上海市某区50岁及以上居民甲状腺结节患病率与影响因素调查

李丽; 于德华; 马瑜; 金花; 陆媛; 付强强

doi:10.16766/j.cnki.issn.1674-4152.002597

上海市某区50岁及以上居民甲状腺结节患病率与影响因素调查

doi: 10.16766/j.cnki.issn.1674-4152.002597

李丽¹,
于德华²,
马瑜²,
金花²,
陆媛²,
付强强^2, ,

1.
上海市长宁区疾病预防控制中心综合办(应急办), 上海 200051
2.
同济大学附属杨浦医院全科医学科上海市全科医学与社区卫生发展研究中心, 上海 200090

基金项目:

上海市卫生和计划生育委员会科研课题 201640066

上海市卫生和计划生育委员会科研课题 20174Y0009

详细信息

通讯作者:
付强强, E-mail: 286852271@qq.com

中图分类号: R581.3 R195.4
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出版历程
- 收稿日期: 2021-09-11
- 网络出版日期: 2022-09-26

Prevalence and influencing factors of thyroid nodule amongst residents aged 50 and above in Shanghai community

LI Li¹,
YU De-huai²,
MA Yu²,
JIN Hua²,
LU Yuan²,
FU Qiang-qiang^{2
, ,}

1.
Department of Emergency and General Office, ChangNing Disease Control and Prevention Center, Shanghai 200051, China

摘要

摘要: 目的探讨上海市杨浦区50岁及以上居民甲状腺结节患病情况, 并分析其可能的危险因素。方法于2016年4月-2017年4月采用多阶段随机整群抽样, 抽取50岁及以上居民进行甲状腺B超检查及问卷调查, 对可能影响甲状腺结节患病率的因素进行单因素和logistic回归分析。结果共获得有效问卷6 002份, 社区老年居民甲状腺结节总体患病率为29.1%(1 747/6 002)。患病率随年龄段的增长而增加, 差异有统计学意义(P < 0.05);女性甲状腺结节患病率为31.2%(1 241/3 980), 男性为25.0%(506/2 022), 女性患病率明显高于男性(P < 0.05);多发结节患病率为1.8%(110/6 002)、两叶结节为11.8%(106/6 002)、峡部结节为0.1%(6/6 002)、右叶结节为7.7%(464/6 002)、左叶结节为7.7%(461/6 002);多因素logistic回归分析结果显示女性(OR=1.364, 95%CI: 1.207~1.542)、年龄增长(66~80岁, OR=1.188, 95%CI: 1.047~1.348;81~岁, OR=1.415, 95%CI: 1.123~1.784)、中心性肥胖(OR=1.167, 95%CI: 1.039~1.310)、缺少体育锻炼(OR=1.236, 95%CI: 1.099~1.390)、睡眠状况差(OR=1.297, 95%CI: 1.154~1.459)是甲状腺结节发生的危险因素。结论杨浦区社区50岁及以上老年居民甲状腺结节患病率为29.1%, 女性患病率明显高于男性, 年龄增长、女性、缺乏体育锻炼、中心性肥胖、睡眠质量差可能是甲状腺结节患病的危险因素。
- 老年人 /
- 甲状腺结节 /
- 患病率 /
- 调查
Abstract: Objective To investigate the prevalence of thyroid nodules in residents aged 50 and above in Yangpu District, Shanghai, and to analyse their possible risk factors. Methods From April 2016 to April 2017, multi-stage random cluster sampling was adopted, and residents aged 50 and above were selected for thyroid B-ultrasound examination and questionnaire survey.Ordinal logistic regression analysis was used for the analyses. Results A total of 6 002 valid questionnaires were obtained.The overall prevalence rate of thyroid nodules amongst elderly residents in the community was 29.1%(1 747/6 002), and the prevalence increased with age.The difference was statistically significant (P < 0.05).The prevalence of thyroid nodules was 31.2%(1 241/3 980) in females and 25.0%(506/2 022) in males.The prevalence was significantly higher in females than in males (P < 0.05).The incidence of multiple nodules, bilobular nodules, isthmus nodules, right lobe nodules and left lobe nodules was 1.8%(110/6 002), 11.8%(106/6 002), 0.1%(6/6 002), 7.7%(464/6 002) and 7.7%(461/6 002), respectively.Multivariate logistic regression analysis showed that female gender (OR=1.364, 95%CI: 1.207-1.542), increasing age (66-80 years, OR=1.188, 95%CI: 1.047-1.348;81 years and above, OR=1.415, 95%CI: 1.123-1.784), central obesity (OR=1.167, 95%CI: 1.039-1.310), lack of physical activity (OR=1.236, 95%CI: 1.099-1.390) and poor sleep status (OR=1.297, 95%CI: 1.154-1.459) were risk factors for thyroid nodules. Conclusion The prevalence rate of thyroid nodules in elderly residents aged 50 years and above in Yangpu District is 29.1%, and the prevalence rate of females is significantly higher than that of males.Age, female gender, lack of physical exercise, central obesity and poor sleep quality may be risk factors for thyroid nodules.
- The aged /
- Thyroid nodules /
- Prevalence /
- Investigation

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表 1 不同性别社区居民甲状腺结节患病情况[例(%)]

Table 1. Prevalence of thyroid nodules in different gender communities [cases (%)]

性别	人数	多发结节	两叶结节	峡部结节	右叶结节	左叶结节	总患病率
女性	3 980	88(2.2)	529(13.3)	6(0.2)	306(7.7)	312(7.8)	1 241(31.2)
男性	2 022	22(1.1)	177(8.8)	0	158(7.8)	149(7.4)	506(25.0)
合计		110(1.8)	706(11.8)	6(0.1)	464(7.7)	461(7.7)	1 747(29.1)
注：不同性别总患病比较，χ²=24.626, P < 0.001。

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表 2 不同年龄社区居民甲状腺结节患病情况[例(%)]

Table 2. Prevalence of thyroid nodules in community residents of different ages [cases (%)]

年龄(岁)	人数	多发结节	两叶结节	峡部结节	右叶结节	左叶结节	总患病率
50~65	3 922	74(1.9)	397(10.1)	4(0.1)	293(7.5)	325(8.3)	1 093(28.9)
66~80	1 726	28(1.6)	240(13.9)	0	152(8.8)	28(6.3)	528(30.6)
≥81	354	8(2.3)	69(19.5)	2(0.6)	19(5.4)	28(7.9)	126(35.6)
合计		110(1.8)	706(11.8)	6(0.1)	464(7.7)	461(7.7)	1 747(29.1)
注：不同年龄段总患病率比较，χ²=11.975, P < 0.001。

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表 3 甲状腺结节影响因素的单因素分析

Table 3. Univariate analysis of influencing factors of thyroid nodules

项目	类别	总人数	患病[例(%)]	χ²值	P值
性别	男性	2 022	506(25.0)	24.626	< 0.001
	女性	3 980	1 241(31.2)
年龄(岁)	50~65	3 922	1 093(28.0)	11.975	< 0.001
	66~80	1 726	528(30.6)
	≥81	354	126(35.6)
学历	初中及以下	3 352	1 007(30.0)	3.215	0.073
	高中及以上	2 650	740(27.9)
BMI	体重过低	208	57(27.4)	0.470	0.925
	体重正常	3 135	913(29.1)
	超重	2 088	614(29.4)
	肥胖	571	163(28.5)
中心性肥胖	无	3 748	1 044(27.9)	7.583	0.006
	中心性肥胖	2 254	703(31.2)
饮酒	不饮酒	5 247	1 571(29.9)	14.059	< 0.001
	饮酒	755	176(23.3)
睡眠质量	睡眠不好	3 693	1 157(31.3)	22.981	< 0.001
	睡眠良好	2 309	590(25.6)
体育锻炼	不锻炼	2 016	645(32.0)	12.262	< 0.001
	经常锻炼	3 986	1 102(27.6)
吸烟	不吸烟	5 123	1 532(29.9)	10.779	0.001
	吸烟	879	215(24.5)

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表 4 甲状腺结节影响因素的多因素logistic回归分析

Table 4. Multivariate logistic regression analysis of influencing factors of thyroid nodules

变量	B	SE	Wald χ²	P值	OR(95% CI)
性别	0.309	0.063	24.385	< 0.001	1.364(1.207~1.542)
年龄
66~80岁	0.172	0.064	7.129	0.008	1.188(1.047~1.348)
≥81岁	0.347	0.118	8.678	0.003	1.415(1.123~1.784)
中心性肥胖	0.154	0.059	6.843	0.009	1.167(1.039~1.310)
体育锻炼	0.212	0.060	12.446	< 0.001	1.236(1.099~1.390)
睡眠状况	0.260	0.060	18.861	< 0.001	1.297(1.154~1.459)

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