山西地区人群甲状腺结节与血脂异常的相关性分析

发布时间：2018-12-30 21:23

【摘要】：目的:分析山西地区的常住居民中甲状腺结节的患病情况,探讨甲状腺结节的发生与血脂异常的关系,了解可能引起甲状腺结节发生的相关危险因素,为血脂异常患者中甲状腺结节性疾病的筛查提供理论依据。方法:使用多阶段分层整群随机抽样的方法,随机抽取山西地区18周岁以上的居民做抽样调查。在城市人群中随机抽取1395例居民,在农村人群中随机抽取1261例居民,共2656例。所有同意参加的调查对象签知情同意书,并填写调查问卷,包括性别、年龄、身高、体重、既往史、口服药物情况等;采集调查对象的空腹静脉血,化验空腹血脂,行甲状腺超声。收集数据进行统计学分析。结果:1.纳入总样本量2656例,甲状腺结节的检出人数为305例,总患病率为11.48%;其中男性样本量为1363例,男性中甲状腺结节的检出人数为134例,其患病率为9.83%;女性样本量为1293例,女性中甲状腺结节的检出人数为171例,其患病率为13.23%,女性甲状腺结节的患病率较男性甲状腺结节的患病率高,差异有统计学意义(χ2=7.519,P=0.006)。2.按年龄分组,60岁以下各年龄组女性结节患病率均高于男性,在40岁年龄组男女结节患病率的差异有统计学意义(χ2=8.575,P=0.003),余年龄组男女结节患病率的差异均无统计学意义(P0.05)。3.男性、女性甲状腺结节的患病率都会随着年龄的增长而增高,增高趋势有统计学意义(总体:χ2=65.88,P0.001;男性:χ2=52.87,P0.001;女性:χ2=19.28,P0.001)。4.受检人群分别按甘油三酯(Triglyceride,TG)、总胆固醇(Total Cholesterol,TC)、低密度脂蛋白(Low-density lipoprotein,LDL)、高密度脂蛋白(High-density lipoprotein,HDL)分组分析甲状腺结节的患病率,LDL异常组甲状腺结节患病率高于LDL正常组,差异有统计学意义(χ2=3.91,P=0.048),TG、TC、HDL异常组与正常组甲状腺结节的患病率差异均无统计学意义(P0.05)。5.按有无甲状腺结节的发生分组,结节组TC水平高于非结节组,差异有统计学意义(t=2.111,P=0.035);结节组与非结节组的TG、LDL、HDL水平差异无统计学意义(P0.05)。6.应用Logistic回归分析,经性别、年龄校正后,总胆固醇水平的增高可能是甲状腺结节发生的危险因素(OR=1.070,95%可信区间为1.009~1.135)。结论:1.山西地区女性甲状腺结节的患病率高于男性,并且甲状腺结节的患病率有随着年龄的增长而增高的趋势。2.甲状腺结节的发生可能与血清低密度脂蛋白、总胆固醇水平相关。3.总胆固醇水平的增高可能是甲状腺结节发生的危险因素。
[Abstract]:Objective: to analyze the prevalence of thyroid nodules in residents of Shanxi Province, to explore the relationship between thyroid nodules and dyslipidemia, and to understand the risk factors that may lead to the occurrence of thyroid nodules. To provide theoretical basis for screening thyroid nodular diseases in patients with dyslipidemia. Methods: multistage stratified cluster random sampling was used to select randomly the residents over 18 years old in Shanxi area. 1395 residents were randomly selected from urban population and 2656 from rural population. All agreed participants signed informed consent forms and completed questionnaires, including gender, age, height, weight, past history, oral medication, etc. Fasting venous blood was collected, fasting blood lipid was tested and thyroid ultrasound was performed. Collect data for statistical analysis. Results: 1. The total sample size was 2656, the total prevalence rate of thyroid nodules was 11.48, the number of male samples was 1363, the number of male thyroid nodules was 134, the prevalence rate of thyroid nodules was 9.83. The prevalence of thyroid nodule in female was 13.23. The prevalence of thyroid nodule in female was higher than that in male (蠂 ~ 2 / 7.519, 蠂 ~ 2 = 7.519, 蠂 ~ 2 = 7.519, 蠂 ~ 2 = 7.519, P < 0.05). P0. 006). According to the age group, the nodule prevalence rate of female under 60 years old was higher than that of male group, and there was significant difference between male and female nodule prevalence rate in 40 years old group (蠂 2 = 8.575 P0. 003). There was no significant difference in nodule prevalence between men and women in the remaining age group (P0.05). The prevalence rate of thyroid nodules in males and females increased with age (overall: 蠂 2: 65.88%, P 0.001; males: 蠂 2, 52.87, P 0.001; female: 蠂 2, 19.28, P 0.001). The prevalence of thyroid nodules was analyzed by triglyceride (Triglyceride,TG), total cholesterol (Total Cholesterol,TC), low density lipoprotein (Low-density lipoprotein,LDL) and high density lipoprotein (High-density lipoprotein,HDL). The prevalence rate of thyroid nodules in abnormal LDL group was higher than that in normal LDL group (蠂 2 / 3.91 P 0.048). There was no significant difference in thyroid nodule prevalence between abnormal TG,TC,HDL group and normal group (P0.05). According to the occurrence of thyroid nodule, the TC level of nodule group was higher than that of non-nodule group, the difference was statistically significant (t = 2.111), and there was no significant difference in TG,LDL,HDL level between nodule group and non-nodule group (P0.05). By using Logistic regression analysis, the increase of total cholesterol level after sex and age correction may be the risk factor of thyroid nodule (OR=1.070,95% confidence interval 1.009 卤1.135). Conclusion: 1. The prevalence of thyroid nodules in women in Shanxi area is higher than that in men, and the prevalence rate of thyroid nodules increases with age. 2. 2. Thyroid nodules may be associated with serum low density lipoprotein (LDL) and total cholesterol levels. Increased total cholesterol may be a risk factor for thyroid nodules.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R581

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