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糖尿病与甲状腺癌死亡率:台湾 12 年前瞻性随访研究。

Diabetes and thyroid cancer mortality: a 12-year prospective follow-up of Taiwanese.

机构信息

Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.

出版信息

Eur J Clin Invest. 2013 Jun;43(6):595-601. doi: 10.1111/eci.12086. Epub 2013 Apr 1.

Abstract

BACKGROUND

The association between diabetes and thyroid cancer is rarely studied. This study evaluated thyroid cancer mortality trend in Taiwanese population, mortality rate ratios between diabetic patients and general population, and risk factors in diabetic patients.

METHODS

In general population, age-standardized trends were evaluated from 1995 to 2006. A total of 113,347 diabetic men and 131,573 diabetic women aged ≥ 25 years recruited during 1995-1998 were followed to 2006. Age- and sex-specific mortality rate ratios were calculated and Cox's regression evaluated the risk factors.

RESULTS

A steady trend of thyroid cancer mortality was observed in the general population. A total of 20 diabetic men and 45 diabetic women died of thyroid cancer, with overall mortality rate 2.32 and 4.26 per 100,000 person-years, respectively. Mortality rate ratios showed positive association with magnitude increased with decreasing age: 1.85 (0.77, 4.43), 1.21 (0.54, 2.73), 2.53 (1.14, 5.59) and 5.80 (2.10, 16.01) for ≥ 75, 65-74, 55-64 and 25-54 years old, respectively, for men; and 0.78 (0.35, 1.74), 2.03 (1.31, 3.13), 2.99 (1.77, 5.04) and 5.34 (2.20, 13.00), respectively, for women. After adjustment, only age was significantly associated with thyroid cancer mortality. Sex, diabetes duration, diabetes type, body mass index, smoking, insulin use and area of residence were not significantly predictive for thyroid cancer mortality.

CONCLUSIONS

The annual thyroid cancer mortality during 1995-2006 in the Taiwanese general population has been steady. Our data suggest a higher risk in diabetic patients, with especially higher mortality rate ratios in younger age. Obesity, smoking and insulin use are not modifiable risk factor.

摘要

背景

糖尿病与甲状腺癌之间的关联很少被研究。本研究评估了台湾人群中甲状腺癌死亡率的趋势、糖尿病患者与普通人群之间的死亡率比值,以及糖尿病患者的风险因素。

方法

在普通人群中,评估了 1995 年至 2006 年的年龄标准化趋势。共纳入了 1995 年至 1998 年期间年龄≥25 岁的 113347 名男性糖尿病患者和 131573 名女性糖尿病患者,随访至 2006 年。计算了年龄和性别特异性死亡率比值,并通过 Cox 回归评估了风险因素。

结果

在普通人群中,甲状腺癌死亡率呈稳定趋势。共有 20 名男性糖尿病患者和 45 名女性糖尿病患者死于甲状腺癌,总死亡率分别为 2.32 和 4.26/100000 人年。死亡率比值与年龄呈正相关,随着年龄的降低而增加:≥75 岁为 1.85(0.77,4.43)、65-74 岁为 1.21(0.54,2.73)、55-64 岁为 2.53(1.14,5.59)、25-54 岁为 5.80(2.10,16.01),男性;女性分别为≥75 岁为 0.78(0.35,1.74)、65-74 岁为 2.03(1.31,3.13)、55-64 岁为 2.99(1.77,5.04)、25-54 岁为 5.34(2.20,13.00)。调整后,只有年龄与甲状腺癌死亡率显著相关。性别、糖尿病病程、糖尿病类型、体重指数、吸烟、胰岛素使用和居住地与甲状腺癌死亡率无显著相关性。

结论

1995 年至 2006 年,台湾普通人群的甲状腺癌年死亡率保持稳定。我们的数据表明糖尿病患者的风险更高,尤其是年轻患者的死亡率比值更高。肥胖、吸烟和胰岛素使用不是可改变的危险因素。

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