绝经后2型糖尿病患者内分泌激素及糖脂代谢指标与甲状腺结节相关性  

Correlation between endocrine hormone and glucolipid metabolism indexes and thyroid nodules in postmenopausal patients with type 2 diabetes mellitus

作　　者：崔露丹 吴晓菲 周兴建 CUI Ludan;WU Xiaofei;ZHOU Xingjian(Department of Endocrinology,Postgraduate Joint Cultivation Base of Xiangyang No.1 People's Hospital Affiliated to Hubei Medical College,Jinzhou Medical University,Xiangyang,Hubei 441000,China;Department of Endocrinology,Xiangyang No.1 People's Hospital Affiliated to Hubei Medical College,Xiangyang,Hubei 441000,China)

机构地区：[1]锦州医科大学湖北医药学院附属襄阳市第一人民医院研究生联合培养基地内分泌科,湖北襄阳441000 [2]湖北医药学院附属襄阳市第一人民医院内分泌科,湖北襄阳441000

出　　处：《中国医学工程》2025年第3期28-34,共7页China Medical Engineering

基　　金：湖北省教育厅科学技术研究项目(B2014051)。

摘　　要：目的 探索并评估绝经后女性2型糖尿病(T2DM)患者内分泌激素及糖脂代谢指标与甲状腺结节相关性,进一步为甲状腺结节筛查提供新思路,帮助甲状腺结节的诊断治疗和预后评估。方法 回顾性收集襄阳市第一人民医院2022年1月至2023年7月159例T2DM患者临床资料,将其分为甲状腺结节组(118例)和非甲状腺结节组(41例),根据TIRADS分级将甲状腺结节分为1~2级亚组、3级亚组、4级及以上亚组,根据结节的直径分为直径<0.5 cm组、0.5 cm≤直径<1.0 cm组、直径≥1.0 cm组。测定各组糖脂代谢指标、甲状腺激素、性激素指标及一般资料;采用Logistic回归分析评估影响因素与甲状腺结节的相关性。结果 绝经后T2DM人群中甲状腺结节的患病率为74.2%。以有无结节分组,与非结节组相比,矫正年龄因素后,结节组黄体生成素(LH)、空腹胰岛素(FINS)水平高于非结节组(P<0.05);以TI-RADS分级分组,LH与TI-ARDS分级呈正相关(O^R=1.061,P=0.024),与游离三碘甲状腺原氨酸(FT3)呈负相关(O^R=0.417,P=0.042);以结节直径分组,糖化血红蛋白(HbA1c)与结节大小呈正相关(O^R=1.365,P=0.007)。结论 LH、FINS是甲状腺结节发生的独立危险因素,LH、HbA1c、FT3水平紊乱,可能会参与绝经后T2DM患者甲状腺结节的形成,影响结节的TI-RADS分级。【Objective】To explore and assess the correlation of endocrine hormones and glycolipid metabolism indexes with thyroid nodules in postmenopausal women with type 2 diabetes mellitus(T2DM),to further provide new ideas for thyroid nodule screening,and to help in the diagnosis and treatment of thyroid nodules and prognosis assessment.【Methods】The clinical data of 159 patients with T2DM in Xiangyang No.1 People's Hospital were retrospectively collected from January 2022 to July 2023,and they were divided into the thyroid nodule group(118 cases)and the non-thyroid nodule group(41 cases).The thyroid nodules were divided into the subgroups of grades 1-2,subgroups of grades 3,and subgroups of grades 4 and above according to the TI-RADS classification,and the nodules were into diameter<0.5 cm group,0.5 cm≤diameter<1.0 cm group,and diameter≥1.0 cm group.Glycolipid metabolism indexes,thyroid hormone,sex hormone indexes and general information of each group were measured.Logistic regression analysis was used to evaluate the correlation between the influencing factors and thyroid nodules.【Results】The prevalence of thyroid nodules in the postmenopausal T2DM population was 74.2%.Grouped by the presence or absence of nodules,the levels of luteinising hormone(LH)and fasting insulin(FINS)were higher in the nodule group compared with the non-nodule group after correcting for the age factor(P<0.05).Grouped by the TI-RADS grading,the LH was positively correlated with the TI-ARDS grading(O^R=1.061,P=0.024),and negatively correlated with the free triiodothyronine(FT3)(O^R=0.417,P=0.042).Grouped by the nodule diameter,glycosylated haemoglobin(HbA1c)was positively correlated with nodule size(O^R=1.365,P=0.007).【Conclusion】LH and FINS are independent risk factors for the development of thyroid nodules,and disturbed levels of LH,HbA1c,and FT3 may be involved in the formation of thyroid nodules in postmenopausal patients with type 2 diabetes,affecting the TI-RADS classification of the nodules.

关 键 词：2型糖尿病 甲状腺结节 内分泌激素 绝经 

分 类 号：R581[医药卫生—内分泌]