中国全科医学 ›› 2023, Vol. 26 ›› Issue (27): 3392-3396.DOI: 10.12114/j.issn.1007-9572.2023.0067

• 论著 • 上一篇    下一篇

代谢相关性脂肪性肝病严重程度与甲状腺结节的相关性研究

白一彤1, 林连捷2, 裴冬梅1,*()   

  1. 1.110004 辽宁省沈阳市,中国医科大学附属盛京医院全科医学科 社会服务部
    2.110004 辽宁省沈阳市,中国医科大学附属盛京医院消化内科
  • 收稿日期:2022-10-27 修回日期:2023-03-01 出版日期:2023-09-20 发布日期:2023-04-03
  • 通讯作者: 裴冬梅

  • 作者贡献:白一彤负责研究设计与实施,收集整理数据并撰写论文;林连捷、裴冬梅对文章进行整体质量控制、监督管理。
  • 基金资助:
    辽宁省社会科学规划基金项目(L19BGL041); 沈阳市科技计划项目(F14-158-9-49)

Correlation between the Severity of Metabolic-associated Fatty Liver Disease and Thyroid Nodules

BAI Yitong1, LIN Lianjie2, PEI Dongmei1,*()   

  1. 1. Social Service Team/Department of General Medicine, Shengjing Hospital of China Medical University, Shenyang 110004, China
    2. Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang 110004, China
  • Received:2022-10-27 Revised:2023-03-01 Published:2023-09-20 Online:2023-04-03
  • Contact: PEI Dongmei

摘要: 背景 脂肪肝与甲状腺结节均为临床常见慢性疾病,且均与代谢密切相关,然而二者之间是否存在一定的相关性鲜有研究。 目的 探讨代谢相关性脂肪性肝病及其严重程度与甲状腺结节的相关性。 方法 选取2020年12月—2021年12月就诊于中国医科大学附属盛京医院的代谢相关性脂肪性肝病患者666例,其中轻度316例为A组,中重度350例为B组,以及同时期的本院健康体检者330例为C组。研究对象均进行BMI测量、血液检测及肝脏、甲状腺超声检查。采用多因素Logistic回归分析探究代谢相关性脂肪性肝病患者合并甲状腺结节的影响因素。 结果 C组研究对象甲状腺结节患病率(19.70%,65/330)低于A、B组(25.36%,81/316;34.86%,122/350),B组研究对象甲状腺结节患病率高于A组(P<0.05);B组研究对象中国超声甲状腺影像报告和数据系统(C-TIRADS)3类、≥4类比例高于A组(P<0.05);多因素Logistic回归分析结果显示,年龄(OR=1.447)、BMI(OR=2.847)、三酰甘油(OR=2.947)、总胆固醇(OR=3.235)、空腹血糖(OR=2.780)、糖化血红蛋白(OR=3.371)是代谢相关性脂肪性肝病患者合并甲状腺结节的危险因素(P<0.05)。 结论 代谢相关性脂肪性肝病患者甲状腺结节患病率增高;随着肝脏脂肪变加重,中、重度代谢相关性脂肪性肝病患者甲状腺结节恶性风险增高;年龄、体质指数、三酰甘油、总胆固醇、空腹血糖、糖化血红蛋白是代谢相关性脂肪性肝病合并甲状腺结节的危险因素。

关键词: 脂肪肝, 甲状腺结节, 肝疾病, 超声, 相关性研究, 影响因素分析, 沈阳市, Logistic模型

Abstract:

Background

Both fatty liver disease and thyroid nodules are common clinical chronic diseases that are closely related to metabolism, but there is little research on whether there is a certain correlation between them.

Objective

To explore the overall and disease severity-specific correlations between metabolic-associated fatty liver disease (MAFLD) and thyroid nodules.

Methods

This study selected 666 MAFLD patients〔including 316 mild cases (group A) , and 350 moderate to severe cases (group B) 〕, and 330 health examinees (group C) from Shengjing Hospital of China Medical University from December 2020 to December 2021. All the subjects underwent general anthropometric measurement, blood tests and ultrasound examination of the liver and thyroid. Multivariate Logistic regression was used to explore the influencing factors of thyroid nodules in MAFLD.

Results

The prevalence rate of thyroid nodules in group C (19.70%, 65/330) was lower than that in group A (25.36%, 81/316) or B (34.86%, 122/350) (P<0.05) . Compared with group A, group B had higher prevalence rate of thyroid nodules (P<0.05) , and higher prevalence rates of C-TIRADS 3 and ≥4 thyroid nodules (P<0.05) . Multivariate Logistic regression analysis showed that age (OR=1.447) , BMI (OR=2.847) , triacylglycerol (TG) (OR=2.947) , total cholesterol (TC) (OR=3.235) , fasting plasma glucose (FPG) (OR=2.780) and glycated haemoglobin (HbA1c) (OR=3.371) were the risk factors of thyroid nodules in MAFLD (P<0.05) .

Conclusion

MAFLD is associated with increased prevalence rate of thyroid nodules. The risk of malignant thyroid nodules increases with the aggravation of hepatic steatosis (namely progression from mild/moderate to severe) . Age, BMI, TG, TC, FPG and HbA1c are associated factors of MAFLD complicated with thyroid nodules.

Key words: Fatty liver, Thyroid nodules, Liver diseases, Ultrasonography, Correlation study, Root cause analysis, Shenyang, Logistic models