南方医科大学学报

南方医科大学学报 ›› 2020, Vol. 40 ›› Issue (02): 268-273.doi: 10.12122/j.issn.1673-4254.2020.02.09

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甲状腺结节检出情况及影响因素： 10年309 576例体检人群分析

赖晓英，欧阳平，朱 宏，安胜利，夏李娟，姚奕婷，张 涵，李 帜，邓 侃   

  • 出版日期:2020-03-14 发布日期:2020-02-20
  • 基金资助:

Detection rate of thyroid nodules in routine health check-up and its influencing factors: a 10-year survey of 309 576 cases

  

  • Online:2020-03-14 Published:2020-02-20

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摘要： 目的 了解广东省健康体检人群甲状腺结节检出情况并分析相关影响因素。方法 回顾分析近10 年广东省某医院309 576 例体检人员甲状腺彩超检查情况。将人群分为甲状腺结节组与非甲状腺结节组，使用SPSS22.0软件，组间比较根据数据类型分别用两独立样本t检验、Mann-Whitney U检验及χ2检验进行分析，用二元logistic回归分析不同影响因素与甲状腺结节之间的关系，计算比值比（OR）与95%置信区间（95% CI）。结果 经过数据结构化和标准化，甲状腺结节总检出率为9.68%，其中男性为7.71%，女性为13.51%，差异有统计学意义（χ2=2677.08，P<0.001）。总体上，甲状腺结节检出率随年龄增长而逐渐升高；不同年龄段，女性检出率均高于男性，差异有统计学意义（P<0.001）。甲状腺结节组男性比例、年龄、BMI、SBP、DBP、FBG、TC、LDL-C、HDL-C、TG及脂肪肝、血脂异常、血糖偏高、代谢综合征检出率均高于非甲状腺结节组，且差异有统计学意义（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：OR=1.660，95%CI:1.613-1.710；≥60岁：OR=3.329，95%CI: 3.202-3.462）、BMI （体质量偏轻：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）、血脂异常（OR=1.053，95%CI: 1.022-1.085）、血糖偏高（OR=1.177，95%CI: 1.105-1.252）、及代谢综合征（OR=1.111，95%CI: 1.071-1.152）有关。结论 广东省某医院体检人群中女性甲状腺结节检出率明显高于男性。性别、年龄、BMI及代谢相关疾病为重要影响因素。男性、体质量偏轻可能是甲状腺结节的保护因素，而年龄增长、超重/肥胖、血脂异常、血糖偏高及代谢综合征可能使甲状腺结节检出风险提高。因此，在健康体检人群中普及甲状腺彩超检查对甲状腺疾病早期防治有重要的临床意义。

Abstract: Objective To analyze the detection rate of thyroid nodules and its influencing factors among individuals undergoing routine health check-up in Guangdong Province. Methods 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 t 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% CI) were calculated. Results 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 (χ2=2677.08, P<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 (P<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 P<0.001). Binary logistic regression analysis showed that thyroid nodules were significantly associated with gender (OR=0.455, 95%CI: 0.443-0.468), age (45-59 years: OR=1.660, 95%CI: 1.613-1.710; ≥60 years: OR=3.329, 95%CI: 3.202- 3.462), BMI (underweight: OR=0.808, 95%CI: 0.755-0.864; overweight: OR=1.074, 95%CI: 1.038-1.112; obesity: OR=1.281, 95%CI: 1.221-1.343), hyperlipidemia (OR=1.053, 95%CI:1.022-1.085), high blood glucose (OR=1.177, 95%CI: 1.105-1.252), and metabolic syndrome (OR=1.111, 95%CI: 1.071-1.152). Conclusion 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.