上海市杨浦区50岁以上居民甲状腺结节与中心性肥胖及内脏脂肪指数的相关性

目的 研究50岁以上居民甲状腺结节与中心性肥胖、及内脏脂肪指数（visceral adiposity index, VAI）的相关性。方法 选取上海市杨浦社区常住居民2220名，测量身高、体质量、腰围、血压，测定空腹血糖及餐后2h血糖、血脂等生化指标，并进行甲状腺彩超检查。结果 在男女两个组别中，甲状腺结节组平均年龄、腰围、三酰甘油、中心性肥胖患病率、VAI均高于无甲状腺结节组（均P<0.05），高密度脂蛋白胆固醇水平低于无甲状腺结节组。女性甲状腺结节组收缩压水平较无甲状腺结节组增高（P<0.05）。中心性肥胖组甲状腺结节患病率、VAI较无中心性肥胖组升高（均P<0.05）。甲状腺结节患病风险随VAI升高逐渐增高（P<0.01）。Logistic回归分析结果显示，年龄、性别、血脂异常、中心性肥胖是甲状腺结节发生的影响因素（P<0.05）。结论 中心性肥胖是甲状腺结节发生的危险因素，甲状腺结节患病风险与VAI密切相关。
Objective To examine the association of thyroid nodules with visceral obesity and visceral adiposity index (VAI) among middle and old-aged residents in Yangpu community. Methods A cross-sectional study with 2 220 residents recruited from Shanghai Yangpu community was conducted. Height, weight, waist circumference, blood pressure, fasting blood glucose, 2-h postprandial blood glucose, and lipid profile were measured, and thyroid ultrasonography was examined in all participants. Results Among 2220 participants the thyroid nodules were detected in 1169 cases (52.65%), the prevalence of thyroid nodules in females (863/1533, 56.29%) was higher than that in males (366/687, 44.54%, P<0.001). Thyroid nodule group had higher average age, waist circumference, triglyceride, VAI, prevalence of visceral obesity and lower high density lipoprotein (HDL) compared with non-thyroid nodule group (all P<0.05). Thyroid nodules group had higher systolic pressure compared with non-thyroid nodule group in females (P<0.05). Visceral obesity group had higher prevalence of thyroid nodules and VAI, compared with non-visceral obesity group (P<0.05). Prevalence of thyroid nodules was increased with VAI（P<0.01）. Older age, female sex, dyslipidemia and visceral obesity were associated with an increased risk of thyroid nodules (all P< 0.05). Conclusion Visceral obesity is a risk factor of thyroid nodules, and the prevalence of thyroid nodules is positively associated with VAI