健康体检人群25(OH)D水平与甲状腺TI-RADS分类的相关性分析  

Correlation Analysis Between 25(OH)D Level and TI-RADS Classification of Thyroid in Healthy Subjects

作　　者：周小燕[1] 雷蓉[1] 杨丹[1] 江毅敏[1] 王冠[1] 柳弥[1] ZHOU Xiao-yan;LEI Rong;YANG Dan;JIANG Yi-min;WANG Guan;LIU Mi(Health Management Center,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,Sichuan,China)

机构地区：[1]川北医学院附属医院健康管理中心,四川南充637000

出　　处：《医学信息》2022年第3期152-155,共4页Journal of Medical Information

基　　金：川北医学院校级科研发展项目(编号:CBY18-A-YB51)。

摘　　要：目的探讨健康体检人群25-羟维生素D[25(OH)D]水平与TI-RADS分类的相关性。方法选取2019年8月-2021年1月川北医学院附属医院10023名接受甲状腺超声检查者作为研究对象,根据TI-RADS分类标准将无甲状腺结节设为对照组,TI-RADS 3类及以下者设为良性组,TI-RADS 4类及以上者设为低度恶性组。比较三组临床资料,分析25(OH)D水平与甲状腺结节的关系。结果10023名接受甲状腺超声检查者中无甲状腺结节6228名,TI-RADS3类及以下者3222名,TI-RADS 4类及以上者573名。三组年龄、收缩压(SBP)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、游离三碘甲状腺原氨酸(FT3)、25(OH)D比较,差异有统计学意义(P<0.05);三组体质指数(BMI)、舒张压(DBP)、空腹血糖(FPG)、甘油三脂(TG)、(LDL-C)、游离甲状腺素(FT4)、促甲状腺激素(TSH)、甲状腺球蛋白抗体(Tg-Ab)、甲状腺过氧化物酶抗体(TPO-Ab)比较,差异无统计学意义(P>0.05);Pearson相关性分析显示,25(OH)D与FT3呈正相关(r=0.129,P<0.05),与TSH、Tg-Ab、TPO-Ab呈负相关(r=-0.076、-0.091、-0.070,P<0.05);多因素Logistic回归分析显示,年龄、SBP是甲状腺结节发生的独立危险因素,而25(OH)D是甲状腺结节发生的保护因素(P<0.05);此外,25(OH)D是低度恶性甲状腺结节发生的保护因素,TC是低度恶性甲状腺结节发生的危险因素(P<0.05)。结论血清25(OH)D水平随着TI-RADS严重程度的增加呈下降趋势,高水平的血清25(OH)D水平对甲状腺结节的发生、发展具有一定的保护作用。Objective To investigate the correlation between 25-hydroxyvitamin D[25(OH)D]level and TI-RADS classification in healthy people.Methods A total of 10023 patients who underwent thyroid ultrasound examination in the Affiliated Hospital of North Sichuan Medical College from August 2019 to January 2021 were selected as the subjects.According to TI-RADS classification criteria,no thyroid nodules were set as control group,TI-RADS 3 and below were set as benign group,TI-RADS 4 and above were set as low-grade malignant group.The clinical data of the three groups were compared to analyze the relationship between 25(OH)D level and thyroid nodules.Results Among the 10023 receiving thyroid ultrasound examination,6228 had no thyroid nodules,3222 had TI-RADS3 and below,and 573 had TI-RADS4 and above.There were significant differences in age,systolic blood pressure(SBP),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),free triiodothyronine(FT3)and 25(OH)D among the three groups(P<0.05).There was no significant difference in body mass index(BMI),diastolic blood pressure(DBP),fasting plasma glucose(FPG),triglyceride(TG),(LDL-C),free thyroxine(FT4),thyroid stimulating hormone(TSH),thyroglobulin antibody(Tg-Ab,and thyroid peroxidase antibody(TPO-Ab)among the three groups(P>0.05).Pearson correlation analysis showed that 25(OH)D was positively correlated with FT3(r=0.129,P<0.05),and negatively correlated with TSH,Tg-Ab and TPO-Ab(r=-0.076,-0.091,-0.070,P<0.05).Multivariate Logistic regression analysis showed that age and SBP were independent risk factors for thyroid nodules,and 25(OH)D was a protective factor for thyroid nodules(P<0.05).In addition,25(OH)D was a protective factor for low-grade malignant thyroid nodules,and TC was a risk factor for low-grade malignant thyroid nodules(P<0.05).Conclusion The level of serum 25(OH)D decreases with the increase of the severity of ultrasonic TI-RADS classification.High level of serum 25(OH)D has a certain protective effect on the occurrence and development of thyroid nodule

关 键 词：25(OH)D TI-RADS分类 甲状腺结节 

分 类 号：R581[医药卫生—内分泌]