摘要
目的探讨肥胖导致的胰岛素抵抗及血清IGF-1水平与甲状腺乳头状癌的关系。方法收集我院就诊的甲状腺结节患者88例,根据术中病理活检或细针穿刺(FNA)活检确诊为甲状腺乳头状癌(papillary thyroid carcionma,PTC)的60例纳入病例组,将病理活检或FNA活检确诊为良性甲状腺结节的28例列入对照组。术前常规采血检测空腹血糖(fasting plasma glucose,FPG)、空腹胰岛素(fasting insulin,FINS),应用酶联免疫吸附法(enzyme-linked immunosorbent assay,ELISA)测定血清IGF-1水平。收集受试者基本信息,包括性别、年龄、家族史、身高、体重、腰围,计算体重指数(body mass index,BMI)及稳态模型评估-胰岛素抵抗指数(homeostasis model assessment-insulin resistance,HOMA-IR),并对受试者进行问卷调查。应用Logistic回归分析法分析FPG、FINS、HOMA-IR及血清IGF-1水平与甲状腺乳头状癌的关系。结果PTC组BMI均值(26.22±4.41)kg/m2高于非PTC组(22.73±1.84)kg/m2,差异有统计学意义(P<0.05),PTC超重及肥胖的患者比例多于非PTC组;PTC组女性腰围大于非PTC组,两组男性腰围尺寸相当。多因素Logistic回归分析显示,PTC的发病风险随血清IGF-1、FINS及HOMA-IR的水平增高而显著增加。结论HOMA-IR及血清IGF-1水平可作为临床筛查甲状腺乳头状癌的有利检测指标,肥胖可作为临床防治甲状腺癌的新靶点。
Objective To explore the relationship between obesity mediated insulin resistance and the level of serum IGF-1 and thyroid papillary carcinoma.Methods A total of 88 patients with thyroidnodules in our hospital were collected,60 patients which diagnosed by intraoperative pathological biopsy or FNA biopsy with papillary thyroid carcinoma(PTC)were included in the case group,28 patients which confirmed by biopsy or FNA with benign thyroid nodules were included in the control group.Fasting blood glucose and fasting insulin were detected before operation through routine blood,and serum IGF-1 levels were measured by ELISA.The basic information of the subjects was collected,including gender,age,family history,height,weight,BMI and HOMA-IR.Logistic regression analysis was used to analyze the relationship between FPG,FINS,HOMA-IR and serum IGF-1 and thyroid papillary carcinoma.Results The PTC group was associated with a higher BMI(26.22±4.41)kg/m^2 than the non PTC group(22.73±1.84)kg/m^2 and the difference was statistically significant(P<0.05).The proportion of overweight and obesity in PTC group was higher than that in non PTC group.Women in the PTC group had greater waist circumference than those in the non PTC group,and the two groups had a similar waist circumference in men.Multivariate Logistic regression analysis showed that the incidence of PTC was increased significantly with the increase of serum IGF-1 level,as well as FINS and HOMA-IR.Conclusion HOMA-IR and serum IGF-1 levels may be used as a useful indicator for clinical screening of PTC.Obesity may be used as a new targets for clinical prevention and treatment of papillary thyroid carcinoma.
作者
周悦
闫爽
ZHOU Yue;YAN Shuang(Department of Endocrinology,The Fourth Affiliated Hospital of Harbin Medical University,Harbin 150001,China)
出处
《哈尔滨医科大学学报》
CAS
2020年第4期383-386,391,共5页
Journal of Harbin Medical University
