大连医科大学学报
大連醫科大學學報
대련의과대학학보
Journal of Dalian Medical University
2015年
5期
488-492
,共5页
甲状腺结节%2型糖尿病%降糖药物%二甲双胍
甲狀腺結節%2型糖尿病%降糖藥物%二甲雙胍
갑상선결절%2형당뇨병%강당약물%이갑쌍고
thyroid nodules%type 2 diabetic mellitus%antidiabetic drugs%metformin
目的：调查采用不同降糖药物治疗的甲状腺功能正常的2型糖尿病患者甲状腺结节的患病情况并进行相关因素分析。方法收集甲状腺功能正常、服用降糖药物≥1年且降糖方案未改变的2型糖尿病患者220例，根据降糖方案分6组，A组单独二甲双胍治疗，B组单独促胰岛素分泌剂治疗，C组单纯胰岛素治疗，D组二甲双胍＋胰岛素治疗，E组胰岛素＋促胰岛素分泌剂、二甲双胍之外的其他降糖口服药治疗，F组：其他降糖口服药联合或单独（多数是阿卡波糖）治疗，分析各组甲状腺结节的患病情况及影响因素。结果220例患者有72．3％存在甲状腺结节。甲状腺结节检测情况随糖尿病病程（OR＝1．078，95％CI：1．023－1．137，P＝0．005）增长、年龄（OR＝1．031，95％CI：1．004－1．058，P＝0．022）增大而增加。 A组甲状腺结节检出率最低，与A组（63．9％）相比，C组（80．0％）和D组（84．4％）结节检出率明显增高（P＜0．05）。以A组为参照组，经性别、年龄、BMI、TSH、甘油三酯、HOMA－IR、糖尿病病程、服药时间校正后，logistic回归分析发现其余5组均不影响甲状腺结节的发生风险（ P＞0．05）。结论住院2型糖尿病患者甲状腺结节患病情况较为普遍，糖尿病长病程及增龄均会增加甲状腺结节患病风险，高胰岛素血症可能是甲状腺结节发病促进因素。本次调查没有发现降糖药物与结节患病风险增加相关。
目的：調查採用不同降糖藥物治療的甲狀腺功能正常的2型糖尿病患者甲狀腺結節的患病情況併進行相關因素分析。方法收集甲狀腺功能正常、服用降糖藥物≥1年且降糖方案未改變的2型糖尿病患者220例，根據降糖方案分6組，A組單獨二甲雙胍治療，B組單獨促胰島素分泌劑治療，C組單純胰島素治療，D組二甲雙胍＋胰島素治療，E組胰島素＋促胰島素分泌劑、二甲雙胍之外的其他降糖口服藥治療，F組：其他降糖口服藥聯閤或單獨（多數是阿卡波糖）治療，分析各組甲狀腺結節的患病情況及影響因素。結果220例患者有72．3％存在甲狀腺結節。甲狀腺結節檢測情況隨糖尿病病程（OR＝1．078，95％CI：1．023－1．137，P＝0．005）增長、年齡（OR＝1．031，95％CI：1．004－1．058，P＝0．022）增大而增加。 A組甲狀腺結節檢齣率最低，與A組（63．9％）相比，C組（80．0％）和D組（84．4％）結節檢齣率明顯增高（P＜0．05）。以A組為參照組，經性彆、年齡、BMI、TSH、甘油三酯、HOMA－IR、糖尿病病程、服藥時間校正後，logistic迴歸分析髮現其餘5組均不影響甲狀腺結節的髮生風險（ P＞0．05）。結論住院2型糖尿病患者甲狀腺結節患病情況較為普遍，糖尿病長病程及增齡均會增加甲狀腺結節患病風險，高胰島素血癥可能是甲狀腺結節髮病促進因素。本次調查沒有髮現降糖藥物與結節患病風險增加相關。
목적：조사채용불동강당약물치료적갑상선공능정상적2형당뇨병환자갑상선결절적환병정황병진행상관인소분석。방법수집갑상선공능정상、복용강당약물≥1년차강당방안미개변적2형당뇨병환자220례，근거강당방안분6조，A조단독이갑쌍고치료，B조단독촉이도소분비제치료，C조단순이도소치료，D조이갑쌍고＋이도소치료，E조이도소＋촉이도소분비제、이갑쌍고지외적기타강당구복약치료，F조：기타강당구복약연합혹단독（다수시아잡파당）치료，분석각조갑상선결절적환병정황급영향인소。결과220례환자유72．3％존재갑상선결절。갑상선결절검측정황수당뇨병병정（OR＝1．078，95％CI：1．023－1．137，P＝0．005）증장、년령（OR＝1．031，95％CI：1．004－1．058，P＝0．022）증대이증가。 A조갑상선결절검출솔최저，여A조（63．9％）상비，C조（80．0％）화D조（84．4％）결절검출솔명현증고（P＜0．05）。이A조위삼조조，경성별、년령、BMI、TSH、감유삼지、HOMA－IR、당뇨병병정、복약시간교정후，logistic회귀분석발현기여5조균불영향갑상선결절적발생풍험（ P＞0．05）。결론주원2형당뇨병환자갑상선결절환병정황교위보편，당뇨병장병정급증령균회증가갑상선결절환병풍험，고이도소혈증가능시갑상선결절발병촉진인소。본차조사몰유발현강당약물여결절환병풍험증가상관。
Objectives To investigate if the use of anti-diabetic drugs affect the presence of thyroid nodules in euthyroid patients with type 2 diabetes mellitus (T2DM).Methods Two hundred and twenty patients with T2DM hospitalized for poor glycemic control were enrolled.All patients wer treated by different hypoglycemic agents with unchanged regime for more than one year.Patients were subgrouped into six groups according to their hypoglycemic modalities:group A, patients who used only metformin;group B, only insulinotropic agents;group C, only insulin;group D, insulin with metformin;group E, insulin with other oral antidiabetic agents; and group F, other oral antidiabetic agents in combination or only ( mostly acarbose) .The presence of thyroid nodules in each group were summarized.Results The frequency of thyroid nodules in this study group of patients with type 2 diabetes mellitus was found to be 72.3%,and there was trend toward a higher frequency in older patients(OR=1.031,95%CI:1.004-1.058,P=0.022) and with longer duration of diabetes (OR=1.078, 95%CI:1.023-1.137,P=0.005).Group A had a lower incidence of thyroid nodules than with other anti -diabetic drugs.Compared with group A (63.9%), the frequency of thyroid nodules in group C (80.0%), and group D (84.4%)were higher (P<0.05).Using group A as a reference, logistic regression analysis was conducted to analyze hazard risk between thyroid nodules and different hypoglycemic modalities.The frequency of thyroid nodules was not different among the patient with different hypoglycemic modalities.Conclusion Thyroid nodule is common in hospitalized euthyroid patients with type 2 diabetes.Longer duration of diabetes, advanced age, higher level of insulin increased thyroid nodules frequen-cy.No association was found among different hypoglycemic agents with development of thyroid nodules.
