适碘地区老年人群糖代谢紊乱与甲状腺结节患病率的相关性

Association between glucose metabolism disorder and prevalence of thyroid nodule in the elderly in iodine-adequate area

摘要:

目的： 调查适碘地区老年人群甲状腺结节的患病率，探讨老年人群糖代谢指标与甲状腺结节的相关性。方法： 选取江苏省宿迁市和徐州市共2 037例老年人（男1 045例，51.3%）进行体格检查、生化检测及甲状腺超声检查。采用logistic回归分析糖代谢指标与甲状腺结节患病、结节个数、结节大小、结节良性和可疑恶性之间的关系。结果： 适碘老年人群甲状腺结节的患病率为35.1%，其中42.4%为多发结节，33.9%的结节≥1 cm。有甲状腺结节组与无甲状腺结节组、单个结节组和多个结节组以及结节<1 cm组和结节≥1 cm组相比，性别、腰围、空腹胰岛素、胰岛素抵抗指数水平差异有统计学意义（均P<0.05）。logistic回归模型校正混杂因素后，空腹血糖、糖化血红蛋白、胰岛素抵抗指数与甲状腺结节患病、甲状腺结节大小相关。结论： 适碘地区老年人甲状腺结节的患病率较高。糖代谢紊乱与甲状腺结节患病、结节大小密切相关。

Abstract:

Objective: To investigate the prevalence of thyroid nodules in the elderly in iodine-adequate area, and to explore the correlation between glucose metabolism disorders and thyroid nodules in the elderly. Methods: A total of 2 037 elderly people (1 045 males, 51.3%) were enrolled from Suqian and Xuzhou in Jiangsu Province. All the participants underwent physical examination, biochemical test, and thyroid ultrasonography. Logistic regression was used to analyze the relationship between glucose metabolism and thyroid nodule prevalence, thyroid nodule number, thyroid nodule size, benign thyroid nodules and suspected malignant nodules. Results: The prevalence of thyroid nodules in the elderly in iodine-adequate area was 35.1%, of which 42.4%were multiple nodules and 33.9%were nodules≥1 cm. There were significant differences in sex, waist circumference, fasting insulin level and insulin resistance index between the groups with and without thyroid nodules, single thyroid nodule group and multiple thyroid nodule group and nodule<1 cm group and nodule≥1 cm group (all P<0.05) . After the confounding factors were adjusted by the logistic regression model, results showed that fasting blood glucose, glycosylated hemoglobin and insulin resistance index were associated with the risk of thyroid nodule occurrence and the size of thyroid nodules. Conclusion: Thyroid nodules is prevalent in the elderly in iodine-adequate area. Glucose metabolism disorder is significantly related to the prevalence and size of thyroid nodules.