糖化血红蛋白在身体质量指数与甲状腺结节患病关联作用的中介效应研究  

Study on the mediating effect of glycated hemoglobin on the association between body mass index and thyroid nodule

作　　者：朱路 李冠澎 湛梓剑 周晨雨 陈洋 陆锦萍 孔令权 卓兰 宋嘉宜 张建清 ZHU Lu;LI Guan-peng;ZHAN Zi-jian;ZHOU Chen-yu;CHEN Yang;LU Jin-ping;KONG Ling-quan;ZHUO Lan;SONG Jia-yi;ZHANG Jian-qing(Academy of Medical Sciences,Shanxi Medical University,Taiyuan,Shanxi 030001,China;不详)

机构地区：[1]山西医科大学医学科学院,山西太原030001 [2]南方科技大学公共卫生及应急管理学院 [3]深圳市疾病预防控制中心

出　　处：《现代预防医学》2025年第4期742-748,共7页Modern Preventive Medicine

基　　金：国家自然科学基金面上项目(22176132);深圳市科创委面上项目(JCYJ20210324135000001);广东省医学科研基金(20221119115615564);深圳市医科院项目(B2403008)。

摘　　要：目的探讨糖化血红蛋白(Glycated hemoglobin,HbA1c)在身体质量指数(Body Mass Index,BMI)与甲状腺结节关联的中介效应,分析BMI升高对甲状腺结节患病的影响机制。方法选取2020年12月至2023年10月在深圳市某三甲医院体检的1627名研究对象,收集其人口学、体格检查和生化检测等信息,采用logistic回归分析BMI、HbA1c与甲状腺结节的关联;采用bootstrap法评估HbA1c在BMI与甲状腺结节关联的中介效应。结果1627名研究对象中男性520人,女性1107人,男女占比分别为32.0%和68.0%,甲状腺结节检出率为40.9%(666/1627)。结节组与非结节组的年龄、BMI、职业、文化程度、食盐摄入情况、HbA1c、碱性磷酸酶水平差异均有统计学意义(P<0.05)。多因素分析显示,BMI和HbA1c水平升高均为甲状腺结节的危险因素,OR(95%CI)分别为1.038(1.002~1.075)和1.297(1.060~1.587)。中介效应分析表明HbA1c部分介导了BMI对甲状腺结节患病的影响(β=0.018,95%CI[0.007~0.035]),HbA1c在BMI与甲状腺结节关联间的中介效应占比为31.58%。结论BMI和HbA1c是甲状腺结节发生风险的影响因素,HbA1c部分介导了BMI对甲状腺结节发病率的影响。Objective To explore the mediating effect of glycated hemoglobin(HbA1c)on the association between body mass index(BMI)and thyroid nodules,and analyze the mechanisms of how an increase in BMI contributes to the development of thyroid nodules.Methods We selected 1627 individuals who underwent health examinations at a hospital in Shenzhen from December 2020 to October 2023.Demographic data,physical examination,and biochemical test information were collected.Logistic regression was used to analyze the association between BMI,HbA1c,and thyroid nodules.The bootstrap method was used to assess the mediating effect of HbA1c on the relationship between BMI and thyroid nodules.Results Among the 1627 participants,there were 520 males and 1107 females,with males and females accounting for 32.0%and 68.0%of the sample,respectively.The detection rate of thyroid nodules was 40.9%(666/1627).Significant differences(P<0.05)were observed between the nodule group and the non-nodule group in terms of age,BMI,occupation,education level,salt intake,HbA1c,and alkaline phosphatase levels.Multivariate analysis indicated that elevated BMI and HbA1c levels were risk factors for thyroid nodules,with OR(95%CI)of 1.038(1.002-1.075)and 1.297(1.060-1.587),respectively.Mediation analysis showed that HbA1c partially mediated the effect of BMI on the prevalence of thyroid nodules(β=0.018,95%CI[0.007-0.035]),with the mediating effect of HbA1c accounting for 31.58%of the total effect.Conclusion BMI and HbA1c are influencing factors of the risk of thyroid nodules,with HbA1c partially mediating the impact of BMI on the incidence of thyroid nodules.

关 键 词：糖化血红蛋白 身体质量指数 甲状腺结节 

分 类 号：R581[医药卫生—内分泌]