周蔚, 汪正园, 夏蒨, 贾晓东, 臧嘉捷, 崔雪莹, 李香亭, 郭常义, 吴凡. 膳食质量与甲状腺结节患病关联的病例对照研究[J]. 环境与职业医学, 2021, 38(11): 1192-1198. DOI: 10.13213/j.cnki.jeom.2021.20603
引用本文: 周蔚, 汪正园, 夏蒨, 贾晓东, 臧嘉捷, 崔雪莹, 李香亭, 郭常义, 吴凡. 膳食质量与甲状腺结节患病关联的病例对照研究[J]. 环境与职业医学, 2021, 38(11): 1192-1198. DOI: 10.13213/j.cnki.jeom.2021.20603
ZHOU Wei, WANG Zhengyuan, XIA Qian, JIA Xiaodong, ZANG Jiajie, CUI Xueying, LI Xiangting, GUO Changyi, WU fan. Case-control study on relationship between diet quality and thyroid nodules[J]. Journal of Environmental and Occupational Medicine, 2021, 38(11): 1192-1198. DOI: 10.13213/j.cnki.jeom.2021.20603
Citation: ZHOU Wei, WANG Zhengyuan, XIA Qian, JIA Xiaodong, ZANG Jiajie, CUI Xueying, LI Xiangting, GUO Changyi, WU fan. Case-control study on relationship between diet quality and thyroid nodules[J]. Journal of Environmental and Occupational Medicine, 2021, 38(11): 1192-1198. DOI: 10.13213/j.cnki.jeom.2021.20603

膳食质量与甲状腺结节患病关联的病例对照研究

Case-control study on relationship between diet quality and thyroid nodules

  • 摘要: 背景

    目前国内外关于甲状腺结节患者的膳食质量研究少见,甲状腺结节与患者膳食质量的关联尚不明确。

    目的

    利用中国健康膳食指数(CHDI)评价甲状腺结节与膳食质量的关系。

    方法

    采用以医院为基础的配对病例对照研究,以同性别,年龄相差不超过3岁为原则,对387例甲状腺结节患者进行1∶1配对,所有对照均来自同一医院的体检人群,且经甲状腺B超检查无甲状腺结节。调查内容包括一般情况调查、膳食调查等。用CHDI评价两组人群的膳食质量,CHDI是以中国居民膳食指南及平衡膳食宝塔推荐量为依据,结合中国人群的膳食营养状况建立的,有13个评分指标,总分最高为100分,总分越高,表明饮食质量越好,以CHDI得分<60、60~<80和≥80分分别认定为膳食质量不合格、合格和良好。

    结果

    甲状腺结节病例组蔬菜总量、深色蔬菜、水果和鱼虾类得分均低于对照组(均P<0.05),经非参数检验发现两组人群蔬菜总量、深色蔬菜、水果、大豆和鱼虾类得分分布的差异有统计学意义(均P<0.05),两组人群食物种类、肉蛋类、纯能量食物供能比得分达满分的比例均超过60%,而全谷物和杂豆薯类、奶类、大豆类、钠得分达满分的比例均低于30%。病例和对照组CHDI得分中位数分别为69.1、 72.9,病例组CHDI得分低于对照组(P<0.05);病例组和对照组膳食质量不合格的比例分别占23.0%和13.7%,其差异有统计学意义(P=0.001)。调整文化程度、婚姻状况、职业、家庭人均月收入、体重指数、高血压/糖尿病患病情况、能量及碘摄入等混杂因素后,logistic回归分析显示:甲状腺结节患病风险与CHDI得分之间呈负相关(CHDI合格组vs. CHDI不合格组,OR=0.484,95%CI: 0.291~0.804;CHDI良好组vs. CHDI不合格组,OR=0.414,95%CI: 0.230~0.746)。

    结论

    甲状腺结节病例组膳食质量较对照组差,主要表现为病例组蔬菜总量、深色蔬菜、水果和鱼虾类食物摄入量低于对照组,而膳食质量良好和合格者较膳食质量不合格者甲状腺结节发生的风险降低。

     

    Abstract: Background

    Both domestic and foreign studies on the diet quality of patients with thyroid nodules are rare at present, and the relationship between thyroid nodules and diet quality is still unclear.

    Objective

    This study aims to evaluate the diet quality of thyroid nodules with the China Healthy Diet Index (CHDI) and to explore the relationship between diet quality and thyroid nodules.

    Methods

    We conducted a hospital-based case-control study in which 387 patients with thyroid nodules were matched individually (1∶1) by gender and age (±3 years) to the controls who ordered a routine physical examine and with negative thyroid nodules reported by B-ultrasound in the same hospital. A structured questionnaire was applied to collect data on general characteristics and diet. CHDI was employed to evaluate the diet quality of the two groups. CHDI is based on the Dietary Guidelines for Chinese Residents and the recommended food intake in the balanced diet pagoda, combined with the dietary nutritional status of Chinese population. The index contains 13 scoring components, and the highest total score is 100, with a higher score representing better dietary quality. CHDI scores < 60, 60-<80, and ≥80 are recognized as unqualified, qualified, and good diet quality, respectively.

    Results

    The scores of the thyroid nodule cases were lower than the scores of the controls in total vegetables, dark vegetables, fruits, and fish/shrimps (all Ps<0.05). The nonparametric test results found that there were significant differences in the distributions of scores in total vegetables, dark vegetables, fruits, soybeans, and fish/shrimps between the case and the control groups (allPs<0.05). The percentages reaching the full scores in food variety, meat and eggs, and empty calories in both groups exceeded 60%, while the percentages reaching the full scores in whole grains/beans/tubers, dairy, soybeans, and sodium were lower than 30% in the two groups. The median CHDI scores of the thyroid nodule cases and the controls were 69.1 and 72.9, respectively; the cases' CHDI score was lower than the controls' (P<0.05). The proportions of unqualified diet in the case and the control groups accounted for 23.0% and 13.7% respectively (P=0.001). After being adjusted for education level, marital status, occupation, monthly household income per capita, body mass index, hypertension/diabetes, energy, and iodine intake, the results of logistic regression analysis showed that the risk for thyroid nodules was negatively associated with CHDI score (CHDI qualified group vs. CHDI unqualified group, OR=0.484, 95%CI: 0.291-0.804; CHDI good dietary quality group vs. CHDI unqualified group, OR=0.414, 95%CI: 0.230−0.746).

    Conclusion

    The diet quality of patients with thyroid nodules is lower than that of the control group, as the former reported lower consumptions of total vegetables, dark vegetables, fruits, and fish/shrimps. Those who have good or qualified diet quality show a reduced risk of thyroid nodules than those with unqualified dietary quality.

     

/

返回文章
返回