2型糖尿病患者血镁水平与甲状腺结节的相关性分析
Study on the Correlation between Serum Magnesium Concentration and Thyroid Nodules among Patients with Type 2 Diabetes Mellitus

目的：探讨2型糖尿病(T2DM)患者中血镁水平与甲状腺结节的相关性。方法：回顾性收集在2013年3月至2020年10月期间就诊于青岛大学附属医院内分泌与代谢性疾病科的3936名T2DM患者的临床资料，研究其血镁水平与甲状腺结节之间的相关性。结果：在所有的T2DM患者中，合并甲状腺结节的患者血镁水平显著低于不合并甲状腺结节的患者(P = 0.018)。根据血镁水平，将患者由低到高分为3组(较低组、中间组和较高组)发现，三组患者的甲状腺结节患病率分别为18.6%，18.0%，14.6% (P = 0.016)。通过进一步两两比较发现，血镁较低组及中间组的T2DM患者的甲状腺结节患病率显著高于血镁较高组(P分别为0.006、0024)，血镁较低组与中间组患者之间的甲状腺结节的患病率无显著差异(P = 0.650)。logistic回归分析显示，较高的血镁水平与甲状腺结节呈负相关(OR = 0.351, P = 0.027)，在调整了年龄、性别、吸烟、饮酒、BMI、收缩压、舒张压、甘油三酯、总胆固醇、高密度脂蛋白、低密度脂蛋白、肌酐、尿酸、谷丙转氨酶、谷草转氨酶等指标后，二者的负相关关系仍然显著存在(OR = 0.215, P = 0.014)结论：在T2DM患者中，合并甲状腺结节的患者血镁水平显著低于不合并甲状腺结节的患者，较高的血镁水平与甲状腺结节呈独立负相关关系，提示低血镁水平可能在一定程度上参与了T2DM患者甲状腺结节的发生发展。
Objective: To investigate the correlation between serum magnesium concentration and thyroid nodules among patients with type 2 diabetes mellitus (T2DM). Methods: The clinical data of 3936 patients with T2DM who were admitted to the Department of Endocrinology and Metabolic Diseases, the Affiliated Hospital of Qingdao University from March 2013 to October 2020 were collected retrospectively, and the correlation between the serum magnesium concentration and thyroid nodules was explored. Results: Among all patients with T2DM, the level of serum magnesium in patients with thyroid nodules was significantly lower than that in patients without thyroid nodules (P = 0.018). According to the level of serum magnesium, the patients were divided into three groups (lower group, middle group and higher group). We found that the prevalence of thyroid nodules among the three groups were 18.6%, 18.0% and 14.6% respectively (P = 0.016). Through further pairwise comparison, it was found that the prevalence of thyroid nodules in subjects with lower serum magnesium and middle serum magnesium were significantly higher than that in subjects with higher serum magnesium (P = 0.006 and 0024, respectively), and there was no significant difference between subjects with lower blood magnesium and middle serum magnesium (P = 0.650). Logistic regression analysis showed that the higher blood magnesium level was negatively correlated with thyroid nodules (OR = 0.351, P = 0.027). After adjusting the confounding factors such as age, gender, smoking, drinking, BMI, systolic blood pressure, diastolic blood pressure, triglyceride, total cholesterol, high-density lipoprotein, low-density lipoprotein, creatinine, serum uric acid, alanine aminotransferase, aspartate aminotransferase, etc., the negative correlation between above still exists significantly (OR = 0.215, P = 0.014). Conclusions: T2DM Patients with thyroid nodules have lower serum magnesium levels than those