绝经女性生殖因素与甲状腺结节的相关性研究

叶月; 甄洁玉; 闵行; 郭梦然; 许晓双; 苏姗; 甄东户

doi:10.16016/j.2097-0927.202208142

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绝经女性生殖因素与甲状腺结节的相关性研究

临床医学 | 更新时间：2026-01-09

- 绝经女性生殖因素与甲状腺结节的相关性研究
- Correlation between reproductive factors and thyroid nodules in postmenopausal women
- 陆军军医大学学报 2023年45卷第6期页码：554-560
- 作者机构：
  
  1.730000 兰州，兰州大学第一临床医学院
  2.730000 兰州，兰州大学第一医院内分泌科
  3.730000 兰州，甘肃省人民医院妇产科
- 作者简介：
  
  [甄东户，E-mail：zhdh8279@163.com ZHEN Donghu, E-mail: zhdh8279@163.com
- 基金信息：
  
  上海市医药卫生发展基金会糖尿病临床研究项目(Ⅰ期10研究);甘肃省自然科学基金(21JR1RA096);甘肃省自然科学基金(21JR1RA105);上海市医药卫生发展基金会国家标准代谢性疾病管理中心专项研究基金(2018-mmczxjj-3);兰州大学第一医院院内基金(ldyyyn-2015-22);兰州大学第一医院院内基金(ldyyn2019-87)
- DOI：10.16016/j.2097-0927.202208142
  中图分类号： R181.23;R581.9;R711.51
- 收稿：2022-08-21，
  
  修回：2022-10-10，
  
  纸质出版：2023-03-30
- 稿件说明：
移动端阅览
叶月, 甄洁玉, 闵行, 等. 绝经女性生殖因素与甲状腺结节的相关性研究[J]. 陆军军医大学学报, 2023,45(6):554-560.

Yue YE, Jieyu ZHEN, Hang MIN, et al. Correlation between reproductive factors and thyroid nodules in postmenopausal women[J]. Journal of Army Medical University, 2023, 45(6): 554-560.
叶月, 甄洁玉, 闵行, 等. 绝经女性生殖因素与甲状腺结节的相关性研究[J]. 陆军军医大学学报, 2023,45(6):554-560. DOI： 10.16016/j.2097-0927.202208142.

Yue YE, Jieyu ZHEN, Hang MIN, et al. Correlation between reproductive factors and thyroid nodules in postmenopausal women[J]. Journal of Army Medical University, 2023, 45(6): 554-560. DOI： 10.16016/j.2097-0927.202208142.

摘要

目的

探讨甘肃省兰州市绝经女性生殖因素与甲状腺结节(thyroid nodules，TNs)的相关性，为TNs的防治提供可靠策略。

方法

选取2014~2016年兰州市天庆嘉园社区、广武门社区和西村街道社区中居住≥5年、≥43岁已绝经女性居民2 270名为研究对象，通过问卷调查收集女性的初潮年龄、绝经年龄、孕次、产次、流产次数、妊娠合并症等资料并进行甲状腺超声检查，采用多因素Logistic回归探讨女性生殖因素与TNs的相关性。

结果

兰州市绝经女性TNs的患病率为60.97%(1 384/2 270)，随着年龄的增加患病率逐渐增加(

趋势

=66.761，

0.001)。TNs组中非高等教育比例、患高血压、糖尿病病史比例、吸烟比例更高，TNs组年龄、腰围(WC)、臀围(HC)、收缩压(SBP)、空腹血糖(FBG)、2 h血糖(2hPG)、甘油三酯(HbA1c)、糖化血红蛋白(TG)、血肌酐(Crea)、血尿酸(UA)水平较非TNs组更高，高密度脂蛋白(HDL-C)、血清促甲状腺激素(TSH)、血清游离三碘甲腺原氨酸(FT3)、甲状腺球蛋白抗体(TGAb)、抗甲状腺过氧化物酶抗体(TPOAb)水平较非TNs组更低。随着孕次、产次、绝经年龄的增加，TNs患病率明显升高(孕次:χ

趋势

=11.874，

=0.001；产次:χ

趋势

=37.385，

0.001；绝经年龄:χ

趋势

=8.897，

=0.003)。纳入多因素Logistic回归结果显示，与绝经年龄

45岁相比，

55岁结节患病风险增加(

=2.372，95%

:1.142~4.926，

=0.021)，初潮年龄、流产次数、宫外孕、服用避孕药史/雌激素、生育巨大儿、妊娠期合并症、母乳喂养、绝经类型等因素与TNs患病无明显相关性。

结论

兰州市绝经女性TNs的患病率较高，女性TNs的患病受多种因素影响，其中绝经年龄延迟是女性TNs患病的高危因素，因此应重点加强绝经前女性的甲状腺超声的检查，提早发现TNs的存在以便早期干预。

Abstract

Objective

To explore the correlation of reproductive factors with thyroid nodules (TNs) in postmenopausal women in Lanzhou

Gansu Province so as to provide reliable strategies for the prevention and treatment of TNs.

Methods

A total of 2 270 postmenopausal female residents aged 43 and over living in Tianqingjiayuan

Guangwumen and Xicun Street Communities for longer than 5 years in Lanzhou from 2014 to 2016 were recruited as the research objects. The data of menarche age

menopausal age

time of pregnancy

time of delivery

time of abortion and pregnancy complications were surveyed and collected through questionnaires. Thyroid ultrasound examination was performed. Multivariate logistic regression analysis was used to explore the correlation between female reproductive factors and TNs.

Results

The prevalence of TNs was 60.97% (1 384/2 270) in postmenopausal women in Lanzhou

and the prevalence was increased gradually with the increase of age (

Chi

-square

trend

=66.761

0.001). The patients in the TNs group had significantly older age

larger proportions of non-higher education level

hypertension

diabetes and smoking

higher levels of WC

SBP

FBG

2hPG

HbA1c

Crea and UA levels

and lower HDL-C

TSH

FT3

TGAb and TPOAb levels when compared with those in the non-TNs group. The prevalence of TNs was increased obviously with the increase of times of pregnancy and childbirth and older menopausal age (time of pregnancies:

Chi

-square

trend

=11.874

=0.001; time of delivery:

Chi

-square

trend

=37.385

0.001; menopausal age:

Chi

-square

trend

=8.897

=0.003). Multivariate logistic regression analysis showed that the risk of nodules was increased for those with postmenopausal age over 55 years than those with the age

45 years (

=2.372

95%

: 1.142~4.926

=0.021). No notable correlation was observed in menarche age

abortion times

ectopic pregnancy

contraceptive/estrogen history

macrosomia

pregnancy complications

breastfeeding

menopausal type and other factors with TNs.

Conclusion

The prevalence of TNs is quite high in menopausal women in Lanzhou

which is affected by many factors. Among them

the delayed menopausal age is a high-risk factor for the prevalence. Therefore

we should focus on strengthening the thyroid ultrasound examination of perimenopausal women

so as to find the existence early for early intervention.

关键词

Keywords

references

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