2024 年第 3 期 第 19 卷

2型糖尿病患者血清巨噬细胞炎症蛋白1α和基质金属蛋白酶9水平与甲状腺结节的相关性研究

Study on the correlation of serum macrophage inflammatory protein-1α and matrix metalloproteinase-9 levels with thyroid nodules in patients with type 2 diabetes mellitus

作者：杨晓月1宋红红2胡少珍1潘颖1鲍晓雪3闫文英4

英文作者：Yang Xiaoyue1 Song Honghong2 Hu Shaozhen1 Pan Ying1 Bao Xiaoxue3 Yan Wenying4

单位：1河北医科大学第三医院药剂科，石家庄050000；2河北省任丘市友谊医院内科，任丘062550；3河北医科大学第三医院内分泌科，石家庄050000；4河北医科大学第三医院临床药学部，石家庄050000

英文单位：1Department of Pharmacy the Third Hospital of Hebei Medical University Shijiazhuang 050000 China; 2Department of Internal Medicine Renqiu Friendship Hospital Hebei Province Renqiu 062550 China; 3Department of Endocrinology the Third Hospital of Hebei Medical University Shijiazhuang 050000 China; 4Department of Clinical Pharmacy the Third Hospital of Hebei Medical University Shijiazhuang 050000 China

关键词：2型糖尿病；巨噬细胞炎症蛋白1α；基质金属蛋白酶9；甲状腺结节

英文关键词：Type2diabetesmellitus;Macrophageinflammatoryprotein-1α;Matrixmetalloproteinase-9;Thyroidnodules

• 摘要：

• 目的 探讨2型糖尿病（T2DM）患者血清巨噬细胞炎症蛋白1α（MIP-1α）、基质金属蛋白酶9（MMP-9）水平与甲状腺结节的相关性。方法 回顾性选取2021年10月至2023年3月于河北医科大学第三医院就诊的T2DM患者154例，根据患者是否合并甲状腺结节分为甲状腺结节组（83例）和无甲状腺结节组（71例）。比较2组甲状腺功能、血糖、血脂、MIP-1α、MMP-9等指标。采用Logistic回归模型分析影响T2DM患者出现甲状腺结节的因素；采用Pearson相关性检验分析T2DM患者血清MIP-1α、MMP-9水平与其他因素的相关性；绘制受试者工作特征曲线分析血清MIP-1α、MMP-9水平对T2DM患者出现甲状腺结节的预测价值。结果 甲状腺结节组促甲状腺激素（TSH）、总三碘甲状腺原氨酸（TT3）、总甲状腺素（TT4）、稳态模型胰岛素抵抗指数（HOMA-IR）、稳态模型胰岛β细胞功能指数、空腹血糖、空腹胰岛素水平均高于无甲状腺结节组，胰岛素敏感指数（ISI）低于无甲状腺结节组（均P＜0.05）。甲状腺结节组血清MIP-1α、MMP-9水平均高于无甲状腺结节组［（29±5）ng/L比（25±5）ng/L、（2.0±0.5）ng/L比（1.4±0.5）ng/L］（均P＜0.001）。 Logistic回归分析结果显示，MIP-1α、MMP-9、TSH、TT3、TT4、空腹胰岛素、HOMA-IR和ISI均为T2DM患者出现甲状腺结节的危险因素（均P＜0.05）。Pearson相关性分析结果表明，T2DM患者血清MIP-1α与MMP-9水平呈正相关（r=0.362，P＜0.001）。血清MIP-1α、MMP-9水平与空腹胰岛素、TSH、HOMA-IR、TT3、TT4均呈正相关，与ISI呈负相关（均P＜0.001）。MIP-1α、MMP-9水平联合检测预测T2DM患者出现甲状腺结节的曲线下面积大于MIP-1α、MMP-9单独检测（均P＜0.05）。结论 血清MIP-1α、MMP-9水平与T2DM患者出现甲状腺结节具有密切关系，对预测T2DM患者甲状腺结节具有重要价值。

• Objective To investigate the correlation of serum macrophage inflammatory protein-1α (MIP-1α) and matrix metalloproteinase-9 (MMP-9) levels with thyroid nodules in patients with type 2 diabetes mellitus (T2DM). Methods Totally 154 patients with T2DM admitted to the Third Hospital of Hebei Medical University from October 2021 to March 2023 were retrospectively enrolled. Patients were divided into the thyroid nodule group (83 cases) and the non-thyroid nodule group (71 cases) according to whether they had thyroid nodules or not. Thyroid function, blood glucose, blood lipid, MIP-1α, MMP-9 and other indicators were compared between the two groups. Logistic regression model was used to analyze the factors affecting the occurrence of thyroid nodules in patients with T2DM. Pearson correlation test was used to analyze the correlation between the serum levels of MIP-1α, MMP-9 and other factors in patients with T2DM. Receiver operating characteristic curve was used to analyze the predictive value of the levels of serum MIP-1α and MMP-9 for the occurrence of thyroid nodules in patients with T2DM. Results The levels of thyroid stimulating hormone (TSH), total triplethyronine (TT3), total thyroxine (TT4), homeostasis model assessment of insulin resistance (HOMA-IR), homeostasis model assessment of islets β cell function, fasting blood glucose and fasting insulin in the thyroid nodule group were higher than those in the non-thyroid nodule group, and the insulin sensitivity index (ISI) in the thyroid nodule group was lower than that in the non-thyroid nodule group (all P<0.05). The levels of serum MIP-1α and MMP-9 in the thyroid nodule group were higher than those in the non-thyroid nodule group ［（29±5）ng/L vs （25±5）ng/L,（2.0±0.5）ng/L vs （1.4±0.5）ng/L］(both P<0.001). Logistic regression analysis showed that MIP-1α, MMP-9, TSH, TT3, TT4, fasting insulin, HOMA-IR and ISI were all risk factors for the occurrence of thyroid nodules in patients with T2DM (all P<0.05). Pearson correlation analysis showed that the levels of serum MIP-1α and MMP-9 were positively correlated in patients with T2DM (r=0.362, P<0.001). The levels of serum MIP-1α and MMP-9 were positively correlated with fasting insulin, TSH, HOMA-IR, TT3 and TT4, and negatively correlated with ISI (all P<0.001). The area under the curve of combined detection of MIP-1α and MMP-9 in predicting thyroid nodules in patients with T2DM was larger than that of MIP-1α or MMP-9 alone (both P<0.05). Conclusion The levels of serum MIP-1α and MMP-9 are closely related to the occurrence of thyroid nodules in patients with T2DM, and they have important value in predicting thyroid nodules in patients with T2DM.