中文摘要：

目的 ：探讨胰岛素抵抗（IR）与女性甲状腺结节血管形成之间的关系。方法：于2011年6—11月,对江苏省南京社区居民进行横断面流行病学调查,纳入1 786例符合研究要求的女性甲状腺结节患者。以甲状腺彩色多普勒测量结节血流类型、阻力指数（RI）、血管生成指数（VI）;同时测定空腹胰岛素（FINS）、空腹血糖（FPG）、餐后2 h血糖（2h PG）、糖化血红蛋白（Hb A1c）,计算胰岛素抵抗指数（HOMA-IR）和体重指数（BMI）。结果 ：HOMA-IR（r=0.36,P〈0.001）和Hb A1c（r=0.20,P〈0.001）与甲状腺结节血流类型呈正相关,尤其在体积〉0.2 m L的结节内更为显著。且在大结节中,HOMA-IR和Hb A1c与RI（HOMA-IR：β=0.41,SE=0.03,r=0.43,P〈0.001;Hb A1c：β=0.23,SE=0.03,r=0.23,P〈0.001）和VI（HOMA-IR：β=0.47,SE=0.04,r=0.53,P〈0.001;Hb A1c：β=0.34,SE=0.11,r=0.37,P〈0.001）呈正相关。结论 ：IR和高血糖与甲状腺结节的类型、RI和VI呈正相关,特别是在大结节中。该研究结果表明IR在女性甲状腺结节的血管分布、结构及密度中起重要作用,将影响甲状腺结节的进展。

英文摘要：

Objective：To investigate the association between IR and the vascularization of thyroid nodules in women. Methods：A cross-sectional,population-based study was conducted in Nanjing,China,from June to November 2011. 1,786 female thyroid nodule cases were enrolled in the study. Power Doppler was performed to measure the flow patterns,resistive index（RI）,and vascular index（VI）of thyroid nodular vascularization. Fasting insulin,fasting glucose,2-hour oral glucose tolerance test,glycosylated hemoglobin（Hb A1c）,homeostasis model assessment of IR（HOMA-IR）,and body mass index were also tested. Results：HOMA-IR（R = 0.36,P 〈0.001）and Hb A1c（R = 0.20,P 〈 0.001）were positively correlated with thyroid nodular flow patterns,and the positive correlations were more significant in participants with large nodules（volume ≥ 0.2 m L）. Additionally,in participants with large nodules,HOMAIR and Hb A1 c were positively correlated with RI（HOMA-IR：β = 0.41,SE = 0.03,R = 0.43,P 〈 0.001;Hb A1c：β = 0.23,SE =0.03,R = 0.23,P 〈 0.001）and VI（HOMA-IR：β = 0.47,SE = 0.04,R = 0.53,P 〈 0.001;Hb A1c：β = 0.34,SE = 0.11,R = 0.37,P 〈0.001）. Conclusion：IR and hyperglycemia were positively correlated with the flow patterns,RI,and VI of thyroid nodules,especially in large nodules. The findings suggest a pivotal role of IR in the distribution,construction,and density of thyroid nodular vascularization,which might contribute to the growth and the progression of thyroid nodules.