北京地区血清25羟维生素D水平与甲状腺乳头状癌发生风险的相关性研究OA

Objective To investigate the association between serum 25-hydroxyvitamin D[25(OH)D]levels and thyroid hormone sensitivity indexes and the risk of papillary thyroid carcinoma in Beijing population.Methods A total of 226 patients with pathologically confirmed papillary thyroid carcinoma after thyroid surgery were enrolled as the case group.The control group consisted of 218 individuals with normal thyroid structure and no thyroid nodules in ultra-sonographic screening.The clinical data,serum 25(OH)D,thyroid hormone sensitivity indexes and distribution of pa-pillary thyroid carcinoma were compared between the two groups.Correlation analysis,risk regression analysis and re-stricted cubic spline risk(RCS)model construction were performed to explore the associations of serum 25-hydroxyvita-min D levels and thyroid hormone sensitivity index with papillary thyroid carcinoma.Results The levels of 25(OH)D in the case group were significantly lower than that in the control group[(17.79±5.08)vs.(21.47±4.51)ng/mL,P＜0.001].The quartile grouping of 25(OH)D showed a significant negative correlation with papillary thyroid carci-noma,and the trend test was significant(P=0.038).The results of RCS regression analysis indicated a significant inverted"U-shaped"nonlinear trend between 25(OH)D and papillary thyroid carcinoma(P=0.021),and this association remained significant after adjusted for confounding factors including gender,age and body mass index(P＜0.001).The serum 25(OH)D in this population had a good discriminatory ability for papillary thyroid carcino-ma.The optimal cut-off value based on Youden's index was 18.95 ng/mL.At this threshold,the sensitivity was ap-proximately 90%and the specificity was approximately 76%.There was no association between 25(OH)D and thy-roid hormone sensitivity indices in both total population and mere patients with papillary thyroid carcinoma.There was no significant association between thyroid hormone sensitivity indices including the thyroid feedback quantile-based index(TFQI),thyroid stimulating hormone index(TSHI),thyroid stimulating hormone cell-T4 resistance index(TT4RI)and the ratio of free thyroxine to free triiodothyronine(FT4/FT3)and the risk of papillary thyroid carcino-ma.The RCS model showed an inverted"U-shaped"relationship between FT4/FT3,TFQI,TSHI,TT4RI and the risk of papillary thyroid carcinoma,but none of these associations were significant(P＞0.05).Conclusion Serum 25(OH)D levels are significantly and negatively associated with papillary thyroid carcinoma in Beijing population,with an inverted"U-shaped"nonlinear relationship.The optimal cutoff value of 25(OH)D for papillary thyroid car-cinoma risk stratification is 18.95 ng/mL,below which the risk of papillary thyroid carcinoma significantly increases.No significant correlations are observed between thyroid hormones,and thyroid-associated antibodies and sensitivity indices and papillary thyroid carcinoma.