亚临床甲状腺功能减退与收缩压水平的关系  

Meta analysis on the relationship between subclinical hypothyroidism and the levels of systolic blood pressure

作　　者：蔡云飞[1] 时景璞[1] 

机构地区：[1]中国医科大学附属第一医院临床流行病学教研室,沈阳110001

出　　处：《中华流行病学杂志》2011年第1期55-59,共5页Chinese Journal of Epidemiology

摘　　要：目的 探讨亚临床甲状腺功能减退（亚临床甲减）与收缩压水平的关系,为高血压防治和病因探索提供证据.方法 检索国内外各类大型数据库中近11年发表的有关亚临床甲减与收缩压水平关系的文献,采用Meta分析方法,利用Stata11软件评价亚临床甲减与收缩压水平之间的关系.计算加权均数差（WMD）及其95%CI,Begg＇s检验法和Egger＇s检验法评价发表性偏倚.结果 （1）亚临床甲减病例组与甲状腺功能正常对照组的收缩压水平之间差异有统计学意义（WMD=2.04mmHg,95%CI：0.64～3.45,P＜0.05）.（2）亚组分析显示,在促甲状腺激素（TSH）均数差值＜7 mU/L组,亚临床甲减病例组与甲状腺功能正常对照组的收缩压水平之间差异有统计学意义（WMD=2.33 mm Hg,95%CI：0.60～4.06,P＜0.05）,在TSH均数差值＞7mU/L组,则无统计学意义;在亚洲组,亚临床甲减病例组与甲状腺功能正常对照组的收缩压水平之间差异有统计学意义（WMD=2.62mmHg,95%CI：1.69～3.55,P＜0.05）,而在欧洲组差异无统计学意义;在社区收集组,亚临床甲减病例组与甲状腺功能正常对照组的收缩压水平之间差异有统计学意义（WMD=2.77 mm Hg,95%CI：1.61～3.93,P＜0.05）,而在医院收集组差异无统计学意义;在横断面研究组,亚临床甲减病例组与甲状腺功能正常对照组的收缩压水平之间差异有统计学意义（WMD=2.77 mm Hg,95%CI：1.61～3.93,P＜0.05）,而病例对照研究组的差异无统计学意义.（3）Begg＇s检验法和Egger＇s检验法检验均无统计学意义（P＞0.05）,所以没有显著的发表偏倚.结论 亚临床甲减和收缩压水平升高有明显相关性.亚临床甲减是否为收缩压水平升高的危险因素之一,还有待进一步大样本的前瞻性研究证实.积极治疗亚临床甲减,对高血压的预防和治疗有一定意义.Objective To investigate the association between subclinical hypothyroidism and levels of systolic blood pressure （SBP）, so as to provide evidence for the development of prevention strategy and understanding the etiology of hypertension. Methods The articles on the association of subclinical hypothyroidism and systolic blood pressure levels were retrieved by searching international and national databases from 1999 to 2010. The relationship between subclinical hypothyroidism and systolic blood pressure levels was assessed by meta analysis with Stata 11software. The weighted mean difference （WMD） and 95% confidence interval （CI） were calculated,and the publication bias was assessed by Begg＇s test and Egger＇s test. Results （1） There was significant difference in SBP levels between patients with subclinical hypothyroidism and normal subjects （WMD= 2.04 mm Hg, 95% CI： 0.64 to 3.45, P〈 0.05 ）. （2） Subgroup analysis indicated that there was significant difference seen in thyroid stimulating hormone （TSH） mean difference values 〈7 mU/L group（WMD=2.33 mm Hg,95%CI：0.60 to 4.06,P〈0.05） but not in the group that TSH mean difference values were 〉7 mU/L. There was significant difference seen in the Asian group （WMD=2.62 mm Hg, 95%CI： 1.69 to 3.55,P〈0.05） in the community group（WMD=2.77mm Hg, 95%CI： 1.61 to 3.93, P〈0.05） but not in the European group and or in the hospital group.There was significant difference in the cross-sectional group （WMD=2.77 mm Hg, 95%CI： 1.61 to 3.93, P〈0.05）, but not in the case-control group. （3） Results from both Begg＇ s test and Egger＇s test did not show significant difference, indicating that there was no publication bias existed.Conclusion Subclinical hypothyroidism was associated with the elevated systolic blood pressure. In terms of the role of subclinical hypothyroidism that might serve as one of the potential risk factor for the elevated systolic blood pressure. Well designed and large sample-sized prospective stu

关 键 词：甲状腺功能减退 亚临床 收缩压 META分析 

分 类 号：R581.2[医药卫生—内分泌]