血清25羟维生素D与气阴两虚2型糖尿病合并甲状腺结节TI-RADS分级相关性分析

Correlation Analysis of Serum 25 Hydroxyvitamin D and Qi-Yin Deficiency Syndrome Type 2 Diabetes Mellitus with Thyroid Nodules TI-RADS Grading

目的分析血清25羟维生素D[25(OH)D]水平与气阴两虚2型糖尿病合并甲状腺结节TI-RADS(甲状腺影像报告与数据系统)分级之间的关系,为精准筛查甲状腺结节患者提供依据。方法收集2021年3月—2023年3月期间在北部战区总医院内分泌科住院的气阴两虚2型糖尿病患者,根据甲状腺超声结果及TI-RADS分级情况,将单纯气阴两虚2型糖尿病不合并甲状腺结节的设为非结节组,将气阴两虚2型糖尿病合并甲状腺结节的设为结节组,其中TI-RADS 2~3类为良性结节组,TI-RADS 4类及以上为可疑恶性结节组,比较3组血清25(OH)D水平,并分析血清25(OH)D与甲状腺结节分级的相关性。结果结节组与非结节组相比,性别、吸烟、高血压、糖尿病病程、血清镁、TgAb比较,差异有统计学意义(P<0.05)。Logistic回归分析结果显示:高血压、糖尿病病程、血肌酐为糖尿病合并甲状腺结节的影响因素。血清25(OH)D与总胆固醇、甘油三酯、甲状旁腺激素(PTH)、甲状腺TI-RADS分级呈负相关(P<0.05),与高密度脂蛋白胆固醇(HDL-C)呈正相关(P<0.05)。结论25(OH)D与气阴两虚2型糖尿病合并甲状腺结节患者TI-RADS分级呈负相关。

Objective To analyze the relationship between 25(OH)D level and TI-RADS grading of thyroid nodules in type 2 diabetes mellitus with Qi-Yin deficiency syndrome,and to provide evidence for accurate screening of thyroid nodules.Methods Patients with type 2 diabetes with Qi-Yin deficiency syndrome admitted to endocrinology department of northern theater general hospital from March 2021 to March 2023 were collected.According to thyroid ultrasound results and TI-RADS grading,type 2 diabetes patients with simple Qi-Yin deficiency syndrome without thyroid nodules were set as non-nodule group,and TI-RADS type 2-3 were set as benign nodules group.TI-RADS type 4 and above were set as suspected malignant nodules group.Serum 25(OH)D levels of the three groups were compared,and the correlation between 25(OH)D and thyroid nodule grading was analyzed.Results There were significant differences in gender,smoking,history of hypertension,course of diabetes,serum magnesium and TgAb between nodules group and non-nodule group(P<0.05).Logistic regression analysis showed that hypertension,diabetes course and serum creatinine were the influential factors of diabetes combined with thyroid nodules.Serum 25(OH)D was negatively correlated with total cholesterol,triglyceride,PTH and thyroid TI-RADS grading(P<0.05),and positively correlated with HDL-C grading(P<0.05).Conclusion There is a negative correlation between 25(OH)D and TI-RADS grading in Qi-Yin deficiency syndrome type 2 diabetes patients with thyroid nodules.