摘要
目的 探讨甲状腺结节(thyroid nodule,TN)患者糖脂代谢指标、生活方式和血清25羟维生素D水平的相关性.方法 选择2022年3～11月于锦州医科大学附属第一医院健康管理中心行甲状腺超声检查的2 553例TN患者为TN组,选择同期1 054例健康体检者为健康组.TN组根据血清25羟维生素D水平将其分为3个亚组,即25羟维生素D充足组、不足组和缺乏组.分析不同血清25羟维生素D水平与糖脂代谢指标、生活方式的关系.采用多元logistic回归分析模型分析TN组维生素D缺乏及不足的影响因素.结果 TN组空腹血糖、体质量指数、甘油三酯水平高于健康组,高密度脂蛋白胆固醇及血清25羟维生素D水平低于健康组,差异均有统计学意义(P<0.05).TN组中,维生素D缺乏组和不足组年龄、空腹血糖、甘油三酯水平显著高于充足组,高密度脂蛋白胆固醇低于充足组,差异均有统计学意义(P<0.05).单因素分析结果显示,TN组中,维生素D缺乏组和不足组吸烟比例明显高于不吸烟比例;同时,睡眠质量差、户外活动时间短和日照时间短患者比例显著高于睡眠质量好、户外活动时间长和日照时间长患者比例,差异均有统计学意义(P<0.05).多元logistic回归分析显示,女性、较高年龄、不饮用牛奶、每日吸烟、户外活动时间不足、睡眠质量较差、日照时间不足等因素是TN组血清25羟维生素D缺乏的危险因素,而较高的高密度脂蛋白胆固醇水平是TN组血清25羟维生素D缺乏的保护因素,差异有统计学意义(P<0.05).结论 锦州地区的TN组血清25羟维生素D水平较低,应强调对该人群维生素D水平监测的重要性.确定导致TN患者血清25羟基维生素D水平降低的潜在危险因素,对于制定以提高维生素D水平为目标的干预措施具有重要的临床意义.
Abstract
Objective To investigate the relationship between glucose and lipid metabolism indicators,lifestyle and serum 25 hydroxyvitamin D levels in patients with thyroid nodule(TN).Methods A total of 2 553 patients with thyroid nodules who underwent thyroid ultrasound examination at the HealthManagementCenter of the First Affiliated Hospital of Jinzhou Medical University from March to November 2022 were selected as the TN group,and 1 054 healthy check-up patients were selected as the healthy group during the same period.The TN group was divided into three subgroups according to the serum 25 hydroxyvitamin D level,namely,25 vitamin D sufficient group,insufficient group and deficient group.The relationship between differ-ent serum 25 hydroxyvitamin D levels and glucolipid metabolic indexes and lifestyle was analyzed.A multi-variate logistic regression analysis model was used to analyze the factors influencing vitamin D deficiency and insufficiency in TN patients.Results In the TN patients,fasting blood glucose,body mass index,and tri-glyceride levels were significantly higher,while HDL and serum 25 hydroxyvitamin D levels were significant-ly lower compared with the healthy group,and the differences were statistically significant(P<0.05).Among TN patients,age,fasting blood glucose and triglyceride levels were significantly higher in the vita-min D deficiency and insufficiency groups than in the sufficiency group,while high-density lipoprotein cho-lesterol was lower than in the sufficiency group,and the differences were statistically significant(P<0.05).Univariate analysis showed that among TN patients with vitamin D deficiency or insufficiency,the propor-tion of smokers was significantly higher than that of nonsmokers;meanwhile,the proportion of patients with poor sleep quality,short outdoor activity time and short sunshine time was significantly higher than that of patients with good sleep quality,long outdoor activity time and long sunshine time,and the differences were statistically significant(P<0.05).Multiple logistic regression analysis showed that female,higher age,not drinking milk,daily smoking,insufficient time for outdoor activities,poor quality of sleep,and insufficient hours of sunlight were risk factors for serum 25 hydroxyvitamin D deficiency in patients with TN,whereas higher levels of high-density lipoprotein cholesterol were protective factors for serum 25 hydroxyvitamin D deficiency in patients with TN,and the differences were statistically significant(P<0.05).Conclusions The low serum 25 hydroxyvitamin D levels in TN patients in the Jinzhou region emphasize the importance of monitoring vitamin D levels in this population.Identifying potential risk factors for lower serum 25 hy-droxyvitamin D levels in TN patients is clinically important for developing interventions aimed at increasing vitamin D levels to improve the vitamin D nutritional status of TN patients.
维普
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