Prevalence Of Thyroid Nodules And Related Risk Factors In Middle-aged And Elderly People In Lanzhou

Object:To understand the prevalence of thyroid nodules（TN）in middle-aged and elderly people in Lanzhou,Gansu Province,to clarify its epidemic characteristics and related influencing factors.Methods:From 2014 to 2016,a total of 3778 residents aged 43 and over who have lived for 5 years and above were selected by cluster sampling in tianqingjiayuan community,guangwumen community and Xicun street community of Lanzhou city.Basic information,physical examination,laboratory test and thyroid ultrasound were collected.According to the ultrasound results,they were divided into TN group and non TN group.The basic characteristics,ultrasound characteristics,questionnaire data,clinical characteristics and the differences of laboratory examination and depression were included in the logistic regression analysis.In addition,data on female reproductive factors were collected to analyze the differences of reproductive factors between the two groups.Finally,logistic regression was included to analyze the independent factors of female TN.Results:（1）A total of 3778 people were included in this study,aged between 43-79 years,with an average age of 60.75±7.71 years,including 1028 men,with an average age of 62.54±7.86 years,and 2750 women,with an average age of 60.09±7.55 years.A total of 2103 people were detected with TN,and the prevalence rate was 55.66%.The prevalence of TN increased significantly with age(overall:χ~2_trend=110.338,P<0.01,male:χ~2_trend=29.046,P<0.01,female:χ~2_trend=104.977,P<0.01).In different age groups,the prevalence of women was higher than that of men（all P<0.05）.（2）In TN,small nodules accounted for 63.34%,large nodules 36.66%,single nodules 39.47%,multiple nodules 60.53%,cystic,cystic solid and solid nodules10.18%,20.21%and 69.61%respectively.These suggest that TN is mainly small nodules,multiple and solid nodules.No calcification,large calcification,colloidal calcification and microcalcification accounted for 83.98%,7.70%,5.14%and 3.19%respectively.High echo,equal echo,low echo,no echo,uniform echo and uneven echo accounted for 4.37%,6.80%,44.03%,11.17%,0.10%and 33.52%respectively,suggesting that the nodules are mainly non calcified and low echo.The left and right diameters,anterior and posterior diameters,upper and lower diameters and anterior and posterior diameters of isthmus in TN group were larger than those in non TN group.（3）In the general population,the proportion of senior citizens,married,non higher education,moderate physical activity,overweight and obesity in TN group was higher than that in TN group.There was a lower proportion of smoking,drinking,drinking coffee and drinking carbonated drinks,and had a higher proportion of history of hypertension and diabetes.The levels of WC,HC,SBP,FBG,2h PG,Hb A1c,FINS,HOMA-IR and TG were higher than those in non group and the level of HDL-C was lower（all P<0.05）.The proportion of elderly in male TN group was higher than that in non TN group,and the proportion of drinking carbonated drinks was lower.The levels of WC,HC,2h PG,Hb A1c,FINS and HOMA-IR in TN group were higher than those in non TN group,the level of HDL-C was lower（all P<0.05）.Female TN group had higher proportion of elderly,non higher education,moderate physical activity,overweight,obesity and smoking than non TN group,had a lower proportion of drinking coffee,had a higher proportion of history of hypertension and diabetes,and the levels of WC,HC,SBP,FBG,2h PG,Hb A1c,FINS,HOMA-IR,TG,Crea,UA in group TN were higher than those in non nodular group and the level of HDL-C was lower（all P<0.05）.（4）The levels of TSH,FT3 and TGAb in TN group were lower than those in non nodule group（all P<0.05）.FT3 in male TN group was lower than that in non TN group（all P<0.05）.The levels of TSH,FT3,TGAb and TPOAb in female TN group were lower than those in non nodule group（all P<0.05）.Grouping thyroid function showed that the prevalence of TN in TGAb and TPOAb negative group was higher than that in non nodule group（all P<0.01）.In female population,the prevalence of TN in TSH normal group,TGAb and TPOAb negative group was higher than that in non nodule group（all P<0.01）.（5）There was no significant correlation between depression and TN.（6）Logistic regression analysis showed that female,advanced age（≥50 years old）,smoking history,Hb A1c and WC were independent risk factors for TN,and FT3was the protective factor for TN.Advanced age（≥60 years old）was an independent risk factor for male TN,and severe physical activity was its protective factor.Advanced age（≥60 years）,WC,SBP and Crea were independent risk factors for female TN,and TSH was its protective factor.（7）The number of pregnancies,births,menopause and menopausal age in female TN group were higher than those in non TN group（P<0.05）.Logistic regression analysis showed that the risk of menopausal women was about 1.33 times that of premenopausal women,and the risk of nodules in postmenopausal women≥45years old was about 1-2.5 times that in postmenopausal women<45 years old.Conclusions:（1）The prevalence of TN in the middle-aged and elderly population in Lanzhou was 55.66%,mainly small nodules,multiple,solid,non calcified and hypoechoic nodules.The prevalence of TN increased significantly with age.The prevalence of women in different age groups was higher than that of men.（2）Female,advanced age（≥50 years old）,smoking history,Hb A1c and WC were independent risk factors for TN in the overall population,and FT3 was its protective factor.Advanced age（≥60 years old）was an independent risk factor for TN in male population,and heavy physical activity was its protective factor.Advanced age（≥60 years old）,WC,SBP and Crea were independent risk factors for TN in female population,and TSH was its protective factor.（3）Menopause and the increase of menopausal age were independent risk factors for TN in women.