高龄老年糖尿病合并甲状腺结节相关性因素分析

Correlation analysis between type 2 diabetes mellitus and thyroid nodules in elderly patients

目的探讨高龄2型糖尿病(年龄≥80岁)患者甲状腺结节患病情况及其相关性。方法选取高龄老年糖尿病患者(糖尿病组)和高龄非糖尿病者(对照组)各103例,通过采集病史和检测空腹血糖、甲状腺激素及甲状腺彩超等结果,比较两组人群甲状腺结节特点并分析与其他指标间的相关性。结果 (1)糖尿病组甲状腺结节的患病率(84.47%)明显高于对照组(70.59%),且糖尿病组甲状腺多发结节比率较高,达80.46%;是否患甲状腺结节与年龄相关(χ2=7.060,P<0.05),与性别、体质指数及血糖水平无明显相关。(2)糖尿病组的甲状腺功能异常阳性率为15.53%,高于对照组6.80%(P<0.05)。其中亚临床甲减患病率在糖尿病组和对照组间分布无统计学差异。糖尿病组的甲状腺功能T3、T4水平均低于对照组,差异具有统计学意义(P<0.05),而促甲状腺激素(TSH)水平在两组间无统计学差异。结论高龄老年糖尿病患者甲状腺疾病患病率较高,可能会影响糖尿病控制和预后,应定期筛查并随访高龄糖尿病人群的甲状腺功能和形态学改变。

Objective To investigate the prevalence of thyroid nodules in elderly patients（age≥80years）with type 2diabetes mellitus（T2DM）,and to analyze the correlation between thyroid nodules and type 2diabetes mellitus.Methods The study included two groups：one group included 103 patients with T2DM（diabetic group）and the other group included 103 patients without T2DM（control group）.Information including clinical history,fasting plasma glucose（FPG）,thyroid hormone,and ultrasonic finding of thyroid glands was collected for both groups.The clinical features of thyroid nodules were compared between the two groups and their relationship with other indices was analyzed.Results（1）The prevalence rate of thyroid nodules in diabetic group was greatly higher than that of the control group（84.47% vs 70.59%）.The proportion of patients with multiple nodules was as high as 80.46% in the diabetic group.Presence of thyroid nodule was significantly associated with patient ages（χ2=7.060,P〈0.05）,but not with gender,body mass index（BMI）,or serum glucose level.（2）The positive rate of thyroid dysfunction in the diabetic group was significantly higher than that in the control group（15.53% vs6.80%,P〈0.05）.The prevalence rates of sub-clinical hypothyroidism were similar between the two groups.T3 and T4levels of thyroid function in the diabetic group were significantly lower than those in the control group（P〈0.05）,and the thyroid stimulating hormone（TSH）levels were similar between the two groups.Conclusion Elderly patients（age≥80years）have a higher liability for thyroid disease,which may affect the control and prognosis of diabetes.It is recommended for those patients to receive regular check-up for thyroid function and morphology changes.