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肥胖和糖尿病与甲状腺结节的关系。

Association of obesity and diabetes with thyroid nodules.

机构信息

Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS) - University of Palermo (Italy), Via del Vespro 129, 90127, Palermo, Italy.

Laboratorio di Metabolismo e Nutrizione Clinica - AOU Policlinico "P. Giaccone", Palermo, Italy.

出版信息

Endocrine. 2018 May;60(2):339-347. doi: 10.1007/s12020-017-1394-2. Epub 2017 Aug 23.

Abstract

AIM

There are conflicting data concerning the possibility that obesity and diabetes raise the risk of thyroid nodules. The incidence of thyroid nodules is increasing, as is that of obesity and diabetes; therefore, understanding whether these metabolic and nutritional disorders influence nodular thyroid disease is important for organizing prevention strategies. This study investigated the association between thyroid nodules, obesity, diabetes, and dietary habits.

MATERIALS AND METHODS

A cohort of randomly selected adults (455 males, 746 females; age: 18-90 years) living in Palermo (Italy), a mild iodine deficiency area, was cross-sectionally investigated. Participants underwent high-resolution ultrasonographic evaluation of the thyroid, and answered a food frequency questionnaire. Laboratory blood measurements were obtained in 587 participants.

RESULTS AND DISCUSSION

Thyroid nodules were detected in 475 (39.5%) participants. The number of thyroid nodules was correlated with age (r = 0.19; P < 0.001), gender (r = 0.08; P = 0.005), and body mass index (r = 0.07; P = 0.02). No significant correlation was observed between the number of nodules and glycated hemoglobin, serum insulin concentrations, and homeostasis model assessment of insulin resistance. Age-adjusted and gender-adjusted prevalence of both overweight/obesity and type 2 diabetes of each group of participants divided according to the number of nodules significantly increased with the number of nodules (P < 0.05 in both cases). The group of participants with nodules exhibited a significantly lower age-adjusted and gender-adjusted habitual intake of milk (P = 0.02). Multivariate regression analysis showed that age, gender, body mass index, diabetes, and habitual consumption of milk were independently correlated with presence of thyroid nodules.

CONCLUSION

This study seems to indicate that an association exists between obesity, diabetes, and thyroid nodules.

摘要

目的

关于肥胖和糖尿病是否会增加甲状腺结节风险,目前存在相互矛盾的数据。甲状腺结节的发病率正在上升,肥胖症和糖尿病的发病率也是如此;因此,了解这些代谢和营养障碍是否会影响结节性甲状腺疾病对于组织预防策略非常重要。本研究调查了甲状腺结节、肥胖、糖尿病和饮食习惯之间的关系。

材料和方法

本研究对居住在意大利帕勒莫(一个轻度碘缺乏地区)的随机选择的成年人(男性 455 名,女性 746 名;年龄:18-90 岁)进行了横断面研究。参与者接受了甲状腺高分辨率超声评估,并回答了食物频率问卷。在 587 名参与者中获得了实验室血液测量值。

结果与讨论

在 475 名(39.5%)参与者中发现了甲状腺结节。甲状腺结节的数量与年龄(r=0.19;P<0.001)、性别(r=0.08;P=0.005)和体重指数(r=0.07;P=0.02)相关。结节数量与糖化血红蛋白、血清胰岛素浓度和稳态模型评估的胰岛素抵抗之间没有观察到显著相关性。根据结节数量对参与者进行分组后,对每个组进行年龄调整和性别调整的超重/肥胖和 2 型糖尿病的患病率均随着结节数量的增加而显著增加(两种情况均 P<0.05)。有结节的参与者组的习惯性牛奶摄入量在年龄调整和性别调整后显著较低(P=0.02)。多元回归分析表明,年龄、性别、体重指数、糖尿病和习惯性牛奶消费与甲状腺结节的存在独立相关。

结论

本研究似乎表明肥胖、糖尿病与甲状腺结节之间存在关联。

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