, 10.8) mg/kg。人群平均盐摄入量为 13.0 克/天。人群尿碘中位数（未校正 78 µg/L，比重校正后 83 µg/L）低于 WHO 指南；肌酐校正中位数为 114 µg/L，但不可靠。大多数人（46-90%）的每日硒摄入量（来自尿硒浓度）低于 EAR。所有作物中的碘和硒浓度都很低，但不存在与健康相关的环境标准。碘盐中的碘浓度低于世卫组织建议的最低浓度。估计的人口平均盐摄入量高于世卫组织建议的每日摄入量。当地可用的食物和饮用水一起估计分别提供 49% 和 72% 的 EAR 的碘（95 µg/天）和硒（45 µg/天）。尽管使用碘盐，但环境和饮食中的低碘和硒使吉尔吉特-巴尔蒂斯坦居民面临碘缺乏症的风险。尿液分析水化比重校正比使用肌酐更一致。碘和硒需要与健康相关的环境标准。当地可用的食物和饮用水一起估计分别提供 49% 和 72% 的 EAR 的碘（95 µg/天）和硒（45 µg/天）。尽管使用碘盐，但环境和饮食中的低碘和硒使吉尔吉特-巴尔蒂斯坦居民面临碘缺乏症的风险。尿液分析水化比重校正比使用肌酐更一致。碘和硒需要与健康相关的环境标准。当地可用的食物和饮用水一起估计分别提供 49% 和 72% 的 EAR 的碘（95 µg/天）和硒（45 µg/天）。尽管使用碘盐，但环境和饮食中的低碘和硒使吉尔吉特-巴尔蒂斯坦居民面临碘缺乏症的风险。尿液分析水化比重校正比使用肌酐更一致。碘和硒需要与健康相关的环境标准。