Prevalence and risk factors of thyroid nodules in the elderly in iodine-sufficient areas

Abstract:

Objective To investigate the prevalence of thyroid nodules and thyroid cancer and the risk factors for thyroid nodules in a rural elderly population in iodine-sufficient areas of Jiangsu Province，China.Methods A cross-sectional survey was performed in iodine-sufficient areas of Jiangsu Province，investigating a total of 2 590 permanent residents aged ≥60 years selected by cluster sampling. They underwent physical examination and biochemical tests. Thyroid nodules were classified using the Thyroid Imaging Report and Data System（TI-RADS），part of which were examined for pathological information through an ultrasound-guided biopsy. A logistic regression analysis was used to analyze the risk factors for thyroid nodules.Results A total of 883 cases of thyroid nodules were detected in 2590 subjects. With an overall prevalence of 34.09%（883/2 590）. The prevalence of female subjects was significantly higher than that of male subjects（χ²=27.885，P=0.000）. There were significant differences in height（Ht），body mass index（BMI），fasting blood glucose（FBG），glycosylated hemoglobin（HbA1c），fasting insulin（FINS），triglyceride（TG），and 25-hydroxyvitamin D［25（OH）D］ between the participants with and without thyroid nodules（t=5.337、P=0.000，t=-5.160、P=0.000，t=-2.341、P=0.019，t=-4.993、P=0.000，t=-2.384、P=0.020，t=-2.940、P=0.003，t=6.432、P=0.000，respectively）. The prevalence of thyroid nodules in men increased with age. The overall detection rate of thyroid cancer in the elderly was 0.34%. The logistic regression analysis showed that the BMI and HbA1c hemoglobin were risk factors for thyroid nodules（OR=1.054，95%CI=1.028-1.081，P<0.01；OR=1.257，95%CI=1.117-1.414，P<0.01）.Conclusion Thyroid nodules are prevalent in the elderly in iodine-sufficient areas of Jiangsu Province，with a low prevalence of thyroid cancer. Glucose and lipid metabolism disorders are significantly related to the prevalence of thyroid nodules.