摘要
目的:探讨甲状腺癌(TC)在2型糖尿病(T2DM)患者中的发病情况及相关危险因素。方法:选择2016年6月—2018年12月期间住院治疗的1662例T2DM患者(T2DM)以及同期604例行健康体检并排除糖尿病的体检者(对照组),比较T2DM患者与对照组之间TC患病率的差异,并比较T2DM并TC患者与T2DM无TC患者之间相关指标的差异。结果:T2DM组TC患病率明显高于对照组(7.46%vs.1.32%),且TC患病率女性患者高于男性患者(54.0%vs.46.0%),≥45岁患者高于<45岁患者(77.4%vs.22.6%),差异均有统计学意义(均P<0.05)。同一TI-RADS分级甲状腺结节术后诊断为TC的比例,T2DM组相对于对照组有升高趋势(因对照组样本量过少,无法进行有效的统计)。T2DM组中,并TC患者的体质量指数、空腹血糖、餐后2h血糖、糖化血红蛋白、促甲状腺激素、甘油三酯、神经元特异性烯醇化酶、细胞角蛋白19片段水平均明显高于无TC患者(均P<0.05)。T2DM组124例TC的病理类型均为乳头状癌。结论:T2DM患者的TC发病风险明显升高,尤其是女性与≥45岁者。T2DM患者良好的血糖、血脂控制以及正常甲状腺功能维持可能对预防TC有一定意义。建议对T2DM患者定期进行甲状腺B超检查。
Objective: To investigate the prevalence of thyroid cancer (TC) in patients with type 2 diabetes mellitus (T2DM) and the relevant risk factors. Methods: A total of 1 662 T2DM patients (T2DM group) hospitalized from June 2016 to December 2018, and 604 subjects (control group) undergoing health maintenance examination and with exclusion of diabetes during the same period were enrolled. The prevalence rates of TC between the two groups were compared, and the relevant variables between T2DM patients with and without TC were also compared. Results: In T2DM group, the prevalence rate of TC was higher than that in control group (7.46% vs. 1.32%), which was also higher in female patients than that in male patients (54.0% vs. 46.0%) and higher in patients ≥45 years than that in those <45 years (77.4% vs. 22.6%), and all differences had statistical significance (all P<0.05). The percentage of postoperatively diagnosed TC in the same TI-RADS classification in T2DM group showed an increasing trend compared to control group (effective statistical analysis could not be performed due to the extremely small sample number in the control group). In T2DM group the body mass index and levels of fasting blood glucose, postprandial 2-h blood glucose, glycosylated hemoglobin, thyroid stimulating hormone, triglyceride, neuron-specific enolase and cytokeratin 19 fragment in patients with TC were significantly higher than those in patients without TC (all P<0.05). All tumors in the 124 cases of the T2DM group were classified as papillary carcinoma. Conclusion: The risk of TC is significantly increased in patients with T2DM, especially in female patients and those ≥45 years. Good blood glucose and lipid control, and maintenance of thyroid function within normal range in T2DM patients may have certain significance for the prevention of TC. Regular thyroid B-ultrasound examination is recommended in patients with T2DM.
作者
曾幸
刘慧霞
萧梅芳
刘波
廖洁
张佳妮
ZENG Xing;LIU Huixia;XIAO Meifang;LIU Bo;LIAO Jie;ZHANG Jiani(Department of Geriatric Endocrinology, Central South University, Changsha 410008, China;Health Management Center, Xiangya Hospital, Central South University, Changsha 410008, China)
出处
《中国普通外科杂志》
CAS
CSCD
北大核心
2019年第5期558-564,共7页
China Journal of General Surgery
关键词
甲状腺肿瘤
癌
乳头状
糖尿病
2型
危险因素
Thyroid Neoplasms
Carcinoma
Papillary
Diabetes Mellitus
Type 2
Risk Factors
