体检人群甲状腺结节发生的相关因素分析

Related factors of thyroid nodule occurrence in physical examination population

目的研究河南地区体检人群甲状腺结节(TN)的患病率,探讨甲状腺结节与甲状腺功能、尿酸及代谢综合征等的相关性。方法选取2018年8月至2019年12月于河南省人民医院进行体检的2694例健康体检人员为研究对象,按甲状腺彩超有无结节将其分为甲状腺正常组(NTN组)和甲状腺结节组(TN组),比较两组血压、血脂、空腹血糖(FPG)、血尿酸(UA)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)、甲状腺过氧化酶抗体(TPO-Ab)、甲状腺球蛋白抗体(Tg-Ab)及代谢综合征(MS)的患病率。通过Pearson相关分析探讨甲状腺结节的相关因素;通过Logistic回归分析探讨甲状腺结节的危险因素。结果在性别、年龄、收缩压(SBP)、TSH、FT4、FT3、UA、FPG、高密度脂蛋白胆固醇(HDL-C)、丙氨酸氨基转移酶(ALT)、谷氨酰转肽酶(γ-GT)、身高、体质量、肌酐(Cr)、尿素氮(BUN)、BUN/Cr方面,TN组与NTN组比较差异均有统计学意义(P均<0.05)。与甲状腺结节的发生呈正相关的因素依次为:年龄、SBP、BUN、Cr、FPG、HDL-C、舒张压、低密度脂蛋白胆固醇、碱性磷酸酶、总胆固醇;与甲状腺结节的发生呈负相关的因素依次为:身高、UA、Cr、体质量、FT4、ALT、FT3、γ-GT、TPO-Ab、Tg-Ab、总甲状腺素、天门冬氨酸氨基转移酶、三酰甘油、BUN、总三碘甲状腺原氨酸、TSH、体质指数。甲状腺结节发生的独立危险因素依次为:性别、FT3、FPG、年龄、体质量、SBP;甲状腺结节发生的保护因素依次为:BUN/Cr、HDL-C、FT4、TSH、BUN、身高、γ-GT、UA、ALT、Cr。结论性别和年龄是甲状腺结节发生的独立危险因素;FT3是甲状腺结节发生的危险因素且与甲状腺结节的发生呈正相关;UA是甲状腺结节发生的负相关因素和保护因素,年龄、SBP、FPG是甲状腺结节发生的独立危险因素和正相关因素。

Objective To study the prevalence of thyroid nodule(TN)in Henan Province,and to analyze the correlation of TN with thyroid function,uric acid and metabolic syndrome.Methods A total of 2694 physical examination personnel who underwent physical examination in Henan Provincial People’s Hospital from August 2018 to December 2019 were selected as the research objects.All selected people were divided into normal thyroid nodule(NTN)group and TN group according to the development of TN detected by ultrasonic examination.The blood pressure,blood lipid,fasting plasma glucose(FPG),blood uric acid(UA),triiodothyronine(FT3),free thyroxine(FT4),thyrotrophin(TSH),thyroid peroxidase antibody(TPO-Ab),anti-thyrotropin receptor antibody(Tg-Ab)and the prevalence of metabolic syndrome(MS)of the two groups were compared.Correlated factors of TN were analyzed by Pearson correlation;risk factors for TN were investigated by Logistic regression analysis.Results There were significant statistical differences between TN group and NTN group in gender,age,systolic blood pressure(SBP),TSH,FT4,FT3,UA,FPG,high density liptein cholesterol(HDL-C),alanine aminotransferase(ALT),γ-glutamyl transpeptidase(γ-GT),height,weight,creatinine(Cr),blood urea nitrogen(BUN),and BUN/Cr(P<0.05).The factors positively correlated with TN were age,SBP,BUN,Cr,FPG,HDL-C,diastolic blood pressure,low density liptein cholesterol,alkaline phosphatase,total cholesterol.The factors negatively correlated with TN were height,UA,Cr,weight,FT4,ALT,FT3,γ-GT,TPO-Ab,Tg-Ab,total thyroxine,aspartate aminotransferase,triglyceride,BUN,total triiodoth-yronine,TSH,and body mass index.The independent risk factors for TN were gender,FT3,FPG,age,weight and SBP.The protective factors of TN were BUN/Cr,HDL-C,FT4,TSH,BUN,height,γ-GT,UA,ALT and Cr.Conclusions Gender and age are independent risk factors for TN.FT3 is a risk factor for TN,and it is positively correlated with TN.UA is a negative correlation factor and protective factor for TN occurrence;while age,SBP and FPG are independent risk factors and positive correlation factors for TN occurrence.