Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, China.
Institute for Endemic Disease Prevention and Control, Yun nan Institute of Endemic Diseases Control and Prevention, Dali, China.
Front Endocrinol (Lausanne). 2024 Nov 7;15:1451911. doi: 10.3389/fendo.2024.1451911. eCollection 2024.
The prevalence of thyroid nodules (TNs) has been increasing rapidly. However, little is known about the drivers of its high prevalence and tendency of malignancy. This study aimed to analyze the factors influencing the prevalence and malignancy of TNs in the adult population.
A multi-stage stratified cluster random sampling was used to conduct a cross-sectional survey of the population in different iodine uptake areas in Anhui Province. The areas with deficient, adequate, and excess iodine intake were grouped according to population's urine iodine. A questionnaire, laboratory examination and ultrasound diagnosis were conducted on the participants. Nodules were diagnosed and distinguished using ultrasonography. Spearman rank correlation, random forest importance ranking, ROC curve, and unconditional binary logistic regression analyses were used to screen for risk factors.
A total of 1,697 participants (539 males and 1,158 females) aged 18-60 years were included, 355 of whom were diagnosed with TN. The prevalence of TNs was 20.9% and varied in different areas, with 21.9%, 25.8%, and 18.0% in the iodine deficient, adequate, and iodine excess areas, respectively. The prevalence of TNs in females was significantly higher than that in males (24.5% vs. 13.2%) and it increased with age. Female sex (OR, 1.67 [1.21-2.30]), old age (>41 years, OR, 2.00 [1.14, 3.50]) and smoking were risk factors for the development and deterioration of TNs.
Patients with TNs should exercise caution when consuming goitrogens and adhere to a scientifically balanced diet. Given the high incidence of TNs in field setting, it is necessary to raise public health awareness among residents and perform regular thyroid ultrasound screening to facilitate early detection and treatment.
甲状腺结节（TNs）的患病率呈快速上升趋势。然而，其高患病率和恶性倾向的驱动因素知之甚少。本研究旨在分析影响成人人群 TN 患病率和恶性程度的因素。
采用多阶段分层聚类随机抽样方法，对安徽省不同碘摄入地区的人群进行横断面调查。根据人群尿碘将碘摄入不足、充足和过量地区进行分组。对参与者进行问卷调查、实验室检查和超声诊断。使用超声诊断甲状腺结节。采用 Spearman 秩相关、随机森林重要性排序、ROC 曲线和非条件二项逻辑回归分析筛选危险因素。
共纳入 1697 名 18-60 岁的参与者（男性 539 名，女性 1158 名），其中 355 名被诊断为 TN。TN 的患病率为 20.9%，且在不同地区有所差异，碘缺乏、充足和碘过量地区分别为 21.9%、25.8%和 18.0%。女性 TN 的患病率明显高于男性（24.5% vs. 13.2%），且随年龄增长而增加。女性（OR，1.67[1.21-2.30]）、高龄（>41 岁，OR，2.00[1.14-3.50]）和吸烟是 TN 发生和恶化的危险因素。
TN 患者在食用致甲状腺肿物质时应谨慎，并坚持科学均衡的饮食。鉴于现场 TN 的发病率较高，有必要提高居民的公共卫生意识，并定期进行甲状腺超声筛查，以便早期发现和治疗。
