人群体质量指数与甲状腺结节患病率及其恶性风险分层的相关性  

Correlation between the body mass index with thyroid nodule prevalence and risk stratification

作　　者：孙荣欣[1] 郑召辉[1] 张强 张媛媛 赵冬[1] SUN Rong-xin;ZHENG Zhao-hui;ZHANG Qiang;ZHANG Yuan-yuan;ZHAO Dong(Center for Endocrine Metabolism and Immune Diseases,Beijing Luhe Hospital Affiliated to Capital Medical University,Beijing Key Laboratory of Diabetes Prevention and Treatment,Beijing 101149,China)

机构地区：[1]首都医科大学附属北京潞河医院内分泌代谢与免疫性疾病中心,北京市糖尿病防治重点实验室,北京101149

出　　处：《川北医学院学报》2021年第1期72-75,共4页Journal of North Sichuan Medical College

基　　金：首都医科大学附属北京潞河医院青年科研孵育专项(LHYY2019-LC14)。

摘　　要：目的:探讨甲状腺结节患病率及结节恶性风险分层与体质量指数(BMI)的相关性。方法:采用横断面调查法对2248名体检者的检查结果进行分析,所有研究对象均依据甲状腺超声检查结果统计的甲状腺结节患病情况分为甲状腺结节组和无结节组,并依据美国甲状腺协会(ATA)标准对检出的甲状腺结节进行恶性风险分层。然后再分析BMI与甲状腺结节患病率及ATA恶性风险分层的统计学关系。结果:2248名受检者甲状腺结节患病率为31.36%(705/2248),甲状腺结节组与无结节组之间的性别构成、平均年龄、BMI、SBP、FPG、TG、FT3、FT4均存在着明显差异(P<0.05)。依据BMI分类标准,将受检者分为低质量组(n=296)、正常质量组(n=1380)、超重肥胖组(n=572),3组甲状腺结节患病率依次升高,分别为29.05%、30.00%、31.84%(P<0.05),而依据ATA恶性风险分层标准,3组受试者的高恶性风险分别占3.38%、3.77%、6.12%(P<0.05)。单因素分析显示,高恶性风险分层组(n=97)和非高恶性风险分层组(n=608)在年龄、BMI、FPG、TSH方面也存在着显著性差异(P<0.05),多因素Logistic分析显示超重肥胖和高水平FPG是甲状腺结节为高恶性风险的独立危险因素(超重肥胖:OR=3.078,95%CI=1.397~6.038,P<0.05;高水平FPG:OR=2.327,95%CI=1.791~3.958,P<0.05)。结论:BMI和甲状腺结节患病率和恶性风险分层紧密相关,超重或肥胖(BMI≥24.0 kg/m^(2))会增加甲状腺结节为高恶性风险分层的可能。Objective:To investigate the correlation between the body mass index(BMI)of population and the prevalence of thyroid nodules,along with the relationship between BMI and the risk stratification of malignant nodules.Methods:A cross-sectional survey was covered to analyze 2,248 physical examinees.According to the results of ultrasound examination,the patients were divided into thyroid nodules group and non-nodule group.Also,the malignant risk of thyroid nodules was stratified based on the standard of American Thyroid Association(ATA).Then the statistical relationship between BMI and the prevalence of thyroid nodules and ATA malignant risk stratification was analyzed.Results:The prevalence rate of thyroid nodules was 31.36%(705/2248).There were significant differences in gender composition,average age,BMI,SBP,FPG,TG,FT3,FT4 between thyroid nodule group and non-nodule group(P<0.05).According to the BMI classification standard,they were divided into low-quality group(n=296),normal weight group(n=1,380),overweight or obesity group(n=572).The prevalence of thyroid nodules in these three groups increased in turn,which were 29.05%,30.00%and 31.84%,respectively,with significant difference(P<0.05).According to ATA malignant risk stratification standard,the high malignant risk of these three groups accounted for 3.38%,3.77%and 6.12%(P<0.05).The univariate analysis showed that the age,BMI,FPG and TSH of patients in high-risk stratification group(n=97)was notable related with that of the patients in non-high-risk stratification group(n=608,P<0.05).Also,further multivariate logistic analysis displayed that overweight,obesity and high-level FPG were independent risk factors for thyroid nodules(OR=3.078,2.327,95%CI=1.397~6.038,1.791~3.958,P<0.05).Conclusion:BMI is closely related to the prevalence of thyroid nodules and the risk stratification of malignancy.Overweight or obesity(BMI≥24.0 kg/m^(2))may increase the risk stratification of thyroid nodules as high malignancy.

关 键 词：体检人群 甲状腺结节 患病率 恶性风险分层 体质量指数 相关性 

分 类 号：R445.1[医药卫生—影像医学与核医学] R736.1[医药卫生—诊断学]