Objective: To investigate the association between thyroid stimulating hormone (TSH) level and metabolic syndrome (MS) in patients with thyroid nodules (TN). Methods: A total of 723 patients with TN were selected from various departments by cluster sampling method, and 487 patients were finally determined to participate in the statistical analysis according to the inclusion and exclusion criteria. According to the quartile method, the TSH of the subjects was divided into four subgroups: low level, medium level, slightly higher level and high level. According to the diagnostic criteria of MS and BMI level, the population was divided into MS group and non-MS group, overweight group and non-overweight group, and the differences of indicators among different groups were compared. Logistic regression analysis was used to explore the independent risk factors of MS and the risk of MS with different TSH levels. The receiver operating curve (ROC) was used to explore the value of TSH as a potential diagnostic marker for MS. Results: In TN, the detection rate of MS was 40.86% (199/487), and the detection rate of MS gradually increased with the increase of TSH level (trend χ2=98.034, P＜0.001). Multivariate logistic regression analysis showed that TSH was an independent risk factor for MS, and the risk of MS in the high-level group was 11.014 times higher than that in the low-level TSH group. The ROC curve showed that the area under the curve (AUC) of TSH was 0.765, the optimal TSH cutoff value was 5.64 mIU/L, the sensitivity was 84.4%, and the specificity was 65.6%. The incidence of TN calcification in MS group and overweight group was higher than that in non-MS group and non-overweight group (P＜0.001). Conclusion: (1) In the TN population, TSH is an independent risk factor for MS and can be used as a potential predictor of MS occurrence. (2) MS or obese patients have a higher probability of deterioration of TN.
HAN Shujuan
,
ZHANG Yonghong
. Correlation analysis between TSH level and various factors of metabolic syndrome in thyroid nodule population[J]. Journal of Baotou Medical College, 2024
, 40(9)
: 36
-42
.
DOI: 10.16833/j.cnki.jbmc.2024.09.007
[1] Zhang F, Teng D, Tong NW, et al. Gender-specific associations between metabolic disorders and thyroid nodules: across-sectional population-based study from China[J]. Thyroid, 2022,32(5):571-580.
[2] Burmank D, Wartofsky L. Thyroid nodules[J]. N Engl J Med, 2015,373(24):2347-2356.
[3] Rojeskim T, Gharib H. Nodular thyroid disease[J]. N Engl J Med, 1985,313(7):428-436.
[4] Papini E, Guglielmi R, Bianchini A, et al. Risk of malignancy in nonpalpable thyroid nodules: predictive value of ultrasound and color-Doppler features[J]. J Clin Endocrinol Metab, 2002,87(5):1941-1946.
[5] Liu JF, Wang CG, Tang XL, et al. Correlation analysis of metabolic syndrome and its components with thyroid nodules[J]. Diabetes Metab Syndr Obes, 2019,12:1617-1623.
[6] Buscemi S, Massentif M, Vasto S, et al. Association of obesity and diabetes with thyroid nodules[J]. Endocrine, 2018,60(2):339-347.
[7] Ramasomgje P,Mathangasinghe Y, Jayawardena R, et al. Prevalence and trends of metabolic syndrome among adults in the asia-pacific region: a systematic review[J]. BMC Public Health, 2017,17(1):101.
[8] Jin MY, Zhang Z, Li YZ, et al. U-shaped associations between urinary iodine concentration and the prevalence of metabolic disorders: across-sectional study[J]. Thyroid, 2020,30(7):1053-1065.
[9] Zhang JJ, Gao YY, Li YZ, et al. The presence of serum TgAb suggests lower risks for glucose and lipid metabolic disorders in euthyroid general population from a national survey[J]. Front Endocrinol, 2020,11:139.
[10] 包燕霞,王显红,姜盼盼,等. 甲状腺结节发病相关影响因素的研究进展[J]. 山西医药杂志,2020,49(17):2290-2292.
[11] Rotondi M, Cappelli C, Magri F, et al. Thyroidal effect of metformin treatment in patients with polycystic ovary syndrome[J]. Clin Endocrinol, 2011,75(3):378-381.
[12] 索艳,王肃. 甲状腺疾病与代谢综合征关系的研究[J]. 医学信息,2022,35(4):53-56.
[13] Guo WX, Tan L, Chen W, et al. Relationship between metabolic syndrome and thyroid nodules and thyroid volume in an adult population[J]. Endocrine, 2019,65(2):357-364.
[14] 郭海健,念馨,梁友芳,等. 基于多中心横断面调查的中国人群代谢综合征的流行情况及危险因素[J]. 中华疾病控制杂志,2019,23(7):796-801.
[15] Tirosh A, Shimon I. Complications of acromegaly: thyroid and colon[J]. Pituitary, 2017,20(1):70-75.
[16] Kimura T, Van Keymeulen A, Golstein J, et al. Regulation of thyroid cell proliferation by TSH and other factors: a critical evaluation of in vitro models[J]. Endocr Rev, 2001,22(5):631-656.
[17] Ayturk S, Gursoy A, Kut A, et al. Metabolic syndrome and its components are associated with increased thyroid volume and nodule prevalence in a mild-to-moderate iodine-deficient area[J]. Eur J Endocrinol, 2009,161(4):599-605.
[18] Pacifico L, Bonci E, Ferraro F, et al. Hepatic steatosis and thyroid function tests in overweight and obese children[J]. Int J Endocrinol, 2013,2013:381014.
[19] Cini G, Carpi A, Mechanick J, et al. Thyroid hormones and the cardiovascular system: pathophysiology and interventions[J]. Biomed Pharmacother, 2009,63(10):742-753.
[20] Anil C, Akkurt A, Ayturk S, et al. Impaired glucose metabolism is a risk factor for increased thyroid volume and nodule prevalence in a mild-to-moderate iodine deficient area[J]. Metabolism, 2013,62(7):970-975.
[21] 杨洋,胥利. 重庆地区成年女性甲状腺结节检出情况及影响因素分析[J]. 现代预防医学,2022,49(11):2054-2058,2064.
[22] 苗曦,王晓宇,马利双,等. 合肥市某区人群亚临床甲状腺功能减退症中促甲状腺激素水平与代谢综合征发病的相关性[J]. 安徽医科大学学报,2022,57(8):1318-1322.
[23] Shin J, Kimm H, Yoonk H, et al. Relationship between metabolic syndrome and thyroid nodules in healthy Koreans[J]. Korean J Intern Med, 2016,31(1):98-105.
[24] 孙荣欣,郑召辉,张强,等. 人群体质量指数与甲状腺结节患病率及其恶性风险分层的相关性[J]. 川北医学院学报,2021,36(1):72-75.
