甲状腺功能正常2型糖尿病患者发生甲状腺结节危险因素分析

Risk factors of thyroid nodules in type 2 diabetes patients with normal thyroid function

目的分析甲状腺功能正常的2型糖尿病患者发生甲状腺结节的危险因素。方法将北部战区总医院自2016年1月至2018年6月收治的94例甲状腺功能正常伴甲状腺结节的2型糖尿病患者纳入结节组。将同期收治的468例无甲状腺结节的甲状腺功能正常的2型糖尿病患者纳入非结节组。回顾性分析两组患者的临床资料并进行比较,采用多因素Logistic回归分析危险因素。结果结节组和非结节组性别、体质量指数比较,差异有统计学意义(P<0.05)。性别、体质量指数18.5~23.9 kg/m^(2)、体质量指数24.0~27.9 kg/m^(2)、体质量指数≥28.0 kg/m^(2)、糖化血红蛋白是发生结节的独立危险因素(P<0.05),二甲双胍和胰岛素的使用、胰岛素抵抗指数与结节发生无关(P>0.05)。结论女性、肥胖、高糖化血红蛋白水平为糖尿病患者甲状腺结节发生的独立危险因素。

Objective To analyze the risk factors for thyroid nodules in type 2 diabetic patients with normal thyroid function.Methods A total of 94 patients with normal thyroid function and type 2 diabetes mellitus with thyroid nodules admitted to General Hospital of Northern Theater Command from January 2016 to June 2018 were included in the nodular group.A total of 468 patients with normal thyroid function and type 2 diabetes mellitus without thyroid nodules who were admitted during the same period were included in the non-nodular group.Clinical data of the two groups were retrospectively analyzed and compared,and risk factors were analyzed by multivariate Logistic regression.Results There were statistically significant differences in gender and body mass index between nodular group and non-nodular group(P<0.05).Gender,body mass index 18.5-23.9 kg/m^(2),body mass index 24.0-27.9 kg/m^(2),body mass index≥28.0 kg/m^(2) and hemoglobin a1 c were independent risk factors for nodules(P<0.05).Metformin,insulin use and insulin resistance index were not associated with nodule occurrence(P>0.05).Conclusion Female,obesity and high hemoglobin a1 c were independent risk factors for thyroid nodules in diabetic patients.