Abstract
Objective To compare different subgroups and explain the effect of Glucose-Lipid metabolism on Thyroid Nodules(TN).Methods The people were selected with physical examination at Peking University Hospital from January 2018 to October 2023.The examiners should have TC,TG,HDL-C,LDL-C,GLu and B-ultrasound exami-nation.First,the glucose and lipid metabolism indexes of those diagnosed with TN and non-TN examiners were com-pared.Then,combining sex,age,body mass index(BMI)and blood pressure(BP),the sex ratios for different age groups were compared.The proportion of each subgroup in the total population was calculated,and the TN detection rate of each subgroup was calculated.The typical subgroups with large base and different detection rate were compared,and the patients with same gender,normal age,BMI and BP,compared with non-TN with normal age,same gender,BMI and BP,compared with the incidence of TN,and further explore the physical and chemical factors.Finally refer to network bi-ology to explain the key factors of TN disease.Results There were 52 182 examiners,28 142 non-TNpatients,24 040 TN examiners.the sex ratio of the different age groups varied differently.Both sample content and TN prevalence were higher aged 49-64 years.The prevalence of TN was significantly higher in the male normal BMI normal BP group than that of the obese hypertension group,as was true in women(P＜0.05).Among men,non-TN examiners with normal BMI and normal BP had low values of TG,GLu,glycated hemoglobin(HbA1c),total protein(TP),albumin(ALB),and alpha-fetoprotein(AFP)compared with the control group.Decreased ALB,AFP,HDL-C,apolipoprotein-A1(Apo-A1),total bilirubin(TBil)and indirect bilirubin(IBil)in TN patients in the obese hypertensive group;TG,GLu,HbA1c,small dense low density lipoprotein cholesterol(sdLDL-C),aspartate aminotransferase(AST),alanine amin-otransferase(ALT),glutamyl transpeptidase(r-GGT),serum total bile acid(TBA),uric acid(UA),globulin(GLB),β2 microglobulin(β2-MG),carcinoembryonic antigen(CEA),alkaline phosphatase(ALP),C reactive protein(CRP)were increased.Among women,patients with normal BMI and normal BP non-TN examiners had lower values of TBA,LDL-C,DBil,TP,ALB and TC compared with the control group.In the obese hypertensive group,TC,HDL-C,Apo-A1,TBil,IBil decreased;TBA,TBP,TP,TG,GLu,HbA1c,sdLDL-C,ALT,r-GGT,UA,GLB,β2-MG,CEA,ALP,CRP,total triiodothyronine,total thyroxine,free triiodothyronine,lactate dehydrogenase increased(P＜0.05).Network biology showed thatWarburg effect with HIF-1α as a key regulator was an important bridge to construct tissue structural abnor-malities and pathological metabolic dysfunction.Conclusions The abnormal structure of the thyroid gland causes the body to respond.When there is no metabolic inflammation,the body can still use albumin compensation.Once obesity and hypertension occur,the body will adopt a more aggressive adaptive way to increase oxygen delivery and inhibit oxy-gen consumption,and anaerobic metabolism suppresses the tricarboxylic acid cycle.The deterioration of glucose and lipid metabolism is not effectively contained,but the body will bear the negative consequences of further deterioration in cell proliferation and apoptosis.关键词
甲状腺结节/脂代谢障碍/葡萄糖代谢障碍/危险因素Key words
Thyroid nodule/Lipid metabolism disorders/Glucose metabolism disorders/Risk factors
