| ObjectiveThrough statistical analysis of clinical and pathological data of papillary thyroid carcinoma,to further explore the correlation between TyG index,blood lipid and other metabolic indicators and the occurrence and pathological characteristics of papillary thyroid carcinoma.MethodsPatients with thyroid nodules in Affiliated Hospital of Jiangsu University from January 2022 to December 2022 were selected and treated with traditional operation.A total of 288 patients were enrolled in this study.according to the nature of postoperative pathological results,they were divided into thyroid papillary adenocarcinoma group and benign thyroid nodule group;according to age,they were divided into < 55 years old group and ≥ 55 years old group;according to body mass index,they were divided into normal weight group,overweight group and obesity group;in PTC group,they were divided into different groups according to their pathological characteristics.Collect the basic information and clinical data of all patients.Including sex,age,height,weight,systolic blood pressure,diastolic blood pressure,fasting blood glucose,total cholesterol,triglyceride,high density lipoprotein cholesterol,low density lipoprotein cholesterol,uric acid,apolipoprotein A1,apolipoprotein B,anti-thyroglobulin antibody,thyroid peroxidase antibody,free triiodothyronine,free thyroxine,thyroid stimulating hormone,whether complicated with hypertension.And calculated triglyceride-glucose index(TyG)= ln [fasting triglyceride(mg/d L)× fasting glucose(mg/d L)/ 2].BMI = weight(kg)/ height ^ 2(m).The data related to this study were collected and recorded and statistically analyzed by SPSS25.0 software.Results1.According to the inclusion and exclusion criteria,there were 288 patients,76 patients with benign thyroid nodules and 212 patients with PTC.By comparing benign nodule group with PTC group,it was found that the body weight,TGAb,TPOAb and TSH in PTC group were higher than those in benign nodule group,while the average age,FPG,HDL-C and APOA1 in benign nodule group were lower than those in benign nodule group.Hypertension accounted for 9.9% of patients with PTC and 18.4% of patients with benign nodules.The difference was statistically significant.2.Multivariate Logistic regression analysis showed that age had a negative correlation with the occurrence of PTC(OR=0.931,95%CI0.90-0.96,P < 0.001)and TPOAb had a positive correlation with PTC(OR=1.002,95%CI 1.00-1.01,P < 0.001).3.In the age group < 55 years old,the body weight and TGAb in PTC group were higher than those in benign nodule group,while HDL-C and APOA1 were lower than those in benign nodule group.In the age group ≥ 55 years old,SP and DP in PTC group were significantly lower than those in benign nodules group.Hypertension accounted for 13.25% of patients with PTC and 2.5% of patients with benign nodules.The difference was statistically significant.4.Multivariate Logistic regression analysis was performed in < 55 years old group and ≥ 55 years old group respectively.The results showed that there was no significant effect of body weight,HDL-C,APOA1,TGAb and other factors on the incidence of PTC in the group < 55 years old.In the age group of ≥ 55 years old,hypertension had a negative correlation with the occurrence of PTC(OR=0.059,95%CI0.01-0.50,P < 0.05).5.In normal body weight,the age,SP,DP,FPG,APOA1 and TyG in PTC group were lower than those in benign nodule group,while TGAb and TSH in PTC group were higher than those in benign nodule group.Hypertension accounted for 5.41% of patients with PTC and 16.33% of patients with benign nodules.The difference was statistically significant.In overweight group(24 ≤ BMI ≤ 27.9),the age of PTC group was lower than that of benign nodule group,while the levels of UA and TGAb were higher than those of benign nodule group.In the obese group(BMI ≥ 28),the age,HDL-C and APOA1 of PTC group were lower than those of benign thyroid nodule group,while UA and TyG were higher than those of benign thyroid nodule group.The proportion of male and female patients with PTC accounted for 82.35% and 17.65% respectively,while that of benign nodule group accounted for 32.35% and 67.65% respectively.The difference was statistically significant.6.Multivariate Logistic regression analysis of different body weight showed that in normal body weight,age had a negative correlation with PTC(OR=0.938,95%CI 0.900.98,P < 0.05),and TSH had a positive correlation with PTC(OR=1.440,95%CI 1.03-2.01,P < 0.05).In overweight,age had a negative correlation with the occurrence of PTC(OR=0.934,95%CI0.90-0.97),while UA had a positive correlation with the occurrence of PTC(OR=1.01,95%CI 1.00-1.01).In obesity group,gender had significant effect on PTC(OR=8.94,95%CI 1.18-60.94),and age had negative correlation on PTC(OR=0.91,95%CI 0.84-0.99 P < 0.05).7.Patients with PTC were divided into groups according to pathological characteristics,and their metabolic indexes(FPG,TG,TC,HDL-C,LDL-C,APOA1,APOB,UA)and different BMI were compared and analyzed.The results showed that the levels of HDL-C and APOA1 in the group with cervical lymph node metastasis were lower than those in the group without cervical lymph node metastasis(P < 0.05).The level of TG in the group with nerve invasion was higher than that in the group without nerve invasion(P <0.05).8.TyG was divided into three groups: q1(TyG ≤ 8.48),q2(8.48 < TyG ≤8.96)and q3(TyG > 8.96).The incidence of PTC in each group was 74.5%,79.8% and 66.7% respectively.There was no significant difference in the incidence of PTC among the three groups.The patients with PTC were divided into Q1,Q2 and Q3 groups according to the ternary method of TyG,including Q1 group(TyG ≤ 8.46,n=70),Q2 group(8.46 < TyG ≤ 8.90,n=72),and Q3 group(TyG > 8.90,n=70).The results showed that compared with Q1 group,UA,APOB,LDL-C and TPOAb in Q2 and Q3 groups increased,while body weight,BMI and TC increased in Q2 group,SP increased in Q3 group,HDL-C and TPOAb decreased in Q2 group and Q3 group,TGAb and APOA1 decreased only in Q3 group.Compared with Q2 group,body weight,SP,BMI,UA,APOB,increased,APOA1,HDL-C decreased in Q3 group,the difference was statistically significant.There was significant difference in sex ratio between Q1 and Q3 groups(P < 0.017).Based on the analysis of the differences of different pathological characteristics among the three groups,it was found that the incidence of nerve invasion in Q1 group was 0%.The incidence of nerve invasion in Q2 group was 1.4%.The incidence of nerve invasion in Q3 group was 7.1%.There was significant difference in the incidence of nerve invasion among the three groups(P < 0.05),but there was no significant difference in other pathological characteristics(P > 0.05).TyG was positively correlated with height,hypertension(no= 1,yes= 2),nerve invasion(no= 1,yes= 2),SP,DP,LDL-C and FT3(r = 0.154,0.191,0.194,0.204,0.142,0.230,0.154,respectively,P < 0.05).It was positively correlated with sex(female = 0,male = 1),body weight,BMI,TC,UA and APOB(r = 0.275,0.389,0.391,0.298,0.386,0.372,P < 0.001).TyG was negatively correlated with TGAb and TPOAb(r=-0.230、-0.206,P<0.05,P <0.001),and negatively correlated with HDL-C and APOA1(r=-0.552、-0.298,P< 0.05).Conclusions(1)TPOAb may be an independent risk factor for the occurrence of PTC;the overall lower average age of PTC patients may benefit from the advances in ultrasound and other imaging technologies.(2)Patients with thyroid nodules aged ≥55 years,especially those with hypertension,may be associated with the occurrence of PTC.(3)Elevated TSH levels in patients with normal body weight may be an independent risk factor for PTC;elevated UA levels in overweight patients are positively correlated with the occurrence of PTC;obese men may be an independent risk factor for the occurrence of PTC.(4)Low levels of HDL-C and APOA1 are correlated with cervical lymph node metastasis in PTC patients,while high levels of TG are associated with nerve invasion in PTC patients.(5)TyG is not significantly correlated with the occurrence of PTC,but is significantly correlated with multiple clinical indicators of PTC patients,and is negatively correlated with nerve invasion in PTC patients. |
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