摘要
目的:探讨2型糖尿病(T2DM)与甲状腺结节之间的相关性。方法:以528例住院T2DM患者为研究对象,回顾分析其体质指数(BMI)、空腹血糖(FPG)、空腹胰岛素(FINS)、糖化血红蛋白(HbA1c)、HOMA-IR以及甲状腺彩超检查的结果,并按肥胖、糖尿病病程、性别、年龄、血糖控制水平分析各亚组的甲状腺结节的发生情况,同时进行多因素Logistic回归分析。结果:T2DM患者总甲状腺结节的患病率为64.39%,单结节、多结节分别为35.00%、65.00%,女(74.62%)多于男(57.87%)(P<0.05)。甲状腺结节患病率不随病程增加而增加(P>0.05),但随年龄增加而增加,老年组(74.60%)明显高于非老年组(53.29%)(P<0.05),肥胖亚组(68.10%)高于非肥胖亚组(61.49%),但尚无统计学意义(P>0.05)。HbA1C≥7.0%亚组患病率(65.25%)较HbA1C<7.0%亚组(61.72%)亦无明显增加(P>0.05)。Logistic多因素回归分析显示,甲状腺结节的发生与年龄、BMI、FPG、HOMA-IR独立相关(β=1.32,OR=3.46;β=0.58,OR=2.37;β=0.61,OR=2.45;β=0.34,OR=1.87;P<0.05)。结论:T2DM患者的甲状腺结节患病率较高,年龄、体质指数、空腹血糖和胰岛素抵抗可能是T2DM患者甲状腺结节发生的独立预测因素。临床实践中,甲状腺结节筛查应作为2型糖尿病患者的常规检查,尤其对于肥胖的老年2型糖尿病患者。
Objective：To explore the correlation between type 2 diabetes mellitus（T2DM） and thyroid nodules.Method：The data for 528 diabetic patients were retrospective studied based on different subgroups according to BMI（BMI≥25 kg/m2 or less）,diabetic duration,sex,age,HbA1c（≥7.0% or less）,which included height,weight,body mass index（BMI）,fasting plasma glucose（FPG）,fasting insulin（FINS）,diabetic history,glycosylated hemoglobin（HbA1c）,insulin resistance（IR） index on homeostasis model assessment（HOMA-IR） and the ultrasonic results of thyroid glands.Thyroid nodule prevalence was recorded and Logistic regressive analysis was applied to assess whether the occurrence of thyroid nodules was correlate with the above age,BMI,FPG,HbA1c,and HOMA-IR.Result：The total prevalence of thyroid nodules was 64.39%,solitary nodule and multi nodules accounted for 35.00% and 65.00% respectively.There was higher prevalence in female T2DM（74.62%） than that in male subjects（57.87%）（P0.05）.Further analysis found that thyroid nodule prevalence was significantly elevated in aged subgroup,while slightly increased in obesity and HbA1C≥7.0% subgroup.The relationship between the nodule prevalence and diabetic duration was not found.Multifactor logistic analysis showed that the occurrence of thyroid nodules independently correlated with age,BMI,FPG,HOMA-IR（β=1.32,OR=3.46,β=0.58,OR=2.37,β=0.34,OR=1.87,all P0.05）.Conclusion：There is higher thyroid nodule prevalence in T2DM,and the age,BMI,FPG and IR may be independent predictors of thyroid nodule.Thyroid nodule screening should be a routine examination in practice especially for the aged and obese T2DM population.
出处
《中国医学创新》
CAS
2012年第36期7-9,共3页
Medical Innovation of China
关键词
2型糖尿病
甲状腺结节
肥胖
胰岛素抵抗
Metabolic syndrome
Thyroid nodule
Obesity
Insulin resistance
