甲状腺功能正常人群中基线甲状腺功能与颈动脉粥样硬化关系的队列研究  

The cohort study on relationship between baseline thyroid function and carotid atherosclerosis in residents with normal thyroid function

作　　者：孟永霞 顾叶青 张庭婧 张卿[4] 刘莉[4] 牛凯军[3] MENG Yong-xia;GU Ye-qing;ZHANG Ting-jing;ZHANG Qing;LIU Li;NIU Kai-jun(Special-service Department,No.983 Hospital of People's Liberation Army,Tianjin 300142,China)

机构地区：[1]中国人民解放军联勤保障部队第九八三医院特勤科,天津300142 [2]中国医学科学院放射医学研究所 [3]天津医科大学营养流行病学研究所公共卫生学院,天津300070 [4]天津医科大学总医院健康管理中心

出　　处：《中国慢性病预防与控制》2021年第4期268-272,共5页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：天津市科技支撑计划重点项目(11ZCGYSY05700,12ZCZDSY20400,13ZCZDSY20200)。

摘　　要：目的探索甲状腺功能正常范围内的甲状腺激素水平与颈动脉粥样硬化之间的关联,为颈动脉粥样硬化的早期识别和防控提供依据。方法本研究人群选自2013—2019年天津市慢性低度炎症与健康促进(TCLSIH)队列研究,该研究从2013年5月开始,对所有参与者进行详细的生活方式问卷调查(包括身体活动、家庭收入、职业、教育水平等)及健康检查(血液指标检测、血管彩超检查等),对符合条件的参与者进行了1年1次的随访,随访内容为颈动脉超声检查,随访至2019年12月31日,中位随访时间为4.2年。本研究选择其中甲状腺功能正常的基线未患颈动脉粥样硬化者3 543人纳入分析。采用SAS 9.3软件进行协方差分析、多因素logistic回归分析和Cox比例风险回归模型分析。结果 Cox回归分析结果显示,在经过多因素调整后,游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)和促甲状腺激素(TSH)与颈动脉粥样硬化发病风险的关联均无统计学意义。FT3和FT4和TSH水平每变化1个单位,与颈动脉粥样硬化发病的风险比(HR)分别为1.12(95%CI:0.99~1.28)、1.01(95%CI:0.98~1.04)和0.97(95%CI:0.90~1.05)。FT3和FT4和TSH水平每变化1个标准差,与颈动脉粥样硬化发病的HR值分别为1.07(95%CI:0.99~1.15)、1.02(95%CI:0.95~1.09)和0.97(95%CI:0.91~1.04),P>0.05。结论甲状腺功能正常人群中基线甲状腺功能与颈动脉粥样硬化的发病风险无关。本研究数据并不支持基线甲状腺功能对颈动脉粥样硬化的发病风险产生影响的假说。Objective To explore the relationship between thyroid hormone level and carotid atherosclerosis in the normal range of thyroid function,and to provide the evidence for early identification and prevention of carotid atherosclerosis. Methods The subjects were selected from the Tianjin chronic low-grade systemic inflammation and health promotion(TCLSIH) cohort study from 2013 to 2019. From May 2013,all participants were investigated with detailed lifestyle questionnaire(including physical activity, family income, occupation, education level, etc.) and health examination( blood index test, vascular color Doppler ultrasound,etc.). Eligible participants received follow-up visit of 1 time for 1 year,which followed up to December 31,2019. The median time of following up was 4.2 years,the follow-up content was carotid ultrasound examination. In this study,3 543 participants with normal thyroid function and without carotid atherosclerosis at baseline were included for analysis. The covariance analysis,multivariate logistic regression analysis and Cox proportional risk regression model analysis were used to analyze the data,the used software was SAS 9.3. Results Cox regression analysis showed that after multivariate adjusting,free triiodothyronine(FT3),free thyroxine(FT4) and thyroid stimulating hormone(TSH) were not significantly associated with the risk of carotid atherosclerosis. When the levels of FT3,FT4 and TSH changed 1 unit,the risk ratios to carotid atherosclerosis were 1.12(95%CI:0.99-1.28),1.01(95%CI:0.98-1.04) and 0.97(95%CI:0.90-1.05),respectively. When the levels of FT3,FT4 and TSH changed1 SD,the risk ratios to carotid atherosclerosis were 1.07(95%CI:0.99-1.15),1.02(95%CI:0.95-1.09) and 0.97(95%CI:0.91-1.04),respectively(P>0.05). Conclusion Baseline thyroid function is not associated with the risk of carotid atherosclerosis in normal thyroid function population. The study data doesn’t support the hypothesis that baseline thyroid function affects the risk of carotid atherosclerosis.

关 键 词：甲状腺功能 颈动脉粥样硬化 游离三碘甲状腺原氨酸 游离甲状腺素 促甲状腺激素 

分 类 号：R181.3[医药卫生—流行病学]