国际内分泌代谢杂志
國際內分泌代謝雜誌
국제내분비대사잡지
International Journal of Endocrinology and Metabolism
2015年
5期
293-297
,共5页
甲状腺结节%代谢综合征%胰岛素抵抗
甲狀腺結節%代謝綜閤徵%胰島素牴抗
갑상선결절%대사종합정%이도소저항
Thyroid nodule%Metabolic syndrome%Insulin resistance
目的 研究甲状腺结节与代谢综合征(MS)及其组分的关系,并对其机制进行探讨.方法 回顾性分析2014年佛山市中医院的3 855名体检者的体检资料.将体检者分别分成MS组和非MS组,胰岛素低抗(IR)组和非IR组.检测身高、体重、血压、空腹血糖、血脂、尿酸等指标.检测促甲状腺激素(TSH)、游离T3、游离T4以评估甲状腺功能.检测空腹血清胰岛素水平,计算稳态模型评估-胰岛素抵抗指数(HOMA-IR),以评估IR情况.使用彩色多普勒超声检查脂肪肝及甲状腺结节的患病情况.结果 (1)共1 455人患甲状腺结节,患病率37.74％.女性患病率高于男性(46.57％vs.32.28％,x2 =79.073,P＜0.01).按年龄分层,在70岁以下人群,甲状腺结节的患病率随年龄增长而上升(P＜0.05).(2)MS组的甲状腺结节患病率显著高于非MS组(50.14％vs.36.47％,x2=25.888,P＜0.01).MS组分超重、高血糖、高血压患者的甲状腺结节患病率也显著升高(42.15％ vs.36.06％,x2=12.515,P ＜0.01;49.92％ vs.35.46％,x2=45.623,P ＜0.01;57.57％ vs.35.84％,x2=61.759,P＜0.01).(3)MS组血清TSH及HOMA-IR水平明显高于非MS组(t=4.763,P＜0.01;t=5.028,P＜0.01).(4) IR组的甲状腺结节患病率显著高于非IR组(67.00％ vs.33.32％,x2=212.115,P＜0.01).(5)多因素Logistic逐步回归分析显示,甲状腺结节的发生与性别、年龄、体重指数、收缩压、MS、IR独立相关(β=0.751,P＜0.01;β=0.061,P＜0.01;β=0.062,P＜0.01;β=0.006,P=0.047;β=0.069,P＜0.01;β=0.725,P＜0.01),与TSH无明显相关.结论 MS患者的甲状腺结节患病率显著升高,其机制可能与IR有关.
目的 研究甲狀腺結節與代謝綜閤徵(MS)及其組分的關繫,併對其機製進行探討.方法 迴顧性分析2014年彿山市中醫院的3 855名體檢者的體檢資料.將體檢者分彆分成MS組和非MS組,胰島素低抗(IR)組和非IR組.檢測身高、體重、血壓、空腹血糖、血脂、尿痠等指標.檢測促甲狀腺激素(TSH)、遊離T3、遊離T4以評估甲狀腺功能.檢測空腹血清胰島素水平,計算穩態模型評估-胰島素牴抗指數(HOMA-IR),以評估IR情況.使用綵色多普勒超聲檢查脂肪肝及甲狀腺結節的患病情況.結果 (1)共1 455人患甲狀腺結節,患病率37.74％.女性患病率高于男性(46.57％vs.32.28％,x2 =79.073,P＜0.01).按年齡分層,在70歲以下人群,甲狀腺結節的患病率隨年齡增長而上升(P＜0.05).(2)MS組的甲狀腺結節患病率顯著高于非MS組(50.14％vs.36.47％,x2=25.888,P＜0.01).MS組分超重、高血糖、高血壓患者的甲狀腺結節患病率也顯著升高(42.15％ vs.36.06％,x2=12.515,P ＜0.01;49.92％ vs.35.46％,x2=45.623,P ＜0.01;57.57％ vs.35.84％,x2=61.759,P＜0.01).(3)MS組血清TSH及HOMA-IR水平明顯高于非MS組(t=4.763,P＜0.01;t=5.028,P＜0.01).(4) IR組的甲狀腺結節患病率顯著高于非IR組(67.00％ vs.33.32％,x2=212.115,P＜0.01).(5)多因素Logistic逐步迴歸分析顯示,甲狀腺結節的髮生與性彆、年齡、體重指數、收縮壓、MS、IR獨立相關(β=0.751,P＜0.01;β=0.061,P＜0.01;β=0.062,P＜0.01;β=0.006,P=0.047;β=0.069,P＜0.01;β=0.725,P＜0.01),與TSH無明顯相關.結論 MS患者的甲狀腺結節患病率顯著升高,其機製可能與IR有關.
목적 연구갑상선결절여대사종합정(MS)급기조분적관계,병대기궤제진행탐토.방법 회고성분석2014년불산시중의원적3 855명체검자적체검자료.장체검자분별분성MS조화비MS조,이도소저항(IR)조화비IR조.검측신고、체중、혈압、공복혈당、혈지、뇨산등지표.검측촉갑상선격소(TSH)、유리T3、유리T4이평고갑상선공능.검측공복혈청이도소수평,계산은태모형평고-이도소저항지수(HOMA-IR),이평고IR정황.사용채색다보륵초성검사지방간급갑상선결절적환병정황.결과 (1)공1 455인환갑상선결절,환병솔37.74％.녀성환병솔고우남성(46.57％vs.32.28％,x2 =79.073,P＜0.01).안년령분층,재70세이하인군,갑상선결절적환병솔수년령증장이상승(P＜0.05).(2)MS조적갑상선결절환병솔현저고우비MS조(50.14％vs.36.47％,x2=25.888,P＜0.01).MS조분초중、고혈당、고혈압환자적갑상선결절환병솔야현저승고(42.15％ vs.36.06％,x2=12.515,P ＜0.01;49.92％ vs.35.46％,x2=45.623,P ＜0.01;57.57％ vs.35.84％,x2=61.759,P＜0.01).(3)MS조혈청TSH급HOMA-IR수평명현고우비MS조(t=4.763,P＜0.01;t=5.028,P＜0.01).(4) IR조적갑상선결절환병솔현저고우비IR조(67.00％ vs.33.32％,x2=212.115,P＜0.01).(5)다인소Logistic축보회귀분석현시,갑상선결절적발생여성별、년령、체중지수、수축압、MS、IR독립상관(β=0.751,P＜0.01;β=0.061,P＜0.01;β=0.062,P＜0.01;β=0.006,P=0.047;β=0.069,P＜0.01;β=0.725,P＜0.01),여TSH무명현상관.결론 MS환자적갑상선결절환병솔현저승고,기궤제가능여IR유관.
Objective To investigate the association of thyroid nodule with metabolic syndrome (MS) and its components,and analyze the underlying mechanism.Methods A total of 3 855 subjects who received physical examination at Foshan Hospital of Traditional Chinese Medicine in 2014 were enrolled in this retrospective study,and were divided into MS group,non-MS group,insulin resistance(IR) group and non-IR group,respectively.Height,weight,blood pressure,fasting blood glucose,serum lipid profile and urine acid were measured.Thyroid function was evaluated by measuring serum thyroid stimulating hormone (TSH),free tri-iodothyronine (FT3) and thyroxine (FT4).Fasting plasma insulin was also measured.IR was estimated by homeostasis model assessment-insulin resistance (HOMA-IR).Fatty liver and thyroid nodules were detected by color Doppler ultrasonography.Results (1) Thyroid nodules were found in 1 455 subjects.The overall prevalence of thyroid nodule was 37.74％.The prevalence of thyroid nodules in women was significantly higher than that in men(46.57％ vs.32.28％,x2 =79.073,P ＜0.01).In those younger than 70 years old,the prevalence of thyroid nodule increased with age (P ＜ 0.05).(2) The prevalence of thyroid nodule was significantly higher in MS group than that in non-MS group (50.14％ vs.36.47％,x2 =25.888,P ＜ 0.01).Patients with MS components including overweight,hyperglycemia or hypertension also had higher thyroid nodule prevalence (42.15％ vs.36.06％,x2 =12.515,P ＜ 0.01;49.92％ vs.35.46％,x2=45.623,P＜0.01;57.57％ vs.35.84％,x2 =61.759,P＜0.01).(3)SerumTSH and HOMA-IR were significantly higher in MS group than those in non-MS group (t =4.763,P ＜ 0.01;t =5.028,P ＜ 0.01).(4) Compared with non-IR group,the prevalence of thyroid nodule in IR group was higher (67.00％ vs.33.32％,x2 =212.115,P ＜ 0.01).(5) In multivariate Logistic regression analysis,factors which were independently correlated with thyroid nodule formation were age,sex,body mass index,systolic blood pressure,MS as well as IR(β =0.751,P ＜0.01;β =0.061,P ＜0.01;β =0.062,P ＜0.01;β =0.006,P =0.047;β =0.069,P ＜ 0.01;β =0.725,P ＜ 0.01),but not TSH.Conclusion The prevalence of thyroid nodule in patients with MS is increased,which might be associated with IR.
