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代谢综合征致结节性甲状腺疾病的机制探讨

A Mechanism Exploration of Metabolic Syndrome Causing Nodular Thyroid Disease.

作者信息

Li Zexin, Zhang Lili, Huang Yingshi, Yang Peixuan, Xu Wencan

机构信息

Health Care Center, The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, China.

Department of Endocrinology, The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, China.

出版信息

Int J Endocrinol. 2019 Nov 26;2019:9376768. doi: 10.1155/2019/9376768. eCollection 2019.

Abstract

BACKGROUND

Metabolic syndrome (MS) and its components have been demonstrated to facilitate the prevalence of thyroid nodules (TNs). The underlying pathogenesis needs to be elucidated.

METHODS

A total of 2722 subjects, who underwent health checkup in our institute from December 2014 to November 2018, were retrospectively and randomly collected. After exclusion, 2068 subjects were chosen, and their anthropic and clinical data were collected.

RESULTS

After matching age, gender, uric acid (UA), and creatinine (Cr) by propensity score matching (PSM), subjects with MS had higher prevalence of TNs than those without MS, as well as higher thyroid-stimulating hormone (TSH) and inflammatory levels, indicated by the higher white blood cell (WBC), lymphocyte (LY), and monocyte/high-density lipoprotein (Mo/HDL). After matching age, gender, UA, Cr, TSH, free triiodothyronine (FT3), thyroxine (FT4), WBC, NE, LY, Mo, NE/LY, LY/Mo, and Mo/HDL by PSM, no significant difference of the prevalence of TNs was found between MS and non-MS groups. Step logistic regression suggested glucose intolerance (GI), among all the components of MS, was an independent impact factor of TNs and was considered to contribute most to the formation of TNs. The prevalence of TNs was higher in the GI group after matching age, gender, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood sugar (FBS), UA, Cr, triglyceride (TG), cholesterol (CHOL), HDL, and low-density lipoprotein (LDL).

CONCLUSIONS

Patients with MS have a higher prevalence of TNs, probably due to the elevated TSH and inflammatory levels . Among the components of MS, glucose intolerance contributes most to the development of TNs.

摘要

背景

代谢综合征(MS)及其组分已被证明会促进甲状腺结节(TNs)的发生。其潜在发病机制有待阐明。

方法

回顾性随机收集了2014年12月至2018年11月在我院接受健康体检的2722名受试者。排除后,选取2068名受试者,并收集其人体测量和临床数据。

结果

通过倾向评分匹配(PSM)对年龄、性别、尿酸(UA)和肌酐(Cr)进行匹配后,MS患者的TNs患病率高于非MS患者,且甲状腺刺激激素(TSH)和炎症水平更高,表现为白细胞(WBC)、淋巴细胞(LY)和单核细胞/高密度脂蛋白(Mo/HDL)水平更高。通过PSM对年龄、性别、UA、Cr、TSH、游离三碘甲状腺原氨酸(FT3)、甲状腺素(FT4)、WBC、中性粒细胞(NE)、LY、Mo、NE/LY、LY/Mo和Mo/HDL进行匹配后,MS组和非MS组的TNs患病率无显著差异。逐步逻辑回归表明,在MS的所有组分中,葡萄糖不耐受(GI)是TNs的独立影响因素,且被认为对TNs的形成贡献最大。在对年龄、性别、体重指数(BMI)、收缩压(SBP)、舒张压(DBP)、空腹血糖(FBS)、UA、Cr、甘油三酯(TG)、胆固醇(CHOL)、高密度脂蛋白(HDL)和低密度脂蛋白(LDL)进行匹配后,GI组的TNs患病率更高。

结论

MS患者的TNs患病率更高,可能是由于TSH和炎症水平升高。在MS的组分中,葡萄糖不耐受对TNs的发生贡献最大。

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