CAJ | 학술논문

目的：探讨糖代谢异常与甲状腺结节的相关性。方法选取同济大学附属杨浦医院于2014年4—12月在上海市杨浦区社区（定海、殷行、江浦、长白等）进行流行病学调查人群4036例。记录受试者临床资料，检测血压、血糖、血脂水平，根据血糖水平将受试者分为正常血糖组和糖代谢异常组，均行甲状腺B超检查。比较两组临床资料、实验室检查指标及甲状腺结节发生率，采用多因素Logistic回归分析甲状腺结节发生的影响因素。结果正常血糖组1995例，其中男611例、女1384例，糖代谢异常组2041例，其中男686例、女1355例，两组性别比较差异有统计学意义（χ2＝4.120， P＝0.042）。两组身高、舒张压比较，差异均无统计学意义（P＞0.05）；糖代谢异常组年龄、体质量、体质指数（ BMI ）、腰围、臀围、收缩压、空腹血糖（ FBG ）、餐后2 h 血糖（2 hPBG ）、三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL－C）水平均高于正常血糖组（P＜0.05），高密度脂蛋白胆固醇（HDL－C）水平低于正常血糖组（P＜0.05）。糖代谢异常组甲状腺结节、多发结节、两叶结节发生率均高于正常血糖组（ P＜0.05）；两组单发结节、左叶结节、右叶结节、峡部结节、结节大于1 cm、伴钙化、伴弥漫性病变、囊性结节、混合性结节发生率比较，差异均无统计学意义（ P＞0.05）。多因素Logistic回归分析结果显示，性别、年龄、糖代谢异常与甲状腺结节的发生有回归关系（ P＜0.05）。结论糖代谢异常人群甲状腺结节发生率高，且多为多发、两叶结节。性别、年龄、糖代谢异常与甲状腺结节的发生有关。
목적：탐토당대사이상여갑상선결절적상관성。방법선취동제대학부속양포의원우2014년4—12월재상해시양포구사구（정해、은행、강포、장백등）진행류행병학조사인군4036례。기록수시자림상자료，검측혈압、혈당、혈지수평，근거혈당수평장수시자분위정상혈당조화당대사이상조，균행갑상선B초검사。비교량조림상자료、실험실검사지표급갑상선결절발생솔，채용다인소Logistic회귀분석갑상선결절발생적영향인소。결과정상혈당조1995례，기중남611례、녀1384례，당대사이상조2041례，기중남686례、녀1355례，량조성별비교차이유통계학의의（χ2＝4.120， P＝0.042）。량조신고、서장압비교，차이균무통계학의의（P＞0.05）；당대사이상조년령、체질량、체질지수（ BMI ）、요위、둔위、수축압、공복혈당（ FBG ）、찬후2 h 혈당（2 hPBG ）、삼선감유（TG）、총담고순（TC）、저밀도지단백담고순（LDL－C）수평균고우정상혈당조（P＜0.05），고밀도지단백담고순（HDL－C）수평저우정상혈당조（P＜0.05）。당대사이상조갑상선결절、다발결절、량협결절발생솔균고우정상혈당조（ P＜0.05）；량조단발결절、좌협결절、우협결절、협부결절、결절대우1 cm、반개화、반미만성병변、낭성결절、혼합성결절발생솔비교，차이균무통계학의의（ P＞0.05）。다인소Logistic회귀분석결과현시，성별、년령、당대사이상여갑상선결절적발생유회귀관계（ P＜0.05）。결론당대사이상인군갑상선결절발생솔고，차다위다발、량협결절。성별、년령、당대사이상여갑상선결절적발생유관。
Objective To investigate the correlation between abnormal glucose metabolism and thyroid nodule.Methods Enrolled 4 036 people who received epidemiological survey conducted by Yangpu Hospital Affiliated to Tongji University from April to December, 2014 in the communities ( Dinghai, Yinhang, Jiangpu, Changbai, ect.) of Yangpu District in Shanghai.Clinical data were recorded , and blood pressure , blood glucose and blood lipid level were examined.According to blood glucose level , the subjects were divided into normal blood glucose group and abnormal glucose metabolism group.Thyroid B-ultrasonic examination was undertaken on all the subjects.Comparison was made between the two groups in clinical data , laboratory examination results and the incidence of thyroid nodule.Multivariate Logistic regression analysis was conducted to analyze the influencing factors for thyroid nodule.Results Normal blood glucose group had 1 995 people, 611 males and 1 384 females, and abnormal glucose metabolism group had 2 041 people, 686 males and 1 355 females, with significant differences between the two groups (χ2 =4.120, P=0.042) .The two groups were not significantly different in height and DBP (P>0.05) .The abnormal glucose metabolism group was higher (P<0.05) in age, body weight, BMI, waistline, hipline, SBP, FBG, 2 hPBG, TG, TC and LDL-C level and was lower (P<0.05) in HDL-C level than normal blood glucose group.Abnormal glucose metabolism was higher ( P<0.05 ) than normal blood glucose group in the incidence rates of thyroid nodule , multiple nodule and two leaf nodule.The two groups were not significantly different in the incidence rates of solitary nodule, left leaf nodule, right leaf nodule, isthmus nodule, nodule longer than 1 cm, calcification, diffuse lesion, cystic nodule and mixed nodule ( P >0.05 ) .Multivariate Logistic regression analysis showed that gender , age, abnormal glucose metabolism had regression relation with thyroid nodule ( P <0.05 ) .Conclusion Patients with abnormal glucose metabolism have higher incidence of thyroid nodule , mostly in the forms of two leaf nodule and multiple nodule.Gender, age and abnormal glucose metabolism have correlation with the occurrence of thyroid nodule.