甲状腺功能异常与代谢综合征组分关系的流行病学研究  

Relationship between the prevalence of thyroid dysfunction and components of metabolic syndrome： an epidemiological survey

作　　者：毛玉山[1] 麦一峰[2] 洪中立[2] 杜娟 朱忠伟 

机构地区：[1]宁波大学医学院附属医院内分泌科,315020 [2]宁波大学医学院附属医院心内科,315020 [3]浙江省宁波市镇海区炼化医院

出　　处：《中华内分泌代谢杂志》2012年第3期196-200,共5页Chinese Journal of Endocrinology and Metabolism

摘　　要：目的探讨甲状腺功能异常与代谢综合征及其各组分的关系。方法调查10461名年龄20～90岁的宁波市某石化企业在职和退休员工人群，测定其体重指数、腰围、血压、空腹血糖、血脂谱和甲状腺功能。采用2005年国际糖尿病联盟（IDF）标准诊断代谢综合征。结果（1）该企业员工甲状腺功能异常和代谢综合征的患病率分别为4．6％和10．2％；（2）有18．1％的员工存在腰围超标并含至少1项代谢异常；（3）TSH降低、正常和升高3组间代谢综合征的患病率差异无统计学意义；（4）代谢综合征5项组分中，经togisac回归分析显示降低的高密度脂蛋白胆固醇（HDL-C）与TSH降低有关（OR=0．313，95％C10．184—0．530），高甘油三酯与TSH升高有关（OR=0．767，95％C10．595—0．991）；（5）进一步分析TSH水平与血脂谱的关系，男性仅总胆固醇和HDL-C随TSH降低而降低；女性除载脂蛋白（A1）外，总胆固醇、低密度脂蛋白胆固醇、甘油三酯、载脂蛋白B随TSH升高而逐渐升高，HDL-C在TSH异常组均显著降低。结论甲状腺功能异常与代谢综合征之间未见有显著相关性。甲状腺功能对于代谢综合征各组分的影响，主要表现为血脂谱改变。Objective To study the relationship between the prevalence of thyroid dysfunction and components of metabolic syndrome. Methods A total of 10 461 working and retired employees aged 20 to 90 years in a Petrochemical Corporation in Ningbo were included. Body mass index （BMI） , waist circumference, blood pressure, fasting blood glucose, blood lipid profile, serum thyroid-stimulating hormone （ TSH）, free thyroxine （ FT4 ）, and free triiodothyronine （FT3 ） were measured in all subjects. Metabolic syndrome was diagnosed according to the International Diabetes Federation （IDF） criteria. Results （ 1 ） The prevalences of metabolic syndrome and overall thyroid dysfunction were 10. 2% and 4. 6% , respectively. （2） 18. 1% petrochemical employees had abdominal obesity with at least one component of metabolic syndrome. （ 3 ） There was no significant difference in the prevalence of metabolic syndrome among the groups with lowered, normal, and elevated TSH. （4） Logistic regression analysis revealed that lowered high density lipoprotein cholesterol （ HDL-C ） was associated with lowered TSH （ OR = 0. 313, 95% CI 0. 184-0. 530 ） , and raised triglyceride was associated with elevated TSH （ OR = 0. 767,95% CI 0. 595- 0. 991 ）. （5） There were significant associations between serum TSH levels and lipid parameters such as total cholesterol in males, triglyceride and low density lipoprotein cholesterol in females, and HDL-C in both genders. Conclusion The prevalence of thyroid dysfunction was not associated with central obesity, hypertension, and hyperglycemia. Lipid disorder was correlated with serum TSH levels.

关 键 词：甲状腺功能异常 代谢综合征 流行病学 

分 类 号：R581[医药卫生—内分泌]