老年2型糖尿病患者并发甲状腺结节检出现状及其与胰岛素抵抗的关系研究  

Detection status of thyroid nodules and its relationship with insulin resistance in elderly patients with type 2 diabetes mellitus

作　　者：谢佳 陈思扬 孙彤 XIE Jia;CHEN Siyang;SUN Tong(General Practice Medical Center,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,China;Health Management Center,General Practice Medical Center,West China Fourth Hospital,Sichuan University,Chengdu,Sichuan 610041,China;Department of Neurosurgery,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,China)

机构地区：[1]四川大学华西医院,全科(特需)病房,四川成都610041 [2]四川大学华西第四医院健康管理中心,四川成都610041 [3]四川大学华西医院神经外科,四川成都610041

出　　处：《公共卫生与预防医学》2025年第2期52-55,共4页Journal of Public Health and Preventive Medicine

摘　　要：目的分析老年2型糖尿病患者并发甲状腺结节的现状及其与胰岛素抵抗的关系。方法以2018年1月至2023年12月四川大学华西医院收治的324例老年2型糖尿病患者为研究对象,分析其甲状腺结节检出情况,并依据其是否合并甲状腺结节分为甲状腺结节组和非甲状腺结节组。测定所有研究对象的胰岛素抵抗指数(HOMA-IR)。采用Spearman相关分析并发甲状腺结节与HOMA-IR的相关性,以受试者特征工作曲线(ROC)分析HOMA-IR对老年2型糖尿病患者并发甲状腺结节的评估价值。结果324例老年2型糖尿病患者中检出甲状腺结节211例,检出率为65.12%,男女甲状腺结节检出率比为1∶1.24。不同胰岛素抵抗水平患者的甲状腺结节检出率存在差异,且HOMA-IR>2.0患者的甲状腺结节检出率高于HOMA-IR≤2.0患者(P<0.05);相关性分析显示,HOMA-IR与老年2型糖尿病患者并发甲状腺结节呈正相关(r=0.650,P<0.05);ROC曲线显示,HOMA-IR评估老年2型糖尿病患者并发甲状腺结节的曲线下面积(AUC)为0.911,灵敏度为81.99%,特异度为96.46%。结论老年2型糖尿病并发甲状腺结节的风险较高,且女性检出风险高于男性,与胰岛素抵抗水平密切相关,通过测定HOMA-IR可为老年2型糖尿病患者并发甲状腺结节的早期评估提供参考依据。Objective To analyze the status of thyroid nodules in elderly patients with type 2 diabetes mellitus(T2DM)and its relationship with insulin resistance.Methods A total of 324 elderly patients with T2DM admitted to West China Hospital of Sichuan University from January 2018 to December 2023 were selected as the study subjects.The detection status of thyroid nodules was analyzed.According to the presence of thyroid nodules,the patients were classified into thyroid nodule group and non-thyroid nodule group.The insulin resistance index(HOMA-IR)of the study subjects was measured.Spearman correlation analysis was applied to analyze the correlation between concurrent thyroid nodules and HOMA-IR.ROC curve was drawn to analyze the value of HOMA-IR in assessing the risk of thyroid nodules in elderly patients with T2DM.Results Among the 324 elderly T2DM patients,211 cases of thyroid nodules were detected,with a detection rate of 65.12%.The detection ratio of thyroid nodules in males and females was 1∶1.24.The thyroid nodule detection rate was different among patients with different levels of insulin resistance,and the detection rate of thyroid nodules in patients with HOMA-IR>2.0 was higher than that in patients with HOMA-IR≤2.0(P<0.05).Correlation analysis indicated that HOMA-IR was positively correlated with thyroid nodule in elderly T2DM patients(r=0.650,P<0.05).ROC curve revealed that the area under the curve(AUC),sensitivity,and specificity of HOMA-IR in evaluating thyroid nodules were 0.911,81.99%,and 96.46%,respectively.Conclusion The risk of thyroid nodules is high in elderly patients with T2DM,and the detection rate in women is higher than that in men,which is closely related to insulin resistance level.HOMA-IR values can provide a reference for the early evaluation of thyroid nodules in elderly T2DM patients.

关 键 词：2型糖尿病 甲状腺结节 胰岛素抵抗 关联性 评估价值 

分 类 号：R181[医药卫生—流行病学]