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甲状腺功能正常女性血脂水平与甲状腺结节风险的相关性

Correlation between blood lipids and risk of thyroid nodules in euthyroid women

  • 摘要:
    目的 探讨甲状腺功能正常女性血脂参数与甲状腺结节风险的相关性及剂量-反应关系,为疾病预防提供参考。
    方法 采用病例对照研究设计,纳入甲状腺功能正常女性1 412例(病例组701例,对照组711例)。采用logistic回归模型分析血脂参数与甲状腺结节风险的相关性,采用限制性立方样条模型分析血脂与甲状腺结节风险的剂量-反应关系。
    结果 Logistic回归模型显示,在校正年龄、体质量指数(body mass index,BMI)及受教育程度后,以血清三酰甘油(triglyceride,TG)最低四分位组(Q1,TG≤0.92 mmol/L)为参照,Q2(TG 0.93~1.24 mmol/L)、Q3(TG 1.25~1.81 mmol/L)、Q4(TG>1.81 mmol/L)组甲状腺结节风险分别增加45%(OR=1.45,95%CI 1.06~1.98)、101%(OR=2.01,95%CI 1.47~2.77)和67%(OR=1.67,95%CI 1.19~2.33)。Log10TG每增加1个单位,甲状腺结节风险升高98%(OR=1.98,95%CI 1.14~3.45);进一步校正甲状腺球蛋白抗体(thyroglobulin antibody, TGAb)、甲状腺过氧化物酶抗体(thyroid peroxidase antibody,TPOAb)和尿碘后,二者相关性仍显著(OR=1.75,95%CI 1.00~3.06,P<0.05)。多因素校正后,血清总胆固醇、高密度脂蛋白胆固醇及低密度脂蛋白胆固醇与甲状腺结节风险均无明显相关性。限制性立方样条模型显示,TG水平与甲状腺结节风险呈非线性剂量-反应关系:甲状腺结节风险在TG<1.23 mmol/L时单调上升,当TG≥1.23 mmol/L时趋于平缓或轻微下降。
    结论 在甲状腺功能正常女性中TG升高与甲状腺结节风险显著相关,二者呈非线性剂量-反应关系。

     

    Abstract:
    Objective To explore the correlation and dose-response relationship between blood lipid parameters and the risk of thyroid nodules (TNs) in euthyroid women, providing references for disease prevention.
    Methods A case-control study was conducted, including 1 412 euthyroid women (701 in the case group and 711 in the control group). Crude and multivariable logistic regression models were used to assess the association between blood lipid parameters and the risk of TNs, and restricted cubic spline regression was applied to explore the dose-response relationship.
    Results Compared with women in the lowest quartile of serum triglyceride (TG; Q1, TG≤0.92 mmol/L), the risk of TNs was 45% (OR=1.45, 95%CI 1.06-1.98) higher for those in Q2 (TG 0.93-1.24 mmol/L), 101% (OR=2.01, 95%CI 1.47-2.77) higher for those in Q3 (TG 1.25-1.81 mmol/L), and 67% (OR=1.67, 95%CI 1.19-2.33) higher for those in Q4 (TG>1.81 mmol/L) after adjusting for age, body mass index (BMI) and education. For each unit increase in log10TG, the risk increased by 98% (OR=1.98, 95%CI 1.14-3.45). Moreover, the correlation remained statistically significant even after further adjustment for thyroglobulin antibody (TGAb), thyroid peroxidase antibody (TPOAb) and urinary iodine (OR=1.75, 95%CI 1.00-3.06, P<0.05). However, correlations of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) with the risk of TNs were not statistically significant. Restricted cubic spline regression analysis further demonstrated the non-linear dose-response relationship of TG levels with the risk of TNs. Specifically, the risk of TNs increased in a monotonic manner at lower TG concentrations (<1.23 mmol/L), but appeared to plateau or even slightly decrease at higher levels of TG (≥1.23 mmol/L).
    Conclusions Among euthyroid women, higher serum TG level is associated with risk of TNs, and this correlation is non-linear.

     

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