糖代谢异常与甲状腺结节相关性研究  

Correlation Between Abnormal Glucose Metabolism and Thyroid Nodule

作　　者：王博[1,2] 刘珺[3] 张玄娥[1,2] 顾蕾[1,2] 唐键[1,2] 唐文佳[1,2] 程笑冰[1,2] 张雪莲[1,2] 周尊海[1,2] 

机构地区：[1]同济大学附属杨浦医院内分泌科 [2]同济医学院全科医学系,上海市200090 [3]上海市第十人民医院中医科

出　　处：《中国全科医学》2015年第30期3648-3652,共5页Chinese General Practice

摘　　要：目的探讨糖代谢异常与甲状腺结节的相关性。方法选取同济大学附属杨浦医院于2014年4—12月在上海市杨浦区社区(定海、殷行、江浦、长白等)进行流行病学调查人群4 036例。记录受试者临床资料,检测血压、血糖、血脂水平,根据血糖水平将受试者分为正常血糖组和糖代谢异常组,均行甲状腺B超检查。比较两组临床资料、实验室检查指标及甲状腺结节发生率,采用多因素Logistic回归分析甲状腺结节发生的影响因素。结果正常血糖组1 995例,其中男611例、女1 384例,糖代谢异常组2 041例,其中男686例、女1 355例,两组性别比较差异有统计学意义(χ2=4.120,P=0.042)。两组身高、舒张压比较,差异均无统计学意义(P>0.05);糖代谢异常组年龄、体质量、体质指数(BMI)、腰围、臀围、收缩压、空腹血糖(FBG)、餐后2 h血糖(2 h PBG)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平均高于正常血糖组(P<0.05),高密度脂蛋白胆固醇(HDL-C)水平低于正常血糖组(P<0.05)。糖代谢异常组甲状腺结节、多发结节、两叶结节发生率均高于正常血糖组(P<0.05);两组单发结节、左叶结节、右叶结节、峡部结节、结节大于1 cm、伴钙化、伴弥漫性病变、囊性结节、混合性结节发生率比较,差异均无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,性别、年龄、糖代谢异常与甲状腺结节的发生有回归关系(P<0.05)。结论糖代谢异常人群甲状腺结节发生率高,且多为多发、两叶结节。性别、年龄、糖代谢异常与甲状腺结节的发生有关。Objective To investigate the correlation between abnormal glucose metabolism and thyroid nodule. Methods Enrolled 4 036 people who received epidemiological survey conducted by Yangpu Hospital Affiliated to Tongji University from April to December,2014 in the communities（ Dinghai, Yinhang, Jiangpu, Changbai, ect.） of Yangpu District in Shanghai. Clinical data were recorded, and blood pressure, blood glucose and blood lipid level were examined. According to blood glucose level, the subjects were divided into normal blood glucose group and abnormal glucose metabolism group. Thyroid B- ultrasonic examination was undertaken on all the subjects. Comparison was made between the two groups in clinical data,laboratory examination results and the incidence of thyroid nodule. Multivariate Logistic regression analysis was conducted to analyze the influencing factors for thyroid nodule. Results Normal blood glucose group had 1 995 people,611 males and 1 384 females, and abnormal glucose metabolism group had 2 041 people,686 males and 1 355 females, with significant differences between the two groups（ χ2= 4. 120,P = 0. 042）. The two groups were not significantly different in height and DBP（ P〈0. 05）. The abnormal glucose metabolism group was higher（ P〈0. 05） in age,body weight,BMI,waistline,hipline,SBP,FBG,2 h PBG,TG,TC and LDL- C level and was lower（ P〈0. 05） in HDL- C level than normal blood glucose group. Abnormal glucose metabolism was higher（ P〈0. 05） than normal blood glucose group in the incidence rates of thyroid nodule,multiple nodule and two leaf nodule. The two groups were not significantly different in the incidence rates of solitary nodule,left leaf nodule,right leaf nodule, isthmus nodule, nodule longer than 1 cm, calcification, diffuse lesion,cystic nodule and mixed nodule（ P〉0. 05）. Multivariate Logistic regression analysis showed that gender, age, abnormal glucose metabolism had regression relation with thyroid nodule（ P〈0. 05）. Conclusion Patients with abnormal glu

关 键 词：葡萄糖代谢障碍 糖尿病 甲状腺结节 

分 类 号：R587.1[医药卫生—内分泌]