甲状腺功能正常老年男性血清促甲状腺激素水平与代谢综合征的相关性分析  

Correlation of thyroid-stimulating hormone with metabolic syndrome in euthyroid male elders

作　　者：肖海英[1] 卢艳慧[1] 成晓玲[1] 方福生[1] 龚燕平[1] 李志冰[1] 李剑[1] 田慧[1] 李春霖[1] 

机构地区：[1]解放军总医院老年内分泌科,北京100853

出　　处：《中华医学杂志》2014年第14期1055-1059,共5页National Medical Journal of China

基　　金：军队保健专项科研课题（12BJZ41）

摘　　要：目的：探讨甲状腺功能正常老年男性血清促甲状腺激素（ TSH ）水平与代谢综合征（ MS）及其各组分的相互关系。方法采用横断面研究方法，收集2011年5-6月在解放军总医院常规年度体检年龄≥60岁甲状腺功能正常的老年男性307例，年龄60～90岁，平均年龄（72.6±7.9）岁。测量身高、体重、血压、血糖、血脂、空腹胰岛素及甲状腺功能，分析TSH及甲状腺激素与代谢综合征及其各组分的相互关系。结果本研究人群MS患病率为40.7％（125／307），MS组及超重／肥胖组TSH水平均高于其正常组[（2.6±1.1）比（2.4±1.0） mU／L，P＝0.014；（2.7±1.1）比（2.3±1.1）mU／L，P＝0.007]。将正常范围内TSH水平按三分位分组后，结果显示随TSH水平增加，超重／肥胖和MS患病率呈上升趋势（ P＝0.042，0.041）；校正年龄、稳态模型胰岛素抵抗指数（ HOMA-IR）后，超重／肥胖和MS患病风险增加，第三分位与第一分位比各增加1.872倍和1.904倍（95％CI：1.051～3.332， P＝0.033；95％CI：1.070～3.387， P＝0.028）。 Logistic多元回归分析表明，TSH是影响MS的重要危险因素（OR＝1.324，95％CI：1.042～1.683）。结论甲状腺功能在正常范围内，随TSH水平升高可能增加老年男性MS的患病风险。Objective To explore the relationship between thyroid-stimulating hormone （ TSH） and metabolic syndrome （ MS） and its components in euthyroid male elders .Methods For this cross-sectional study, 307 euthyroid male elders aged over 60 years participating in a routine annual health screening examination at our hospital during May-June 2011 were enrolled.Their mean age was （72.6 ±7.9） years. Height, weight, blood pressure, blood glucose, blood lipids, fasting insulin levels and thyroid functions （ TT3 , TT4 , FT3 , FT4 , TSH, Tg ＆ TPOAb） were measured.And the association of thyroid functions and the presence of MS and its components was analyzed . Results The prevalence of MS was 40.7%（125/307）.The TSH level was significantly higher in the MS and obeses group than that in control group （（2.6 ±1.1） vs （2.4 ±1.0）mU/L, P=0.014;（2.7 ±1.1） vs （2.3 ±1.1）mU/L, P=0.007）.The prevalence of MS and obesity showed a gradual increase according to the TSH tertiles .When comparing subjects in the highest and lowest tertile of TSH , the former group demonstrated 1.872 and 1.904-fold increases in the odds ratio for obesity and MS after adjusting for age and homeostasis model assessment for insulin resistance （HOMA-IR） （95%CI： 1.051 -3.332, P =0.033; 95%CI： 1.070 -3.387, P =0.028）.Logistic regression analysis showed that the TSH levels were independent influencing factors for MS in male elders （OR=1.324, 95%CI：1.042 -1.683）.Conclusion High circulating TSH level, albeit normal, is associated with elevated risk for metabolic syndrome in male elders .

关 键 词：甲状腺功能试验 促甲状腺素 代谢综合征X 老年男性 

分 类 号：R589[医药卫生—内分泌]