肥胖与超声高度怀疑模式的甲状腺结节风险：一项大型横断面流行病学研究。
Adiposity and the risk of thyroid nodules with a high-suspicion sonographic pattern: a large cross-sectional epidemiological study.
作者信息
Lai Xingjian, Zhang Bo, Wang Yong, Jiang Yuxin, Li Jianchu, Gao Luying, Wang Ying
机构信息
Department of Ultrasound, Chinese Academy of Medical Sciences & Peking Union Medical College Hospital, Beijing 100730, China.
Department of Ultrasound, China-Japan Friendship Hospital, Beijing 100029, China.
出版信息
J Thorac Dis. 2019 Dec;11(12):5014-5022. doi: 10.21037/jtd.2019.11.79.
BACKGROUND
To our knowledge, no previous studies have evaluated the association between obesity and the risk of thyroid nodules with a high-suspicion sonographic pattern defined by the 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancers. In this large cross-sectional epidemiological study, we investigated whether a positive association existed between anthropometric measurements and the risk of thyroid nodules.
METHODS
In total, 10,504 individuals from two towns in northern China were enrolled between May to September 2016. The height and weight were measured and the body mass index (BMI), body fat percentage (BFP), and body surface area (BSA) were calculated. A logistic regression model was used to estimate age-, sex-, and study site-adjusted odds ratios (ORs) and confidence intervals (CIs) for each of the anthropometric measurements with respect to the risk of thyroid nodules.
RESULTS
The final analyses included 9,096 participants, among whom 3,614 (39.7%) had thyroid nodules and 365 (4.0%) had thyroid nodules with a high-suspicion sonographic pattern. An increased risk of any thyroid nodules was associated with greater height, weight, BFP, and BSA in both men and women. Compared with the lowest quartile of BFP, the ORs for the highest quartile were 1.33 (95% CI: 1.09-1.62) in women and 1.89 (95% CI: 1.35-2.65) in men. An increased risk of thyroid nodules with a high-suspicion sonographic pattern was associated with greater weight, BMI, BFP, and BSA in both men and women. Compared with the lowest quartile of BFP, the ORs for the highest quartile were 2.19 (95% CI: 1.32-3.64) in women and 3.10 (95% CI: 1.31-7.36) in men.
CONCLUSIONS
Our results demonstrated that BFP was the most pronounced anthropometric factor associated with an increased risk of any thyroid nodules and thyroid nodules with a high-suspicion sonographic pattern.
背景
据我们所知，此前尚无研究评估肥胖与甲状腺结节风险之间的关联，甲状腺结节的超声特征采用2015年美国甲状腺协会针对成年甲状腺结节和分化型甲状腺癌患者的管理指南所定义的高度可疑模式。在这项大型横断面流行病学研究中，我们调查了人体测量指标与甲状腺结节风险之间是否存在正相关。
方法
2016年5月至9月期间，共纳入了来自中国北方两个城镇的10504人。测量身高和体重，并计算体重指数（BMI）、体脂百分比（BFP）和体表面积（BSA）。采用逻辑回归模型估计每个人体测量指标相对于甲状腺结节风险的年龄、性别和研究地点调整后的比值比（OR）和置信区间（CI）。
结果
最终分析纳入了9096名参与者，其中3614人（39.7%）有甲状腺结节，365人（4.0%）有超声特征高度可疑的甲状腺结节。男性和女性中，身高、体重、BFP和BSA越高，任何甲状腺结节的风险增加。与BFP最低四分位数相比，最高四分位数的OR在女性中为1.33（95%CI：1.09-1.62），在男性中为1.89（95%CI：1.35-2.65）。男性和女性中，体重、BMI、BFP和BSA越高，超声特征高度可疑的甲状腺结节风险增加。与BFP最低四分位数相比，最高四分位数的OR在女性中为2.19（95%CI：1.32-3.64），在男性中为3.10（95%CI：1.31-7.36）。
结论
我们的结果表明，BFP是与任何甲状腺结节和超声特征高度可疑的甲状腺结节风险增加相关的最显著人体测量因素。
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