Prevalence and risk factors of thyroid nodules in the elderly in iodine-sufficient areas

Zhang Lina; Ni Wenjing; Zhang Mengjie; Mi Weinuo; Sun Yu; Li Xingjia; Chen Guofang; Liu Chao; Xu Shuhang

doi:10.13406/j.cnki.cyxb.003406

您当前的位置：

首页 >

文章列表页 >

Prevalence and risk factors of thyroid nodules in the elderly in iodine-sufficient areas

Clinical research | 更新时间：2025-12-29

- Prevalence and risk factors of thyroid nodules in the elderly in iodine-sufficient areas
- Journal of Chongqing Medical University Vol. 49, Issue 1, Pages: 24-30(2024)
- 作者机构：
  
  1.南京中医药大学附属中西医结合医院/江苏省中西医结合医院内分泌科，南京 210028
  2.南京中医药大学鼓楼临床医学院感染性疾病科，南京 210008
  3.徐州医科大学附属宿迁医院内分泌科，宿迁 223800
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.003406
  CLC： R581
- Received：05 June 2023，
  
  Revised：2023-07-23，
  
  Accepted：28 August 2023，
  
  Published：28 January 2024
- 稿件说明：
移动端阅览
张丽娜,倪文婧,张梦杰,等.适碘地区老年人甲状腺结节的患病率及危险因素调查[J].重庆医科大学学报,2024,49(1):24-30.

Zhang Lina,Ni Wenjing,Zhang Mengjie,et al.Prevalence and risk factors of thyroid nodules in the elderly in iodine-sufficient areas[J].Journal of Chongqing Medical University,2024,49(1):24-30.
张丽娜,倪文婧,张梦杰,等.适碘地区老年人甲状腺结节的患病率及危险因素调查[J].重庆医科大学学报,2024,49(1):24-30. DOI： 10.13406/j.cnki.cyxb.003406.

Zhang Lina,Ni Wenjing,Zhang Mengjie,et al.Prevalence and risk factors of thyroid nodules in the elderly in iodine-sufficient areas[J].Journal of Chongqing Medical University,2024,49(1):24-30. DOI： 10.13406/j.cnki.cyxb.003406.

摘要

目的

调查江苏适碘地区农村老年人群甲状腺结节和甲状腺癌的患病率，并分析甲状腺结节患病的危险因素。

方法

采用整群抽样的方法对江苏适碘地区进行横断面调查研究，选取2 590例60岁及以上的常驻居民进行体检与生化检查，采用甲状腺影像学报告及数据系统（Thyroid Imaging Reporting And Data System，TI-RADS）分类方法对甲状腺结节进行分类评估，并对部分甲状腺结节进行超声引导下活检病理检查，采用Logistic回归分析甲状腺结节的危险因素。

结果

2 590例受者中共检出甲状腺结节883例，总体患病率为34.09%（883/2 590），女性患病率明显高于男性（

=27.885，

=0.000），有甲状腺结节组和无甲状腺结节组相比，身高、体质指数、空腹血糖、糖化血红蛋白、空腹胰岛素、甘油三酯、25羟维生素D差异有统计学意义（分别为

=5.337、

=0.000，

=-5.160、

=0.000，

=-2.341、

=0.019，

=-4.993、

=0.000，

=-2.384、

=0.020，

=-2

.940、

=0.003，

=6.432，

=0.000）。男性甲状腺结节的患病率随年龄的增加而增加。老年人甲状腺癌的总体检出率为0.34%。Logistic回归分析结果显示，体质指数和糖化血红蛋白是甲状腺结节患病的危险因素（

=1.054，95%CI=1.028~1.081，

0.01；

=1.257，95%CI=1.117~1.414，

0.01）。

结论

甲状腺结节是老年人常见的甲状腺疾病，但甲状腺癌的患病率总体较低。糖脂代谢紊乱与甲状腺结节的患病密切相关。

Abstract

Objective

To investigate the prevalence of thyroid nodules and thyroid cancer and the risk factors for thyroid nodules in a rural elderly population in iodine-sufficient areas of Jiangsu Province，China.

Methods

A cross-sectional survey was performed in iodine-sufficient areas of Jiangsu Province，investigating a total of 2 590 permanent residents aged ≥60 years selected by cluster sampling. They underwent physical examination and biochemical tests. Thyroid nodules were classified using the Thyroid Imaging Report and Data System（TI-RADS），part of which were examined for pathological information through an ultrasound-guided biopsy. A logistic regression analysis was used to analyze the risk factors for thyroid nodules.

Results

A total of 883 cases of thyroid nodules were detected in 2590 subjects. With an overall prevalence of 34.09%（883/2 590）. The prevalence of female subjects was significantly higher than that of male subjects（

=27.885，

=0.000）. There were significant differences in height（Ht），body mass index（BMI），fasting blood glucose（FBG），glycosylated hemoglobin（HbA1c），fasting insulin（FINS），triglyceride（TG），and 25-hydroxyvitamin D［25（OH）D］ between the participants with and without thyroid nodules（

=5.337、

=0.000

，t

=-5.160、

=0.000，

=-2.341、

=0.019

，t

=-4.993、

=0.000，

=-2.384、

=0.020，

=-2.940、

=0.003，

=6.432、

=0.000，respectively）. The prevalence of thyroid nodules in men increased with age. The overall detection rate of thyroid cancer in the elderly was 0.34%. The logistic regression analysis showed that the BMI and HbA1c hemoglobin were risk factors for thyroid nodules（

=1.054，95%CI=1.028-1.081，

0.01；

=1.257，95%CI=1.117-1.414，

0.01）.

Conclusion

Thyroid nodules are prevalent in the elderly in iodine-sufficient areas of Jiangsu Province，with a low prevalence of thyroid cancer. Glucose and lipid metabolism disorders are significantly related to the prevalence of thyroid nodules.

关键词

Keywords

references

Zhu Y ， Tong MK ， Wang YY ， et al . Prevalence of thyroid nodules and its association with water iodine among Chinese men and women [J ] . Environ Res ， 2022 ， 212 （ Pt B ）： 113270 ．

冯尚勇，朱　妍，张真稳，等 . 江苏社区人群甲状腺结节的流行病学研究 [J ] . 中华内分泌代谢杂志， 2011 ， 27 （ 6 ）： 492 - 494 ．

Feng SY ， Zhu Y ， Zhang ZW ， et al . Epidemiologic study on thyroid nodules in community population of Jiangsu [J ] . Chin J Endocrinol Metab ， 2011 ， 27 （ 6 ）： 492 - 494 ．

Feng SY ， Zhang ZW ， Xu SH ， et al . The prevalence of thyroid nodules and their association with metabolic syndrome risk factors in a moderate iodine intake area [J ] . Metab Syndr Relat Disord ， 2017 ， 15 （ 2 ）： 93 - 97 ．

Wang JY ， Yu FF ， Shang YN ， et al . Thyroid cancer：incidence and mortality trends in China，2005-2015 [J ] . Endocrine ， 2020 ， 68 （ 1 ）： 163 - 173 ．

Ni WJ ， Zhang MJ ， Wang XW ， et al . Age-specific serum thyrotropin reference range for the diagnosis of subclinical hypothyroidism and its association with lipid profiles in the elderly population [J ] . Sci Rep ， 2022 ， 12 （ 1 ）： 20872 ．

Tessler FN ， Middleton WD ， Grant EG ， et al . Re：ACR thyroid imaging，reporting and data system（TI-RADS）：white paper of the ACR TI-RADS committee [J ] . J Am Coll Radiol ， 2018 ， 15 （ 3 Pt A ）： 381 - 382 ．

中华医学会超声医学分会浅表器官和血管学组，中国甲状腺与乳腺超声人工智能联盟 . 2020甲状腺结节超声恶性危险分层中国指南：C-TIRADS [J ] . 中华超声影像学杂志， 2021 （ 3 ）： 185 - 200 ．

Society of Ultrasound in Medicine Vascular Ultrasound Group ， Ultrasound B . 2020 Chinese guidelines for ultrasound malignancy risk stratification of thyroid nodules：the C-TIRADS [J ] . Chin J Ultrason ， 2021 （ 3 ）： 185 - 200 ．

Cibas ES ， Ali SZ . The 2017 Bethesda system for reporting thyroid cytopathology [J ] . Thyroid ， 2017 ， 27 （ 11 ）： 1341 - 1346 ．

Jung CK ， Baek JH ， Na DG ， et al . 2019 Practice guidelines for thyroid core needle biopsy：a report of the Clinical Practice Guidelines Development Committee of the Korean Thyroid Association [J ] . J Pathol Transl Med ， 2020 ， 54 （ 1 ）： 64 - 86 ．

中华医学会地方病学分会，中国营养学会，中华医学会内分泌学分会 . 中国居民补碘指南 [M ] . 北京：人民卫生出版社， 2018 ．

Local Epidemiology Society of Chinese Medical Association ， Chinese Nutrition Society ， Chinese Society of Endocrinology . Iodine supplementation guidelines for Chinese residents [M ] . Beijing ： People's Medical Publishing House ， 2018 ．

Organization W H ， UNICEF . Assessment of iodine deficiency disorders and monitoring their elimination: a guide for programme managers. 3nd ed .[J ] . Geneva Switzerland WHO Department of Nutrition for Health & Development ， 2007 .

中华医学会糖尿病学分会 . 中国2型糖尿病防治指南（2020年版） [J ] . 中华内分泌代谢杂志， 2021 ， 37 （ 4 ）： 311 - 398 ．

Chinese Diabetes Society . Guideline for the prevention and treatment of type 2 diabetes mellitus in China（2020 edition） [J ] . Chin J Endocrinol Metab ， 2021 ， 37 （ 4 ）： 311 - 398 ．

Yao J ， Zhang W ， Wang J ， et al . The status of iodine nutrition after removing iodized salt in high water iodine regions：a cross-sectional study in China [J ] . Biol Trace Elem Res ， 2022 ， 200 （ 3 ）： 1020 - 1031 ．

Sun H ， Wang HY ， Lian XL ， et al . Association between urinary iodine concentration and thyroid nodules in adults：a cross-sectional study in China [J ] . Biomed Res Int ， 2020 ， 2020 ： 4138657 ．

Lou XM ， Wang XF ， Wang ZF ， et al . The effect of iodine status on the risk of thyroid nodules：a cross-sectional study in Zhejiang，China [J ] . Int J Endocrinol ， 2020 ， 2020 ： 3760375 ．

Tian CY ， Bu Y ， Ji CL ， et al . Iodine nutrition and the prevalence status of thyroid nodules in the population：a cross-sectional survey in Heilongjiang Province，China [J ] . Biol Trace Elem Res ， 2021 ， 199 （ 9 ）： 3181 - 3189 ．

Fan LL ， Tan L ， Chen YT ， et al . Investigation on the factors that influence the prevalence of thyroid nodules in adults in Tianjin，China [J ] . J Trace Elem Med Biol ， 2018 ， 50 ： 537 - 542 ．

黄隆盛，王　锐，李琴，等 . 88例甲状腺继发性肿瘤临床病理分析 [J ] . 四川大学学报（医学版）， 2022 ， 53 （ 4 ）： 707 - 710 ．

Huang LS ， Wang R ， Li Q ， et al . Analysis of clinicopathological characteristics of 88 cases with secondary neoplasms of the thyroid gland [J ] . J Sichuan Univ Med Sci ， 2022 ， 53 （ 4 ）： 707 - 710 ．

Negro R ， Rucco M ， Creanza A ， et al . Machine learning prediction of radiofrequency thermal ablation efficacy：a new option to optimize thyroid nodule selection [J ] . Eur Thyroid J ， 2020 ， 9 （ 4 ）： 205 - 212 ．

Deng YJ ， Li HT ， Wang M ， et al . Global burden of thyroid cancer from 1990 to 2017 [J ] . JAMA Netw Open ， 2020 ， 3 （ 6 ）： e208759 ．

Ito Y ， Miyauchi A ， Kihara M ， et al . Patient age is significantly related to the progression of papillary microcarcinoma of the thyroid under observation [J ] . Thyroid ， 2014 ， 24 （ 1 ）： 27 - 34 ．

Shi LY ， Liu J ， Yu LJ ， et al . Clinic-pathologic features and prognostic analysis of thyroid cancer in the older adult：a SEER based study [J ] . J Cancer ， 2018 ， 9 （ 15 ）： 2744 - 2750 ．

Qi Q ， Zhou AY ， Guo SP ， et al . Explore the diagnostic efficiency of Chinese thyroid imaging reporting and data systems by comparing with the other four systems（ACR TI-RADS，kWak-TIRADS，KSThR-TIRADS，and EU-TIRADS）：a single-center study [J ] . Front Endocrinol ， 2021 ， 12 ： 763897 ．

Wang ZH ， Vyas CM ， van Benschoten O ， et al . Quantitative analysis of the benefits and risk of thyroid nodule evaluation in patients ≥70 years old [J ] . Thyroid ， 2018 ， 28 （ 4 ）： 465 - 471 ．

Chen H ， Song AP ， Wang Y ， et al . BRAF V600E mutation test on fine-needle aspiration specimens of thyroid nodules：clinical correlations for 4600 patients [J ] . Cancer Med ， 2022 ， 11 （ 1 ）： 40 - 49 ．

Liang JL ， Cai WS ， Feng DD ， et al . Genetic landscape of papillary thyroid carcinoma in the Chinese population [J ] . J Pathol ， 2018 ， 244 （ 2 ）： 215 - 226 ．

Gilani SM ， Abi-Raad R ， Garritano J ， et al . RAS mutation and associated risk of malignancy in the thyroid gland：an FNA study with cytology-histology correlation [J ] . Cancer Cytopathol ， 2022 ， 130 （ 4 ）： 284 - 293 ．

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Advances in the clinical treatment of osteoporotic vertebral compression fractures

Role of cancer-associated fibroblasts in the proliferation，invasion， and treatment of thyroid cancer

A comparative study of robot-assisted transoral-vestibular thyroidectomy and conventional open thyroidectomy

Association between glucose metabolism disorder and prevalence of thyroid nodule in the elderly in iodine-adequate area

A cross-sectional study of thyroid disease and dyslipidemia in elderly people in iodine excessive areas

Related Author

Ma Qingwei

Zhang Lei

Wang Qiuru

Peng Dayong

Chen Meng

Yang Yun

Zhang Kaining

Zeng Weinan

Related Institution

Department of Orthopedic Surgery，The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital

Department of Orthopedics Surgery，West China Hospital， Sichuan University

Department of Orthopedic Surgery，Qilu Hospital of Shandong University

Laboratory of Human Diseases and Immunotherapies,West China Hospital,Sichuan University

Rehabilitation Medicine Center,West China Hospital,Sichuan University

⁰