体检人群甲状腺结节与代谢指标相关性的研究  

Study on the correlation between thyroid nodule and metabolic index in physical examination population

作　　者：保方[1] 施英娟[1] 丛辉[1] 关茜[1] Bao Fang;Shi Yingjuan;Cong Hui;Guan Xi(Laboratory Medicine Center,Affiliated Hospital of Nantong University,Nantong 226001,China)

机构地区：[1]南通大学附属医院医学检验科,南通226001

出　　处：《中华预防医学杂志》2023年第12期2110-2116,共7页Chinese Journal of Preventive Medicine

摘　　要：目的探讨体检人群甲状腺结节(thyroid nodule,TN)的患病率及其影响因素,为TN的早预防和干预提供参考。方法采用横断面研究的方法,纳入2017年1月至2020年4月在南通大学附属医院体检中心的6950名体检者作为研究对象,所有受试者进行甲状腺高分辨率超声检查,同时测量身高、体重指数(body mass index,BMI)、血压,检测空腹血糖(FBG)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、尿酸(UA)、同型半胱氨酸(HCY)等代谢性指标,SPSS26.0统计软件进行数据分析。正态分布的数值变量采用均值±标准差即(x¯±s)表示,两组之间的比较采用t检验;非正态分布的数值变量采用中位数(四分位数范围)即M(Q_(1),Q_(3))表示,Mann-Whitney U检验用于两组之间的比较,Kruskal-Wallis检验用于多组之间的比较。结果6950名研究对象甲状腺结节(TN)的患病率为53.97%(3751/6950),其中男性患病率为47.08%(2218/4711),女性患病率为68.47%(1533/2239),女性明显高于男性(χ^(2)=278.575,P<0.001);TN患病率总体水平随年龄升高而增加(χ^(2)=552.145,P<0.001),男性(χ^(2)=304.086,P<0.001),女性(χ^(2)=202.178,P<0.001);不同年龄段,女性患病率均高于男性,差异有统计学意义(P<0.05)。男性TN组和Non-TN组比较,饮酒史、BMI、血压、HCY和FBG指标有显著差异(P均<0.05)。女性TN组和Non-TN组比较,BMI、血压、HCY、FBG、TC、TG、LDL-C和UA指标有显著差异(P均<0.05)。单因素logistic回归模型显示,FBG<6.1 mmol/L(P<0.001)和TC<5.2 mmol/L(P=0.013)是发生TN的保护因素;UA处于正常值(P=0.013)是发生TN的危险因素。经过校正性别、吸烟、饮酒、BMI和血压后,多因素logistic回归模型显示FBG<6.1 mmol/L(OR:0.713,95%CI:0.621~0.817,P<0.001)是发生TN的保护因素。结论TN的患病率较高,性别、年龄、血压、BMI、FBG等指标为TN的重要影响因素,对该类指标异常的体检人群应加强健康筛查和管Objective By analyzing the prevalence and influencing factors of thyroid nodules(TN)among a population undergoing physical examinations in Nantong region,this study aims to provide theoretical basis for early prevention and intervention of TN.Methods A cross-sectional study was conducted,including 6950 participants who underwent physical examinations at the Affiliated Hospital of Nantong University from January 2017 to April 2020.All participants underwent high-resolution ultrasound examination of the thyroid,and measurements of height,body mass index(BMI),blood pressure.Fasting blood glucose(FBG),total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C),uric acid(UA),homocysteine(HCY)and other metabolic indicators were detected.Data analysis was performed using SPSS 26.0 statistical software.The numerical variables with normal distribution were expressed as mean±standard deviation(x¯±s),and the t-test was used for comparison between the two groups.Numerical variables with non-normal distribution were expressed as median(interquartile range),namely M(Q_(1),Q_(3)).The Mann-Whitney U test was used for comparison between two groups,and the Kruskal-Wallis test was used for comparison between multiple groups.Results The prevalence of thyroid nodules among the 6950 participants was 53.97%(3751/6950),with a rate of 47.08%(2218/4711)in males and 68.47%(1533/2239)in females,which was significantly higher in females than in males(χ^(2)=278.575,P<0.001).The prevalence of TN increased with age both overall(χ^(2)=552.145,P<0.001),in males(χ^(2)=304.086,P<0.001),and in females(χ^(2)=202.178,P<0.001).The prevalence of TN was higher in females than in males across different age groups(P<0.05).In the comparison between males in the TN and non-TN groups,significant differences were found in terms of alcohol consumption history,BMI,blood pressure,HCY,and FBG(all P<0.05).In the comparison between females in the TN and non-TN groups,significant difference

关 键 词：甲状腺结节 患病率 危险因素 体检 

分 类 号：R581[医药卫生—内分泌]