Analysis Of The Characteristics And Influencing Factors Of Thyroid Nodules In Baohe District Of Hefei City

Objectives To investigate the prevalence of thyroid nodule in Baohe district of Hefei city,and to analyze the related influencing factors of thyroid nodule.Methods According to the operation manual produced by the National Survey of Thyroid Diseases and Diabetes(TIDE)project,cluster sampling cross-sectional survey method was adopted to select 2,584 permanent residents over 18 years old(residence time?5years)in Baohe district of Hefei city from September to October 2016.According to the exclusion criteria,a total of 2,500 cases were finally included in the analysis population,of which 1,300 were residents of changqing street(representing the city)and 1,200 were residents of dawei town(representing the countryside).Height,weight,waist circumference(WC),systolic blood pressure(SBP),diastolic blood pressure(DBP),and body mass index(BMI)were measured from 7:30 to 9:00 the next morning after fasting for 10h.A questionnaire survey(including gender,age,diet,previous medical history,etc.)was completed by a specially-assigned person.After taking morning urine and fasting venous blood,Give 75 grams of oral glucose tolerance test(75 g-OGTT),complete some laboratory indicators such as fasting blood glucose(FBG),2 h blood glucose(2 hPG),blood uric acid(SUA),triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-c),low-density lipoprotein cholesterol(LDL-c),thyroid peroxidase antibody(TPOAb),thyroglobulin antibody(TgAb),Urine iodine median(MUI)etc.and B-ultrasound examination of thyroid nodules.SPSS22.0 software was used for statistical analysis,and the measurement data was expressed as mean±standard deviation(x?s).For comparison between the two groups,independent sample t-test was used if the variables met normal distribution,and non-parametric test(Wilcoxon)was used if the variables did not meet normal distribution.The comparison of enumeration data was conducted by using the four-table x~2 test and the trend x~2 test,and multivariate Logistic regression analysis was applied to explore the related influencing factors of thyroid nodules in the total population.Results(1)Among the 2500 subjects,280 patients with thyroid nodules were detected according to the results of high-resolution ultrasound examination,with the detection rate of 11.2%.The percentage of thyroid nodules diagnosed with thyroid palpation was 5.28%,and there was a statistically significant difference between the two(x~2=3.453,P=0.035).There were180 cases of thyroid nodules detected in the female population,with a detection rate of16.54%,and 100 cases of thyroid nodules detected in the male population,with a detection rate of 7.08%,showing a statistically significant difference(x~2=3.45,P=0.035).171 cases of thyroid nodules were detected in urban population,with a detection rate of 13.15%,while 109 cases of thyroid nodules were detected in rural population,with a detection rate of 9.08%,and there was significant statistical difference(x~2=1.23,P=0.045).In addition,the detection rate of thyroid nodules in people with abnormal glucose metabolism,high blood pressure,overweight/obesity,hyperlipidemia,hyperuricemia,metabolic syndrome(MS),and smokers were 24.67.%,15.44%,17.96%,13.36%,10.53%,16.61%,23.49%,respectively.(2)In this study,the mean age of thyroid nodule detection group was 45.55±10.25 years old.According to age stratification,thyroid nodule detection rate was the highest in the age group of 40~59,accounting for 66.07%.In addition,this study also found that there are differences in the distribution of multiple thyroid nodules,which were more common on the left and both sides.;thyroid nodules are most common in cystic nodules,accounting for 63.57%,followed by cystic solid nodules,accounting for 30%,and about12.8%of patients had thyroid nodules accompanied by calcification and strong echo.In terms of the size of thyroid nodules,nodules<1 cm in diameter were the most common,accounting for 58.94%.Among the patients with thyroid nodules,about 2/3 of the patients are in the iodine nutritional status in the super appropriate state.Among the 280 cases of thyroid nodules detected,the proportion of patients with abnormal glucose metabolism(diabetes+impaired glucose regulation)was the highest,up to 67.5%.The proportion of patients with obesity and/or overweight,hypertension,abnormal lipid metabolism and hyperuricemia,as well as smoking were 46.43%,28.57%,38.93%,12.14%and 50.00%,respectively.(3)The waist circumference,smoking proportion,and proportion of diabetes in the female group were lower than those in the male group(P<0.05);The FPG,2hPG,HbA1c,and MUI indexes in the female group were significantly higher than those in the male group(P<0.05).In addition,there were no significant difference between the male group and the female group in age,BMI,SBP,DBP,TG,TCH,ldl-c,hdl-c,SUA,FT4,positive thyroid antibody rate,MS detection rate,IGR detection rate,family history of diabetes and family history of thyroid disease(P>0.05).(4)BMI,2hPG,HbA1c,TCH,MUI,and family history of thyroid disease in the rural group were significantly lower than those in the urban group(P<0.05).There were no significant differences between the rural and urban groups in gender,age,WC,SBP,DBP,FPG,TG,LDL-C,HDL-C,FT4,TSH,thyroid antibody positive rate,smoking proportion,MS detection rate,IGR detection rate,diabetes detection rate and proportion of family history of diabetes(P>0.05).(5)The FT4 and MUI of the single nodule group were significantly lower than those of the multiple nodules group(P<0.05).The detection rate of MS and diabetes was significantly higher than that of multiple nodules group(P<0.05).In addition,there was no significant difference between the two groups in gender,age,BMI,WC,SBP,DBP,FPG,2hPG,HbA1c,TG,TCH,LDL-C,HDL-C,TSH,thyroid antibody positive rate,smoking proportion,IGR detection rate,family history of thyroid disease and family history of diabetes(P>0.05).(6)The detection rates of HbA1c,TSH,MUI,MS,diabetes detection rate,and family history of diabetes in the thyroid autoantibody-negative group were lower than those in the thyroid autoantibody-positive group(P<0.05).There were no significant differences between the two groups in gender,age,BMI,WC,SBP,DBP,FPG,2hPG,FT4,TG,TCH,LDL-C,HDL-C,smoking proportion,IGR detection rate,and family history of thyroid disease.Difference(P>0.05).(7)2500 subjects were divided into thyroid nodule group(TN group)and no thyroid nodule group(NTN group).The results showed that compared with the NTN group,the proportion of female patients,BMI,SBP,2hPG,HbA1c,LDL-C,TSH,MUI,smoking proportion,MS detection rate,IGR detection rate,diabetes detection rate,family history of thyroid disease and family history of diabetes in the TN group were all significantly increased(P<0.05).There were no significant differences between the two groups in age,WC,DBP,FPG,FT4,TG,TCH,HDL-C,SUA,and thyroid antibody positive rates(P>0.05).With or without nodules as the dependent variable,Gender,BMI,SBP,2h PG,HbA1c,LDL-c,TSH,MUI,smoking history,IGR,diabetes,family history of thyroid disease,and family history of diabetes were included as independent variables.The results showed that female,BMI,SBP,HbA1c,LDL-c,MUI,and family history of thyroid disease were all risk factors for thyroid nodules.Conclusion(1)The overall prevalence of thyroid nodules in the residents of Baohe District,Hefei City is 11.20%,most of whom were females,The incidence was high among the population aged 40-59,and single,cystic and small nodules with diameter less than 1cm were common.(2)Logistic regression analysis showed that thyroid nodules were associated with various metabolic or metabolic diseases.The gender was female,BMI was larger,SBP,HbA1c,LDL-c,MUI,and family history of thyroid disease were all independent risk factors for thyroid nodules.