2型糖尿病合并甲状腺结节患者脂代谢、IGF-1及HbA1c水平与结节性质的关系  

Relationship between lipid metabolism,IGF-1 and HbA1c levels and the nature of nodules in patients with type 2 diabetes mellitus and thyroid nodules

作　　者：张琴[1] 牛敏[1] 霍琴琴 张学辉 申金付[1] 裴晓艳[2] ZHANG Qin;NIU Min;HUO Qin-qin(Department of Endocrinology,Fuyang People's Hospital,Fuyang Anhui 236000,China)

机构地区：[1]阜阳市人民医院内分泌科,安徽阜阳236000 [2]蚌埠医学院第一附属医院内分泌科,安徽蚌埠233000

出　　处：《临床和实验医学杂志》2022年第18期1971-1974,共4页Journal of Clinical and Experimental Medicine

基　　金：安徽高校自然科学研究项目(编号:KJ2019A0353)。

摘　　要：目的探讨2型糖尿病(T2DM)合并甲状腺结节患者脂代谢指标、血清胰岛素样生长因子-1(IGF-1)、糖化血红蛋白(HbA1c)水平与结节性质的关系。方法回顾性选取2018年1月至2021年12月阜阳市人民医院确诊的T2DM合并甲状腺结节患者90例,根据甲状腺结节的病理学检查结果将患者分为良性组70例、恶性组20例。检测两组患者脂代谢指标、血清IGF-1、HbA1c水平;采用甲状腺影像报告与数据系统(TI-RADS)对90例患者进行评价,采用Pearson法分析差异具有统计学意义的指标与TI-RADS评分的关系。采用Logistic回归模型分析结节恶性的影响因素。结果良性组和恶性组的血清总胆固醇、甘油三酯、低密度脂蛋白胆固醇(LDL-C)、白蛋白、总蛋白、空腹血糖、空腹胰岛素(FINS)、空腹C肽、促甲状腺激素(TSH)、甲状腺球蛋白(Tg)、甲状腺过氧化物酶抗体(TPOAb)测定值比较,差异均无统计学意义(P>0.05);恶性组患者的血清HDL-C水平低于良性组患者,血清IGF-1、HbA1c、甲状腺球蛋白抗体(TgAb)水平均高于良性组,差异均有统计学意义(P<0.05)。恶性组患者的TI-RADS评分高于良性组患者,差异有统计学意义(P<0.05)。TI-RADS评分与HDL-C呈负相关(r=-0.551,P<0.05),TI-RADS评分与IGF-1、HbA1c、TgAb呈正相关(r=0.574、0.428、0.447,P<0.05)。Logistic回归模型结果显示:T2DM合并甲状腺结节患者HDL-C水平降低、IGF-1增高、HbA1c增高、TgAb增高是结节恶性的独立危险因素(P<0.05)。结论T2DM合并甲状腺恶性结节患者较良性结节患者血清HDL-C水平降低,IGF-1、HbA1c、TgAb水平增高,血清HDL-C、IGF-1、HbA1c、TgAb水平变化与T2DM患者甲状腺结节恶性程度(TI-RADS评分)有关。Objective To explore the relationship between lipid metabolism indexes,serum insulin-like growth factor-1(IGF-1),glycosylated hemoglobin(HbA1c)levels and the nature of nodules in patients with type 2 diabetes mellitus(T2DM)combined with thyroid nodules.Methods In this study,90 patients with T2DM and thyroid nodules diagnosed in Fuyang People's Hospital from January 2018 to December 2021 were retrospectively selected.According to the pathological examination results of thyroid nodules,the patients were divided into benign group 70 cases and malignant group 20 cases;two groups of patients were tested lipid metabolism index,serum IGF-1,HbA1c level,90 patients were evaluated by Thyroid Imaging Report and Data System(TI-RADS),and the relationship between statistically significant indexes and TI-RADS score was analyzed by Pearson method.The influencing factors of nodule malignancy were analyzed using Logistic regression model.Results There were no statistically significant differences of serum total cholesterol,triglyceride,low-density lipoprotein cholesterol(LDL-C),albumin,total protein,fasting blood glucose,fasting insulin(FINS),fasting C-peptide,thyroid stimulating hormone(TSH),thyroglobulin(Tg),thyroid peroxidase antibody(TPOAb)between benign and malignant groups(P>0.05);the level of serum HDL-C in the malignant group was lower than that in the benign group,the levels of serum IGF-1,HbA1c and thyroglobulin antibody(TgAb)in the malignant group were higher than those in the benign group,and the differences were statistically significant(P<0.05).The TI-RADS score of the malignant group was higher that of the benign group,the difference was statistically significant(P<0.05);TI-RADS score was negatively correlated with HDL-C(r=-0.551,P<0.05),TI-RADS score was correlated with IGF-1,HbA1c,TgAb was positively correlated(r=0.574,0.428,0.447,P<0.05).Logistic regression model results showed that the level of HDL-C in T2DM patients with thyroid nodules decreased,IGF-1 increased,HbA1c increased,TgAb Increased height is an indep

关 键 词：2型糖尿病 甲状腺结节 脂代谢 胰岛素样生长因子-1 糖化血红蛋白 恶性 

分 类 号：R587.2[医药卫生—内分泌] R581[医药卫生—内科学]