上海市健康体检人群BMI、腰围与甲状腺自身抗体阳性发生风险的关联研究

Correlation between BMI or waist circumference and the risk of positive thyroid autoantibody among physical examinees in Shanghai

目的分析上海市健康体检人群BMI、腰围(WC)与甲状腺自身抗体阳性发生风险的关系。方法采用多阶段整群抽样法随机选取2019年1—9月在华东疗养院健康体检中心的3840名上海市健康体检人群,收集人口学资料、体格检查及实验室指标。采用多因素Logistic回归和限制性立方样条(RCS)探索BMI、WC与甲状腺自身抗体阳性发生风险的关系。结果上海市健康体检人群甲状腺自身抗体阳性发生率为23.2%(892/3840),RCS结果显示BMI、WC的连续变化与甲状腺自身抗体阳性呈线性剂量-反应关系(Pfor non⁃linearity>0.05)。多因素Logistic回归分析结果显示,以BMI与WC定义的肥胖人群,其甲状腺自身抗体阳性发生风险分别是非肥胖人群的1.82倍和2.20倍;单纯腹型肥胖(OR=2.06)和复合型肥胖(OR=2.79)均是甲状腺自身抗体阳性的独立危险因素。结论上海市健康体检人群BMI、WC的增加会显著增加甲状腺自身抗体阳性风险,应关注存在复合型肥胖及单纯腹型肥胖的人群,并制定合理的肥胖管理方案降低内脏脂肪含量。

Objective To analyze the correlation between body mass index(BMI)or waist circumference(WC)and the risk of positive thyroid autoantibody among physical examinees in Shanghai.Methods A total of 3840 physical examinees in Shanghai were randomly selected by multi⁃stage cluster sampling method in the health examination center of Huadong Sanatorium from January to September 2019.Demographic data,physical examination,and laboratory indicators were collected.Multivariate Logistic regression and restricted cubic spline(RCS)were used to explore the correlation be⁃tween BMI or WC and the risk of positive thyroid autoantibody.Results The incidence rate of positive thyroid autoanti⁃body was 23.2%(892/3840).The result of RCS showed that there was linear dose⁃response relationship between continu⁃ous changes of BMI or WC and positive thyroid autoantibody(Pfor non⁃linearity>0.05).Multivariate Logistic regression showed that obese people defined by BMI and WC had 1.82 and 2.20 times of the risk of positive thyroid autoantibody,respective⁃ly,compared with non⁃obese people.Simple abdominal obesity(OR=2.06)and compound obesity(OR=2.79)were in⁃dependent risk factors for positive thyroid autoantibody.Conclusions The increase of BMI and WC in the physical exam⁃inees in Shanghai significantly increases the risk of positive thyroid autoantibody.Attention should be paid to the popula⁃tion with compound obesity and simple abdominal obesity,and a reasonable obesity management program should be devel⁃oped to reduce visceral fat content.