摘要
目的观察男性2型糖尿病患者甲状腺结节与内分泌激素水平的关系。方法490例男性2型糖尿病患者被分为甲状腺结节组228例（192例结节性良性结节，30例囊性结节，6例甲状腺癌），无甲状腺结节组（262例）。根据甲状腺结节大小，分为：结节〈1．0cm组，结节1．0～2．0cm组，结节〉2．0cm组。检测各组血糖、血脂、血清胰岛素、甲状腺功能、性激素和肾上腺激素水平。分析激素水平与甲状腺结节的相关性。结果与无甲状腺结节组相比，甲状腺结节组空腹胰岛素（FINS）、稳态模型评估一胰岛素抵抗指数（HOMA-IR）、促甲状腺激素（TSH）和黄体生成素（LH）水平明显升高（t=2．65-3．59，P均〈0．05）；而且所有甲状腺结节亚组FINS、HOMA-IR、TSH和LH水平较高，与结节〈1．0cm组相比，结节〉2．0cm组FINS、HOMA-IR、TSH和LH水平升高（F=8．26、5．39、7．65、9．32，P均〈0．05）；按三分位法进行分组，高水平FINS组、高水平HOMA—IR组、高水平TSH组、高水平LH组甲状腺结节的发病率均显著增加（x2=4．37、5．29、6．54、3．36，P均〈0．05）；Pearson相关性分析发现，甲状腺结节大小与FINS、HOMA—IR、TSH、LH水平呈正相关（r=0．215、0．387、0．382、0．181，P均〈0．05）；logistic回归分析发现FINS（OR=1．252，95％C1：1．164～1．295，P〈0．05）、HOMA—IR（OR=1．326，95％CI：1．053～1．352）、TSH（OR=1．217，95％CI：1．021～1．159，P〈0．05）和LH（OR=1．358，95％CI：1．063～1．174，P〈0．05）是甲状腺结节的独立危险因素。结论内分泌激素水平失衡在甲状腺结节的发病机制中起重要作用，FINS、HOMA-IR、TSH和LH是男性2型糖尿病患者甲状腺结节的独立危险因素。
Objective To investigate the association between thyroid nodules and levels of endo- crine hormones in male patients with type 2 diabetes. Methods A total of 490 male patients with type 2 diabetes mellitus were enrolled, and were divided into thyroid nodule group （n = 228, 192 had a solid benign nodule, 30 had a cystic nodule, and 6 had a cancerous nodule） and non-thyroid nodule group （ n = 262）, According to the size of thyroid nodule, all patients were further divided into small nodule group （ 〈1.0 cm）, medium nodule group （1.0-2.0 cm） and big nodule group（ 〉2.0 cm）. Blood glucose, blood lipids, serum insulin, thyroid function, sex hormones and adrenal hormone were measured in all groups. The correlations between hormone levels and thyroid nodules were analyzed. Results Compared with non-thyroid nodule group, levels of fasting insulin level （FINS）, homeostasis model assessment of insu- lin resistance （HOMA-IR）, thyroid stimulating hormone （TSH） and luteinizing hormone （LH） were signif- icantly elevated in thyroid nodule group （t = 2.65-3.59, all P 〈 0.05 ）. The levels of FINS, HOMA-IR, TSH and LH were higher in all thyroid nodule sub-groups; compared with small nodule group, the levels of FINS, HOMA-IR, TSH and LH were statistically significant in big nodule group （ F = 8.26,5.39,7.65,9.32, all P 〈 0.05 ）. The incidence of thyroid nodules increased significantly in patients with high levels of FINS, HOMA-IR, TSH and LH（x2 = 4.37, 5.29,6.54,3.36, all P 〈 0. 05 ）. Pearson correlation analysis found that the incidence of thyroid nodules was positively correlated with the levels of FINS, HOMA-IR, TSH and LH（ r=0. 215,0. 387,0. 382,0. 181 ,all P 〈 0. 05 ）. Logistic regression analysis revealed that FINS （ OR = 1. 252, 95% CI： 1. 164-1. 295, P 〈 0.05 ）, HOMA-IR （ OR = 1. 326, 95 % CI： 1. 053-1. 352）, TSH （OR=1.217, 95%CI： 1.021- 1.159, P〈0.05） and LH （0R=1.358, 95%CI： 1.063- 1.174, P 〈 0. 05 ） were independent risk factors f
作者
郑仁东
张会峰
胡咏新
曹雯
曹琳
孙洪平
褚晓秋
刘克冕
刘超
Zheng Rendong;Zhang Huifeng;Hu Yongxin;Cao Wen;Cao Lin;Sun Hongping;Chu Xiaoqiu;Liu Kemian;Liu Chao(Endocrine and Diabetes Center, Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing University of Traditional Chinese Medicine, Nanjing 210028, China)
出处
《国际内分泌代谢杂志》
2018年第4期222-227,共6页
International Journal of Endocrinology and Metabolism
关键词
甲状腺结节
男性
2型糖尿病
胰岛素抵抗
甲状腺激素
性激素
Thyroid nodules
Male
Type 2 diabetes mellitus
Insulin resistance
Thyroid hor-mones
Gonadal hormone
