甲状腺结节与代谢综合征的相关性研究  

Association of thyroid nodule and metabolic syndrome

作　　者：梁绮君[1] 余寿益[1] 李淑华[1] 胡晨鸣[1] 杨焱[1] 

机构地区：[1]佛山市中医院健康管理中心,528000

出　　处：《国际内分泌代谢杂志》2015年第5期293-297,共5页International Journal of Endocrinology and Metabolism

基　　金：广东省科技厅项目（2013B022000023）

摘　　要：目的 研究甲状腺结节与代谢综合征（MS）及其组分的关系,并对其机制进行探讨.方法 回顾性分析2014年佛山市中医院的3 855名体检者的体检资料.将体检者分别分成MS组和非MS组,胰岛素低抗（IR）组和非IR组.检测身高、体重、血压、空腹血糖、血脂、尿酸等指标.检测促甲状腺激素（TSH）、游离T3、游离T4以评估甲状腺功能.检测空腹血清胰岛素水平,计算稳态模型评估-胰岛素抵抗指数（HOMA-IR）,以评估IR情况.使用彩色多普勒超声检查脂肪肝及甲状腺结节的患病情况.结果 （1）共1 455人患甲状腺结节,患病率37.74％.女性患病率高于男性（46.57％vs.32.28％,χ^2 =79.073,P＜0.01）.按年龄分层,在70岁以下人群,甲状腺结节的患病率随年龄增长而上升（P＜0.05）.（2）MS组的甲状腺结节患病率显著高于非MS组（50.14％vs.36.47％,χ^2=25.888,P＜0.01）.MS组分超重、高血糖、高血压患者的甲状腺结节患病率也显著升高（42.15％ vs.36.06％,χ^2=12.515,P ＜0.01;49.92％ vs.35.46％,χ^2=45.623,P ＜0.01;57.57％ vs.35.84％,χ^2=61.759,P＜0.01）.（3）MS组血清TSH及HOMA-IR水平明显高于非MS组（t=4.763,P＜0.01;t=5.028,P＜0.01）.（4） IR组的甲状腺结节患病率显著高于非IR组（67.00％ vs.33.32％,χ^2=212.115,P＜0.01）.（5）多因素Logistic逐步回归分析显示,甲状腺结节的发生与性别、年龄、体重指数、收缩压、MS、IR独立相关（β=0.751,P＜0.01;β=0.061,P＜0.01;β=0.062,P＜0.01;β=0.006,P=0.047;β=0.069,P＜0.01;β=0.725,P＜0.01）,与TSH无明显相关.结论 MS患者的甲状腺结节患病率显著升高,其机制可能与IR有关.Objective To investigate the association of thyroid nodule with metabolic syndrome （MS） and its components,and analyze the underlying mechanism.Methods A total of 3 855 subjects who received physical examination at Foshan Hospital of Traditional Chinese Medicine in 2014 were enrolled in this retrospective study,and were divided into MS group,non-MS group,insulin resistance（IR） group and non-IR group,respectively.Height,weight,blood pressure,fasting blood glucose,serum lipid profile and urine acid were measured.Thyroid function was evaluated by measuring serum thyroid stimulating hormone （TSH）,free tri-iodothyronine （FT3） and thyroxine （FT4）.Fasting plasma insulin was also measured.IR was estimated by homeostasis model assessment-insulin resistance （HOMA-IR）.Fatty liver and thyroid nodules were detected by color Doppler ultrasonography.Results （1） Thyroid nodules were found in 1 455 subjects.The overall prevalence of thyroid nodule was 37.74%.The prevalence of thyroid nodules in women was significantly higher than that in men（46.57% vs.32.28%,χ^2 =79.073,P 〈0.01）.In those younger than 70 years old,the prevalence of thyroid nodule increased with age （P 〈 0.05）.（2） The prevalence of thyroid nodule was significantly higher in MS group than that in non-MS group （50.14% vs.36.47%,χ^2 =25.888,P 〈 0.01）.Patients with MS components including overweight,hyperglycemia or hypertension also had higher thyroid nodule prevalence （42.15% vs.36.06%,χ^2 =12.515,P 〈 0.01;49.92% vs.35.46%,χ^2=45.623,P〈0.01;57.57% vs.35.84%,χ^2 =61.759,P〈0.01）.（3）SerumTSH and HOMA-IR were significantly higher in MS group than those in non-MS group （t =4.763,P 〈 0.01;t =5.028,P 〈 0.01）.（4） Compared with non-IR group,the prevalence of thyroid nodule in IR group was higher （67.00% vs.33.32%,χ^2 =212.115,P 〈 0.01）.（5） In multivariate Logistic regression analysis,factors which were independently correlated with thyroid nodule formation were age,sex,body mass index,

关 键 词：甲状腺结节 代谢综合征 胰岛素抵抗 

分 类 号：R736.1[医药卫生—肿瘤]