Lai Xiaoying, Ouyang Ping, Zhu Hong, An Shengli, Xia Lijuan, Yao Yiting, Zhang Han, Li Zhi, Deng Kan
Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
Hospital Office, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2020 Feb 29;40(2):268-273. doi: 10.12122/j.issn.1673-4254.2020.02.20.
To analyze the detection rate of thyroid nodules and its influencing factors among individuals undergoing routine health check-up in Guangdong Province.
We analyzed the results of thyroid ultrasonography of 309 576 individuals receiving routine health check-up in a general hospital in Guangdong Province over the past 10 years. The data were compared between the individuals with and without thyroid nodules using two independent samples test, MannWhitney U test and Chi-square test. Binary logistic regression was used to analyze the relationship between different factors and thyroid nodules, and the odds ratio (OR) and 95% confidence interval (95% ) were calculated.
Based on the structured and standardized data, the total detection rate of thyroid nodules was 9.68% among the individuals, 7.71% in male and 13.51% in female subjects, showing a significant gender difference (χ=2677.08, < 0.001). In the overall population, the detection rates of thyroid nodules gradually increased with age, but in each age group, the detection rate remained significantly higher in female subjects than in male subjects ( < 0.001). The subjects with thyroid nodules showed a significant higher percentage of male gender, an older age, a greater BMI, and significantly higher SBP, DBP, FBG, TC, LDL-C, HDL-C, TG as well as higher detection rates of fatty liver, hyperlipidemia, hyperglycemia, and metabolic syndrome than those without thyroid nodules (all < 0.001). Binary logistic regression analysis showed that thyroid nodules were significantly associated with gender (OR=0.455, 95%: 0.443-0.468), age (45-59 years: OR=1.660, 95%: 1.613-1.710; ≥ 60 years: OR=3.329, 95%: 3.202- 3.462), BMI (underweight: OR=0.808, 95%: 0.755-0.864; overweight: OR=1.074, 95%: 1.038-1.112; obesity: OR=1.281, 95%: 1.221-1.343), hyperlipidemia (OR=1.053, 95%:1.022-1.085), high blood glucose (OR=1.177, 95%: 1.105-1.252), and metabolic syndrome (OR=1.111, 95%: 1.071-1.152).
The detection rate of thyroid nodule is much higher in female than in male individuals in Guangdong Province and is significantly associated with gender, age, BMI and metabolic related diseases. Male gender and underweight might be protective factors for thyroid nodules, while an advanced age, overweight/obesity, hyperlipidemia, high blood glucose and metabolic syndrome are associated with an increased risk of thyroid nodules. Thyroid ultrasound examination is recommended in routine health check-up for early detection and treatment of thyroid diseases.
分析广东省接受常规健康体检人群的甲状腺结节检出率及其影响因素。
我们分析了广东省某综合医院过去10年中309576例接受常规健康体检者的甲状腺超声检查结果。采用两独立样本t检验、Mann-Whitney U检验和卡方检验对有甲状腺结节和无甲状腺结节的个体数据进行比较。采用二元logistic回归分析不同因素与甲状腺结节的关系，并计算比值比（OR）和95%置信区间（95%CI）。
基于结构化和标准化数据，人群中甲状腺结节的总检出率为9.68%，男性为7.71%，女性为13.51%，显示出显著的性别差异（χ²=2677.08，P<0.001）。在总体人群中，甲状腺结节的检出率随年龄增长逐渐升高，但在各年龄组中，女性的检出率仍显著高于男性（P<0.001）。有甲状腺结节的个体在男性性别、年龄较大、BMI较高以及收缩压、舒张压、空腹血糖、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、甘油三酯方面的比例显著更高，同时脂肪肝、高脂血症、高血糖和代谢综合征的检出率也高于无甲状腺结节者（均P<0.001）。二元logistic回归分析显示，甲状腺结节与性别（OR=0.455，95%CI：0.443-0.468）、年龄（45-59岁：OR=1.660，95%CI：1.613-1.710；≥60岁：OR=3.329，95%CI：3.202-3.462）、BMI（体重过轻：OR=0.808，95%CI：0.755-0.864；超重：OR=1.074，95%CI：1.038-1.112；肥胖：OR=1.281，95%CI：1.221-1.343）、高脂血症（OR=1.053，95%CI：1.022-1.085）、高血糖（OR=1.177，95%CI：1.105-1.252）和代谢综合征（OR=1.111，95%CI：1.071-1.152）显著相关。
广东省女性甲状腺结节的检出率远高于男性，且与性别年龄、BMI和代谢相关疾病显著相关。男性性别和体重过轻可能是甲状腺结节的保护因素，而高龄、超重/肥胖、高脂血症、高血糖和代谢综合征与甲状腺结节风险增加有关。建议在常规健康体检中进行甲状腺超声检查，以便早期发现和治疗甲状腺疾病。
