中老年人甲状腺功能与结直肠腺瘤性息肉关系的研究

Relationship between colorectai adenomatous polyps and thyroid function in middle-aged and elderly people

目的探讨中老年人群甲状腺功能与结直肠腺瘤性息肉（CAP）间的关系。方法选取2008年3月-2011年10月体检时做结肠镜检查的≥45岁企业在职和退休员工3042名，根据结肠镜和病理学检查结果分为CAP组（425例）和结肠镜检查未见异常的非CAP组（2617例）；同时以血清游离三碘甲状腺原氮酸（FT3，）3．8～6．0pmol／L为依据，分为〈3．8pmoL／L组、3．8～6．0pmol／L组和〉6．0pmol／L组；对各组结肠镜及病理学检查结果、BMI和甲状腺功能等指标进行分析。结果女性CAP组的年龄、血FT3高于非CAP组，分别为（60±8）与（57±8）岁、4．9[M（4．3，5．6）]与4．5[M（4．2，4．9）]pmol／L；男性CAP组的年龄、腰围高于非CAP组，分别为（62±9）岁与（58±9）岁、（87±8）cm与（85±9）cm，两者差异均有统计学意义。男性CAP检m率高于女性（17．6％与8．5％），差异有统计学意义（X2=49．418，P〈0．01）。女性FT3〉6．0pmol／L组CAP检出率高于〈3．8pmol／L组和3．8～6．0pmol／L组（31．6％、10．9％、8．0％），差异均有统计学意义（X2值分别为4．726、10．620，P值分别为0．03、0．001）。多因素非条件logistic回归分析显示，甲状腺功能对CAP的影响因性别而异，女性年龄、FT3，（OR=1．60，95％CI：1．12～2．28，P=0．01）与CAP相关；男性仅年龄、腰围与CAP相关。结论较高的FL水平可能是中老年女性患CAP的危险因素，男性似乎不受影响。

Objective To explore the relationship between thyroid hormone and colorectal adeuomatous polyps （CAP） in middle-aged and elderly people. Methods We surveyed 3 042 middle-aged employees and retirees aged 45 years and over at a petrochemical enterprise of Ningbo. Their colonoseopic findings, body mass index, waist circumference and thyroid function were analyzed. Results Age and serum free triiodothyronine （ FT3 ） of females with CAP were higher than those of the corresponding non-CAP group, so were age and waist circumference of males with CAP （P 〈 0. 05）. Furthermore, these differences were statistically significant. The detection rate of CAP was significantly higher in males than in females （X： =49. 418, P 〈 0. 01 ）. The detection rate of CAP was higher in females with higher levels of FT3. Multivariate unconditional logistic, regression analyses showed the effects of thyroid hormone on the CAP differed by gender. Age and FT3 （ OR = 1.60, 95% CI： 1.12 - 2.28, P = 0. 01 ） were correlated with CAP in females. However, only age and waist circumference were correlated with CAP in males. Conclusion Elevated FT3 may be a risk factor of CAP in elderly females. The detection rate of CAP may not be affected by FT3 levels in males.