甘肃省武威市汉族中老年女性甲减患者HHcy、HUA与甲状腺结节患病的相关性研究

Correlation between hyperhomocysteinemia,hyperuricemia and thyroid nodule in Han Chinese middleaged and elderly female patients with hypothyroidism in Wuwei City,Gansu Province

目的探讨甘肃省武威市汉族中老年女性甲减患者高同型半胱氨酸血症(HHcy)、高尿酸血症(HUA)与甲状腺结节发生的相关性及其危险因素。方法选取2019年2月-2022年2月甘肃省武威市人民医院体检中心的181例汉族中老年女性体检者,依据甲状腺功能分为非甲减组和甲减组,其中非甲减组99例,甲减组82例;测量身高、体重,计算体重指数;使用双能X线骨密度仪测定腰椎及髋部骨密度;彩色多普勒超声诊断仪检查甲状腺结节;采用化学发光法测定骨代谢标志物、甲功,速率法测定血脂、同型半胱氨酸、尿酸;采用多因素Logistic回归分析甲状腺结节的危险因素。结果年龄、HHcy、HUA为甲状腺结节患病的危险因素,95%CI分别为[1.03,1.14]、[3.59,21.67]、[3.36,23.18];骨钙素、β胶原降解产物、甲状旁腺激素、25-羟基羟维生素D以及钙、磷、甲状腺功能、血脂、骨密度对甲状腺结节患病差异无统计学意义(P>0.05)。结论甘肃省武威市汉族中老年女性甲减患者甲状腺结节患病率高,同时存在HHcy、HUA;年龄、HHcy、HUA为甲状腺结节患病的独立危险因素。

Objective To explore the correlation between and risk factors of the incidence of thyoid nodules and hyperhomocysteinemia(HHcy),hyperuricemia(HUA)in middle-aged and elderly women with hypothyroidism in Wuwei City,Gansu Province.Methods A total of 181 Han middle-aged and elderly women undergoing physical examination at the Physical Examination Center of Wuwei People's Hospital from Feb.2019 to Feb.2022 were selected and were divided into the non hypothyroid and hypothyroid groups based on their thyroid function,with 99 cases in the former group and 82 cases in the latter.Height and weight were measured,and body mass index calculated;Bone mineral density of lumbar and hip were measured by dual energy X-ray absorptiometry.Thyroid nodules were detected by color Doppler ultrasound diagnostic instrument.The indexes of bone metabolism and thyroid function were measured by the chemiluminescence method,and the blood lipids,homocysteine and uric acid were determined by the rate method.Multivariate Logistic regression analysis was used to screen the risk factors for the incidence rate of thyroid nodules.Results Age,HHcy,and HUA were risk factors for the morbidity of thyroid nodules,and the 95%CI were separately[1.03,1.14],[3.59,21.67],[3.36,23.18].However,there was no statistically significant difference in the incidence of thyroid nodules among osteocalcin,β-C-terminal telopeptide of type I collagen,parathormone,25 hydroxy vitamin D,calcium,phosphorus,thyroid function,blood lipids and bone mineral density(P>0.05).Conclusion A high incidence of thyroid nodules was found in middle-aged and elderly Han women with hypothyroidism in Wuwei City,Gansu Province,with a simultaneous presence of HHcy and HUA.In addition,age,HHcy and HUA were independent risk factors for thyroid nodules.