Correlations between papillary thyroid carcinoma and indicators including body mass index
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摘要:目的 探讨甲状腺乳头状癌（PTC）与年龄、性别、体质量指数（BMI）及甲状腺功能的相关性。方法 回顾性分析662例PTC患者（PTC组）和842例甲状腺良性结节（BTN）患者（BTN组）的临床资料，比较2组年龄、性别、BMI和甲状腺功能水平，采用Logistic回归分析评价甲状腺乳头状癌的危险因素，并比较2组不同年龄患者的BMI水平差异。结果 PTC组年龄、血清游离三碘甲状腺原氨酸（FT3）水平低于BTN组，男性占比、BMI和促甲状腺激素（TSH）水平高于BTN组，差异有统计学意义（P < 0.05）。Logistic多因素分析提示，低年龄、男性、高TSH、低FT3、高BMI是PTC的危险因素。≤ 40岁患者中，PTC组肥胖者占比高于BTN组，差异有统计学意义（P < 0.05）。结论 PTC患者BMI偏高，提示肥胖可能与PTC发病相关。男性、低年龄、高BMI、低FT3、高TSH是PTC的危险因素。40岁及以下PTC患者的肥胖率高于BTN患者。
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关键词:
- 甲状腺乳头状癌 /
- 甲状腺结节 /
- 体质量指数 /
- 促甲状腺激素 /
- 游离三碘甲状腺原氨酸
Abstract:Objective To investigate the correlations between papillary thyroid carcinoma (PTC) and age, gender, body mass index (BMI), as well as thyroid function.Methods The clinical data of 662 cases with PTC (PTC group) and 842 cases with benign thyroid nodules (BTN) (BTN group) was retrospectively analyzed. Age, gender, BMI and thyroid function level were analyzed between the two groups. Logistic regression analysis was used to evaluate the risk factors of PTC. The difference in BMI level of patients with differed age stratification between the two groups was compared.Results Compared with BTN group, age and serum free tri-iodothyronine (FT3) level in the PTC group were lower, while the male ratio, BMI and thyroid stimulating hormone (TSH) level were higher (P < 0.05). Logistic multivariate analysis showed that younger age, male, high level of TSH, low level of FT3 and high BMI were risk factors of PTC. Among patients ≤ 40 years old, the proportion of obese patients in the PTC group was higher than that in the BTN group (P < 0.05).Conclusion BMI of patients with PTC is higher, suggesting that obesity may be related to occurrence of PTC. Gender, younger age, high BMI, low FT3 and high TSH are risk factors of PTC. The obesity rate of PTC patients is higher than that of BNT in young people aged under 40 years. -
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表 1 2组患者临床特征比较(x±s)[n(%)]
指标 BTN组(n=842) PTC组(n=662) t/ χ2 P 年龄/岁 52.93±12.38 47.34±12.87 8.471 < 0.001 性别 男 179(21.26) 177(26.74) 6.156 0.013 女 663(78.74) 485(73.26) BMI/(kg/m2) 23.73±3.21 24.10±3.46 -2.123 0.034 BMI < 18.5 kg/m2 28(3.33) 24(3.63) 3.362 0.339 18.5~ < 24.0 kg/m2 440(52.26) 322(48.64) 24.0~ < 28.0 kg/m2 297(35.27) 239(36.10) ≥28.0 kg/m2 77(9.14) 77(11.63) FT3/(pmol/L) 5.11±0.71 4.98±0.67 3.613 < 0.001 FT4(pmol/L) 17.01±2.93 16.79±3.02 1.409 0.159 TSH/(mIU/L) 1.90±2.14 2.99±5.27 -5.009 < 0.001 TSH < 3.0 mIU/L 737(87.53) 537(81.12) 11.762 0.001 ≥3.0 mIU/L 105(12.47) 125(18.88) BTN: 甲状腺良性结节; PTC: 甲状腺乳头状癌; BMI: 体质量指数; FT3: 游离三碘甲状腺原氨酸;
FT4: 游离甲状腺素; TSH: 促甲状腺素。
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表 2 影响PTC发生的多因素分析
因素 B SE Wald P OR 95%CI 性别 -0.382 0.130 8.687 0.003 0.682 0.529~0.880 年龄 -0.039 0.004 76.853 < 0.001 0.962 0.954~0.971 BMI 0.041 0.017 6.199 0.013 1.042 1.009~1.076 FT3 -0.396 0.094 17.678 < 0.001 0.673 0.560~0.810 TSH 0.478 0.153 9.741 0.002 1.613 1.195~2.178 BMI: 体质量指数; FT3: 游离三碘甲状腺原氨酸; TSH: 促甲状腺素。
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表 3 2组不同年龄段患者BMI分布情况[n(%)]
组别 BMI < 18.5 kg/m2 18.5~ < 24.0 kg/m2 24.0~ < 28.0 kg/m2 ≥28.0 kg/m2 BTN组(n=842) ≤40岁亚组(n=119) 8(6.72) 62(52.10) 44(36.98) 5(4.20) 41~64岁亚组(n=577) 16(2.77) 296(51.30) 204(35.36) 61(10.57) ≥65岁亚组(n=146) 4(2.74) 82(56.16) 49(33.56) 11(7.54) PTC组(n=662) ≤40岁亚组(n=199) 12(6.03) 103(51.76) 62(31.16) 22(11.05)* 41~64岁亚组(n=403) 8(1.98) 190(47.15) 155(38.46) 50(12.41) ≥65岁亚组(n=60) 4(6.67) 29(48.33) 22(36.67) 5(8.33) BMI: 体质量指数; BTN: 甲状腺良性结节; PTC: 甲状腺乳头状癌。与BTN组比较, * P < 0.05。
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