老年女性2型糖尿病合并代谢相关脂肪性肝病患者血清维生素D与甲状腺结节的相关性分析  

Correlation analysis between serum vitamin D and thyroid nodules in elderly women with type 2 diabetes mellitus complicated with metabolic dysfunction-associated fatty liver disease

作　　者：张媛君 刘菊香[2] 吕亚亚 权金星 ZHANG Yuanjun;LIU Juxiang;LYU Yaya;QUAN Jinxing(The First School of Clinical Medicine,Lanzhou University,Lanzhou,Gansu 730099,China;Department of Endocrinology,Gansu Provincial Hospital,Lanzhou,Gansu 730099,China)

机构地区：[1]兰州大学第一临床医学院,甘肃兰州730099 [2]甘肃省人民医院内分泌科,甘肃兰州730099

出　　处：《医药前沿》2025年第9期16-19,共4页Journal of Frontiers of Medicine

基　　金：甘肃省自然科学基金(22JR5RA657);甘肃省人民医院科技创新平台基金青年资助项目(21GSSYC-7)。

摘　　要：目的分析老年女性2型糖尿病(T2DM)合并代谢相关脂肪性肝病(MAFLD)患者血清维生素D水平与甲状腺结节(TN)患病风险的相关性。方法回顾性分析2019年1月—2023年2月在甘肃省人民医院内分泌科住院的191例老年女性T2DM合并MAFLD患者的临床资料,以是否患有TN将其分为有TN组(n=107)和无TN组(n=84)。比较两组患者维生素D缺乏患病率,通过Pearson相关分析及二元Logistic回归分析评估维生素D与各项指标的相关性及T2DM合并MAFLD患者患TN的影响因素。结果有TN组25羟维生素D[25(OH)D]水平低于无TN组(P<0.05),同型半胱氨酸(Hcy)和C反应蛋白(CRP)水平高于无TN组(P<0.05)。25(OH)D水平与HDL-C呈正相关(P<0.05),与CRP、空腹血糖、糖化血红蛋白、三酰甘油呈负相关(P<0.05)。25(OH)D≥20 ng/mL是T2DM合并MAFLD患者患TN的保护因素,CRP≥6mg/L及Hcy≥15μmol/L是T2DM合并MAFLD患者患TN的危险因素(P<0.05)。结论血清维生素D水平高是患TN的保护因素,对其进行监测可为老年女性T2DM合并MAFLD患者患TN的预测和诊断提供依据。Objective To explore the correlation between serum vitamin D level and the onset risk of thyroid nodules(TN)in elderly women with type 2 diabetes mellitus(T2DM)complicated with metabolic dysfunction-associated fatty liver disease(MAFLD).Methods The clinical data of 191 elderly female patients with T2DM and MAFLD who were hospitalized in Department of Endocrinology,Gansu Provincial Hospital from January 2019 to February 2023 were retrospectively analyzed.The patients were divided into TN group(n=107)and non-TN group(n=84)according to whether they had TN or not.The prevalence rate of vitamin D deficiency was compared between the two groups.The correlations between vitamin D and various indicators and the influencing factors of TN in patients with T2DM complicated with MAFLD were evaluated by Pearson correlation analysis and binary Logistic regression analysis.Results The level of 25-hydroxyvitamin D[25(OH)D]in the TN group was lower than that in the non-TN group(P<0.05),and the levels of homocysteine(Hcy)and C-reactive protein(CRP)were higher than those in the non-TN group(P<0.05).The 25(OH)D level was positively correlated with HDL-C(P<0.05),and negatively correlated with CRP,fasting blood glucose,glycosylated hemoglobin and triglyceride(P<0.05).The 25(OH)D equal or more than 20 ng/mL was a protective factor,while CRP equal or more than 6 mg/L and Hcy equal or more than 15μmol/L were risk factors for TN onset in patients with T2DM complicated with MAFLD(P<0.05).Conclusions High serum vitamin D level may be a protective factor for thyroid nodules,and monitoring the level actively may provide a basis for the prediction,diagnosis and treatment of thyroid nodules in elderly women with T2DM complicated with MAFLD.

关 键 词：2型糖尿病 维生素D缺乏 代谢相关脂肪性肝病 甲状腺结节 老年女性 

分 类 号：R587[医药卫生—内分泌]