体重指数与乳头状甲状腺癌发生的关系研究

Relationship between BMI and papillary thyroid carcinoma

目的探讨体重指数(BMI)与乳头状甲状腺癌(PTC)发生的关系。方法收集行甲状腺切除术的174例甲状腺疾病患者的临床资料。根据患者的病理诊断结果将患者分为PTC组(n=62)与甲状腺良性结节(BTN)组(n=112)。同时,根据BMI将174例甲状腺疾病患者分为正常体重组(n=72)与超重及肥胖组(n=102)。结果单因素分析结果显示:PTC的发生与性别、血清总胆固醇(TC)水平无关(P﹥0.05),与年龄,血清促甲状腺素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、三酰甘油(TG)水平,空腹血浆血糖(FPG)水平,BMI有关(P﹤0.05)。多因素分析结果显示:年龄、BMI、FPG水平对PTC的发生有影响(P﹤0.05);其中,年龄是保护因素,而BMI、FPG水平是危险因素。正常体重组的PTC比例为26.4%(19/72),低于超重及肥胖组的42.2%(43/102),差异有统计学意义(P﹤0.05)。结论 BMI、FPG水平均是PTC发生的独立危险因素,其中,超重及肥胖的甲状腺疾病患者较正常体重者发生PTC的风险大。

Objective To investigate the relationship between body mass index（BMI） and the occurrence of papillary thyroid carcinoma（PTC）. Method The clinical data of 174 patients with thyroid nodules undergoing thyroidectomy were collected. According to the pathological diagnosis, the patients were stratified as PTC group（n=62） and benign nodules of thyroid（BTN） group（n=112）. At the same time, these patients were grouped by BMI as normal weight group（n=72） or overweight and obesity group（n=102）. Result Univariate analysis showed that, PTC was not associated with gender or total cholesterol（TC）（P〉0.05）, while was related to age, thyroid-stimulating hormone（TSH）, free triiodothyronine（FT3）, free thyroxine（FT4）, triglyceride（TG）, fasting plasma glucose（FPG）, and BMI（P〈0.05）. Further multivariate analysis indicated that： age, BMI and FPG had significant effects on the occurrence of PTC（P〈0.05）; and age was a protective factor, but BMI and FPG were risk factors. The proportion of PTC in normal body weight group was 26.4%（19/72）,which was significantly lower than that in overweight and obesity group at 42.2%（43/102）, and the difference was statistically significant（P〈0.05）. Conclusion BMI and FPG levels are independent risk factors for PTC, patients with thyroid nodules who are overweight or obese are more likely to develop PTC than those with normal body weight.