甲状腺结节代谢指标相关性研究

Correlation Study of Metabolic Indexes of Thyroid Nodules

摘要: 目的：探讨血清脂联素在良性甲状腺器质改变疾病中的表达，以及其与代谢生化指标间的相关性。方法：回顾性分析在我院体检中心检测项目完善的171份体检报告，以甲状腺彩超结果分组分为无甲状腺结节组(74)、有甲状腺结节组(83)弥漫性改变组(16)，统计年龄、结节最大直径、空腹血糖(BG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)、血尿酸(UA)、脂联素(APN)、血清游离三碘甲腺原氨酸(FT3)、血清游离甲状腺素(FT4)、促甲状腺激素(TSH)。统计三组间脂联素表达差异。以总体纳入人群为统一整体，对脂联素与其他指标间相关性。结果：1) 三组间比较采用多独立样本秩和检验H检验，P < 0.05，组间存在差异。血清脂联素在弥漫性改变组中高于无结节组存在显著性差异。2) 采用Pearson相关性分析，甲状腺结节组中最大直径与FBG显著正相关(r = 0.247, P < 0.05)，与其他因素无相关性。3) 脂联素与FBG (r = −0.332)、TG (r = −0.209)、血清UA (−0.364)、FT3 (r = −0.214)呈显著负相关(P < 0.01)，与TC (r = 0.167, P < 0.05)呈正相关、与HDL-C (r = 0.442, P < 0.01)呈显著性正相关。与年龄、LDL-C、TSH、FT4无明显相关。结论：血清脂联素在弥漫性状腺改变疾病中表达增高。弥漫性改变组样本量过小是本研究的重大局限性，其相关结论仅为初步发现，需大规模研究验证。空腹血糖可能影响甲状腺结节的最大直径，可通过改善代谢，提高脂联素的表达。

Abstract: Objective: To investigate the expression of serum adiponectin in benign thyroid diseases and its correlation with metabolic biochemical indexes. Methods: A total of 171 people with complete detection items in the physical examination center of our hospital were retrospectively analyzed. According to the results of thyroid ultrasound, they were divided into Normalthyroid group (74), Thyroid nodule group (83) and Diffuse change group (16). Age, maximum diameter of nodules, fasting plasma glucose (FBG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglycerides (TG), blood uric acid (UA), adiponectin (APN), serum free triiodothyronine (FT3), serum free thyroxine (FT4), thyrotropin (TSH) were measured. The difference of adiponectin expression among the three groups was statistically analyzed. Taking the overall inclusion population as a unified whole, the correlation between adiponectin and other indicators was analyzed. Result: 1) Comparison between the three groups using multiple independent samples rank sum test H test, P < 0.05, there are differences between groups. There was a significant difference in serum adiponectin between the diffuse change group and the non-nodule group. 2) Pearson correlation analysis showed that the maximum diameter in the thyroid nodule group was significantly positively correlated with FBG (r = 0.247, P < 0.05), and had no correlation with other factors. serum UA (−0.364), FT3 (r = −0.214, P < 0.01), positively correlated with TC (r = 0.167, P < 0.05), and positively correlated with HDL-C (r = 0.442, P < 0.01). There was no significant correlation with age, LDL-C, TSH and FT4. Conclusion: Serum adiponectin is increased in diffuse glandular alteration disease. The small sample size of the diffuse change group is a major limitation of this study, and its conclusions are only preliminary findings and need to be verified by large-scale research. Fasting blood glucose may affect the maximum diameter of thyroid nodules, which can improve adiponectin expression by improving metabolism.