论文部分内容阅读
目的:探讨血清25-(OH)D_3、胰岛素抵抗与甲状腺乳头状癌(papillary thyroid carcinoma,PTC)的相关性。方法:随机选取2014年9月至2015年9月于郑州大学第一附属医院诊断为PTC的患者358例作为观察组,同期健康体检者290例作为正常对照组,检测其血清25-(OH)D_3、空腹血糖、空腹胰岛素水平及研究PTC肿瘤组织中B型RAF基因V600E(BRAF~(V600E))表达情况,采用独立样本t检验、Logistic回归分析及Pearson相关性分析进行数据统计分析。结果:1PTC组与正常对照组比较:25-(OH)D_3水平较低(P=0.000),胰岛素抵抗指数(insulin resistance index,IRI)较高(P=0.000)。2PTC组间比较:有淋巴结转移者的血清25-(OH)D_3水平及平均年龄低于无淋巴结转移者(P=0.000、P=0.002),有BRAF~(V600E)突变者的血清25-(OH)D_3水平低于无BRAF~(V600E)突变者(P=0.000);IRI在PTC有淋巴结转移者或BRAF~(V600E)突变者较高(P=0.000);PTC患者25-(OH)D_3水平与IRI未见明显相关。3二元logistic回归分析表明:女性、高胰岛素抵抗是PTC的危险因素(P=0.006、P=0.001),高25-(OH)D_3是PTC保护因素(P=0.000)。结论:高25-(OH)D_3可能是PTC的保护因素,改善胰岛素敏感性可能有助于预防PTC的发生发展。
Objective: To investigate the correlation between serum 25- (OH) D_3, insulin resistance and papillary thyroid carcinoma (PTC). Methods: A total of 358 patients diagnosed as PTC at the First Affiliated Hospital of Zhengzhou University from September 2014 to September 2015 were selected as observation group and 290 healthy subjects were selected as normal control group. Serum 25- (OH) D_3, fasting blood glucose, fasting insulin levels and the expression of type B RAF gene V600E (BRAF ~ (V600E)) in PTC tumor tissue were analyzed by using the independent sample t test, Logistic regression analysis and Pearson correlation analysis. Results: The level of 25- (OH) D_3 was lower (P = 0.000) and the insulin resistance index (IRI) was higher in 1PTC group than in normal control group (P = 0.000). (P = 0.000, P = 0.002), serum 25- (OH) D 3 levels in patients with lymph node metastasis and those with BRAF V600E mutation were lower than those without lymph node metastasis (P = 0.000). The level of 25- (OH) D 3 in patients with PTC was significantly lower than those without BRAF V600E (P = 0.000) D_3 level and IRI no significant correlation. Bivariate logistic regression analysis showed that female patients with hyperinsulinemia were the risk factors of PTC (P = 0.006, P = 0.001) and high 25- (OH) D 3 was the protective factor of PTC (P = 0.000). Conclusion: High 25- (OH) D 3 may be a protective factor of PTC. Improving insulin sensitivity may help prevent the occurrence and development of PTC.