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代谢综合征对甲状腺结节风险增加及大小的影响。

The Impact of Metabolic Syndrome on Increased Risk of Thyroid Nodules and Size.

作者信息

Bener Abdulbari, Özdenkaya Yaşar, Barışık Cem Cahit, Öztürk Mustafa

机构信息

Department of Biostatistics and Medical Informatics, Cerrahpaşa Faculty of Medicine, Istanbul University, Istanbul, Turkey.

Department of Evidence for Population Health Unit, School of Epidemiology and Health Sciences, The University of Manchester, Manchester, United Kingdom.

出版信息

Health Serv Res Manag Epidemiol. 2018 Jun 6;5:2333392818775517. doi: 10.1177/2333392818775517. eCollection 2018 Jan-Dec.

Abstract

AIM

The present research aimed to determine the relation between metabolic syndrome (MetS) and thyroid volume and nodule prevalence among Turkish population patients.

METHODS

This retrospective cohort study was carried on 850 patients between the ages of 20 and 65 who visited the diabetic, endocrinology, and general surgery outpatient clinics in the Mega Medipol and Medipol Hospital between January 2014 and December 2017. This study included sociodemographic information, body mass index (BMI), diabetes mellitus (DM), systolic (SBP) and diastolic (DBP) blood pressures, and clinical biochemistry results such as serum triglyceride, total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein (LDL) cholesterol, hemoglobin A1c (HbA1c), fasting blood glucose levels, thyroid-stimulating hormone (TSH), T3, T4, and other MetS parameters. Thyroid fine needle aspiration biopsy was suggested to patients whose thyroid nodules were greater than 1.00 cm. The definition and diagnostic of MetS used as proposed by the National Cholesterol Education Program-Third Adult Treatment Panel.

RESULTS

There were statistically significant differences between patients with thyroid nodules and those without regarding age, gender, BMI, physical activity, cigarette smoking, shisha smoking, family history of diabetes, hypertension, and thyroid. Meanwhile, statistically significant differences were found between with and without MetS for calcium ( = .028), magnesium ( < .001), potassium ( < .001), fasting blood glucose ( = .047), HbA1c ( < .001), HDL ( < .001), LDL ( < .001), albumin ( = .008), bilirubin ( = .002), triglyceride ( = .011), SBP ( = .001) and DBP ( = .011), TSH ( = .005), T3 ( < .001), and T4 ( < .001). Furthermore, there were statistically significant differences between participants with and without thyroid nodules for calcium ( < .001), magnesium ( < .001), potassium ( < .001), fasting blood glucose ( = .010), HbA1c ( = .019), HDL ( < .001), LDL ( = .012), albumin ( = .002), bilirubin ( < .001), triglyceride ( < .001), SBP ( < .001) and DBP ( = .004), TSH ( = .015), T3 ( < .001), and T4 ( < .001). Multivariate stepwise logistic regression analysis used for independent predictors for the presence of thyroid nodules which TSH ( < .001), family history of thyroid and DM ( < .001), age in years ( = .025), DBP and SBP ( < .001), BMI ( = .014), HDL-C ( = .034), and waist circumference (in cm; = .044) were considered at higher risk as a predictors of thyroid with patients with MetS.

CONCLUSION

The results of the current study confirm a strong positive association between MetS and thyroid nodules risk among patients with MetS. This study suggest that the patients with MetS can be considered as a marker to have moderately increased risk of future thyroid nodules and cancer. Meanwhile, MetS, obesity, and hyperglycemia could be a qualifiable and modifiable risk factor for thyroid nodules. The regularly glycemic control may be the most important treatment for the reduction of incidence or the prevention of thyroid.

摘要

目的

本研究旨在确定土耳其人群患者中代谢综合征(MetS)与甲状腺体积及结节患病率之间的关系。

方法

这项回顾性队列研究针对2014年1月至2017年12月期间在Mega Medipol和Medipol医院糖尿病、内分泌和普通外科门诊就诊的850名年龄在20至65岁之间的患者进行。该研究纳入了社会人口统计学信息、体重指数(BMI)、糖尿病(DM)、收缩压(SBP)和舒张压(DBP)、以及血清甘油三酯、总胆固醇、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白(LDL)胆固醇、糖化血红蛋白(HbA1c)、空腹血糖水平、促甲状腺激素(TSH)、T3、T4等临床生化结果以及其他MetS参数。对于甲状腺结节大于1.00厘米的患者建议进行甲状腺细针穿刺活检。MetS的定义和诊断采用美国国家胆固醇教育计划成人治疗专家组第三次报告所提议的标准。

结果

甲状腺结节患者与无甲状腺结节患者在年龄、性别、BMI、身体活动、吸烟、水烟吸食、糖尿病家族史、高血压和甲状腺方面存在统计学显著差异。同时,有和无MetS的患者在钙(P = .028)、镁(P < .001)、钾(P < .001)、空腹血糖(P = .047)、HbA1c(P < .001)、HDL(P < .001)、LDL(P < .001)、白蛋白(P = .008)、胆红素(P = .002)、甘油三酯(P = .011)、SBP(P = .001)和DBP(P = .011)、TSH(P = .005)、T3(P < .001)和T4(P < .001)方面存在统计学显著差异。此外,有和无甲状腺结节的参与者在钙(P < .001)、镁(P < .001)、钾(P < .001)、空腹血糖(P = .010)、HbA1c(P = .019)、HDL(P < .001)、LDL(P = .012)、白蛋白(P = .002)、胆红素(P < .001)、甘油三酯(P < .001)、SBP(P < .001)和DBP(P = .004)、TSH(P = .015)、T3(P < .001)和T4(P < .001)方面存在统计学显著差异。多因素逐步逻辑回归分析用于确定甲状腺结节存在的独立预测因素,其中TSH(P < .001)、甲状腺和糖尿病家族史(P < .001)、年龄(岁;P = .025)、DBP和SBP(P < .001)、BMI(P = .014)、HDL-C(P = .034)和腰围(厘米;P = .044)被认为是MetS患者甲状腺风险较高的预测因素。

结论

本研究结果证实MetS与MetS患者甲状腺结节风险之间存在强正相关。本研究表明,MetS患者可被视为未来甲状腺结节和癌症风险适度增加的一个标志。同时,MetS、肥胖和高血糖可能是甲状腺结节的一个可量化且可改变的风险因素。定期血糖控制可能是降低甲状腺发病率或预防甲状腺疾病的最重要治疗方法。

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