目的:调查江苏适碘地区农村老年人群甲状腺结节和甲状腺癌的患病率,并分析甲状腺结节患病的危险因素.方法:采用整群抽样的方法对江苏适碘地区进行横断面调查研究,选取2 590例60岁及以上的常驻居民进行体检与生化检查,采用甲状腺影像学报告及数据系统(Thyroid Imaging Reporting And Data System,TI-RADS)分类方法对甲状腺结节进行分类评估,并对部分甲状腺结节进行超声引导下活检病理检查,采用Logistic回归分析甲状腺结节的危险因素.结果:2 590例受者中共检出甲状腺结节883例,总体患病率为34.09％(883/2 590),女性患病率明显高于男性(x2=27.885,P=0.000),有甲状腺结节组和无甲状腺结节组相比,身高、体质指数、空腹血糖、糖化血红蛋白、空腹胰岛素、甘油三酯、25羟维生素D差异有统计学意义(分别为 t=5.337、P=0.000,t=-5.160、P=0.000,t=-2.341、P=0.019,t=-4.993、P=0.000,t=-2.384、P=0.020,t=-2.940、P=0.003,t=6.432,P=0.000).男性甲状腺结节的患病率随年龄的增加而增加.老年人甲状腺癌的总体检出率为0.34％.Logistic回归分析结果显示,体质指数和糖化血红蛋白是甲状腺结节患病的危险因素(OR=1.054,95％CI=1.028～1.081,P＜0.01;OR=1.257,95％CI=1.117～1.414,P＜0.01).结论:甲状腺结节是老年人常见的甲状腺疾病,但甲状腺癌的患病率总体较低.糖脂代谢紊乱与甲状腺结节的患病密切相关.
Prevalence and risk factors of thyroid nodules in the elderly in iodine-sufficient areas
Objective:To investigate the prevalence of thyroid nodules and thyroid cancer and the risk factors for thyroid nodules in a rural elderly population in iodine-sufficient areas of Jiangsu Province,China.Methods:A cross-sectional survey was performed in iodine-sufficient areas of Jiangsu Province,investigating a total of 2 590 permanent residents aged ≥60 years selected by cluster sam-pling.They underwent physical examination and biochemical tests.Thyroid nodules were classified using the Thyroid Imaging Report and Data System(TI-RADS),part of which were examined for pathological information through an ultrasound-guided biopsy.A logistic regression analysis was used to analyze the risk factors for thyroid nodules.Results:A total of 883 cases of thyroid nodules were detected in 2590 subjects.With an overall prevalence of 34.09％(883/2 590).The prevalence of female subjects was signifi-cantly higher than that of male subjects(x2=27.885,P=0.000).There were significant differences in height(Ht),body mass index(BMI),fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),fasting insulin(FINS),triglyceride(TG),and 25-hydroxyvitamin D[25(OH)D]between the participants with and without thyroid nodules(t=5.337、P=0.000,t=-5.160、P=0.000,t=-2.341、P=0.019,t=-4.993、P=0.000,t=-2.384、P=0.020,t=-2.940、P=0.003,t=6.432、P=0.000,respectively).The prevalence of thyroid nodules in men increased with age.The overall detection rate of thyroid cancer in the elderly was 0.34％.The logistic regression analysis showed that the BMI and HbA1c hemoglobin were risk factors for thyroid nodules(OR=1.054,95％CI=1.028-1.081,P＜0.01;OR=1.257,95％CI=1.117-1.414,P＜0.01).Conclusion:Thyroid nodules are prevalent in the elderly in iodine-sufficient areas of Jiangsu Province,with a low prevalence of thyroid cancer.Glucose and lipid metabolism disorders are significantly related to the prevalence of thyroid nodules.
万方数据
维普
