糖尿病前期胰岛素抵抗与甲状腺结节TI-RADS分级的相关性研究

Correlation Between Insulin Resistance and TI-RADS Category of Thyroid Nodules in Pre-diabetes

目的探讨糖尿病前期患者并发甲状腺结节的危险因素以及胰岛素抵抗程度与甲状腺结节TI-RADS分级之间的关系。方法选取糖尿病前期患者115例,根据超声检查结果分为甲状腺结节组(TN)和非甲状腺结节组(Non-TN),对甲状腺结节组进行甲状腺影像报告和数据系统(TI-RADS)分级,收集患者的性别、年龄、身高、体质量、腰围、臀围、血压,测定空腹血糖(FBG)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C),空腹胰岛素(FINS)及促甲状腺激素(TSH),计算腰/臀(WHC)、体质量指数(BMI)及胰岛素抵抗指数(HOMA-IR)。结果甲状腺结节组与非甲状腺结节组患者的BMI、WHR、HOMA-IR水平的差异有统计学意义(P<0.05)。胰岛素抵抗指数与甲状腺结节TI-RADS分级之间存在正相关关系,差异有统计学意义(P<0.05)。结论胰岛素抵抗和与甲状腺结节的发病是明显相关的,随着胰岛素抵抗程度的增加,甲状腺结节的TI-RADS分级也随之增高,恶性结节的可能性也越大。

Objective To explore the risk factors of thyroid nodules in patients with pre-diabetes mellitus and the relationship between insulin resistance and thyroid nodule imaging reporting and data system （TI-RADS） classification. Methods 115 patients with pre-diabetes were divided into thyroid nodules （TN） and non thyroid nodule group（Non-TN） according to the results of ultrasound examination, and TN were classifed in TI-RADS. Collected the patient＇s gender, age, height, weight, waist circumference, hip circumference, blood pressure, measured fasting blood glucose （FBG）, total cholesterol （TC）, triglyceride （TG）, low density lipoprotein cholesterol（LDL-C）, fasting insulin （FINS） and thyroid stimulating hormone （TSH）, and calculated the waist/hips （WHC）, body mass index （BMI） and insulin resistance index（HOMA-IR）. Results There were significant diferences in the BMI, WHR, HOMA-IR of TN and Non-TN （P 〈 0.05）. There was a positive correlation between insulin resistance index and TI-RADS grade of thyroid nodules （P 〈 0.05）. Conclusion Insulin resistance was obvious associated with the onset of thyroid nodule, with the increase of the degree of insulin resistance, the classifcation of thyroid nodule TI - RADS and the possibility of malignant nodules were also subsequently heighten.