甲状腺功能水平与肌少症相关特征表型的关联  

Association between thyroid function levels and phenotypes associated with sarcopenia

作　　者：李嘉彤 金玥 刘润嘉 宋博文 朱晓倩 李念虎[2] Li Jiatong;Jin Yue;Liu Runjia;Song Bowen;Zhu Xiaoqian;Li Nianhu(Shandong University of Traditional Chinese Medicine,Jinan 250014,Shandong Province,China;Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250014,Shandong Province,China)

机构地区：[1]山东中医药大学,山东省济南市250014 [2]山东中医药大学附属医院,山东省济南市250014

出　　处：《中国组织工程研究》2025年第6期1312-1320,共9页Chinese Journal of Tissue Engineering Research

基　　金：山东省自然科学基金项目(ZR2019MH044),项目负责人:李念虎;徐展望山东省名老中医药专家传承工作室建设项目(鲁卫函[2019]92号),项目负责人:李念虎;脊柱正骨手法中医药特色技术(鲁卫函[2022]93号),项目负责人:李念虎。

摘　　要：背景:多项观察性研究发现甲状腺功能水平与肌少症之间存在密切关系,但是甲状腺功能水平与肌少症发病之间的因果关系尚不明确。目的:采用两样本孟德尔随机化方法研究甲状腺功能水平与肌少症的因果关系。方法:利用促甲状腺激素、游离三碘甲状腺原氨酸、游离四碘甲状腺原氨酸、亚临床甲状腺功能亢进症、亚临床甲状腺功能减退症和肌少症的4种相关表型——左手握力、右手握力、四肢瘦体质量、步速的全基因组关联研究汇总数据进行两样本孟德尔随机化分析,分别采用逆方差加权法、加权中位数法、简单模式法、加权中值方法和MR-Egger回归法作为分析方法,同时采用异质性检验、多效性检验、MR-PRESSO、留一法、漏斗图等方法进行敏感性分析。结果与结论:促甲状腺激素的增高会增加左手握力(β=0.02,SE=0.01,P=0.01)、右手握力(β=0.02,SE=0.01,P=0.01),游离三碘甲状腺原氨酸的增高会降低左手握力(β=-0.06,SE=0.02,P=9.5×10^(-5))、右手握力(β=-0.07,SE=0.02,P=9.3×10^(-5)),亚临床甲状腺功能亢进症会降低步速(β=-4.4×10^(-3),SE=1.7×10^(-3),P=0.01)。敏感性分析结果与主要分析基本一致。结果表明:促甲状腺激素上升是肌少症保护因素,游离三碘甲状腺原氨酸上升和亚临床甲状腺功能亢进症可能导致肌少症发生风险增加。BACKGROUND:Several observational studies have found a close relationship between thyroid function levels and sarcopenia,but the causal relationship between thyroid function levels and the onset of sarcopenia is not yet clear.OBJECTIVE:To investigate the causal relationship between thyroid function levels and sarcopenia using a two sample Mendelian randomization method.METHODS:A two sample Mendelian randomization analysis was conducted using genome-wide association study data on thyrotropin,free triiodothyronine,free tetraiodothyronine,subclinical hyperthyroidism,subclinical hypothyroidism,and four related phenotypes of sarcopenia-left hand grip strength,right hand grip strength,limb lean mass,and gait speed.The inverse-variance weighted method,weighted median method,simple mode method,weighted median estimator method,and MR Egger regression method were used as analysis methods,while heterogeneity test,pleiotropy test,MR-PRESSO,leave-one-out method,funnel plot and other methods were used for sensitivity analysis.RESULTS AND CONCLUSION:Elevated levels of thyroid-stimulating hormone increased left-(β=0.02,SE=0.01,P=0.01)and right-handed grip strength(β=0.02,SE=0.01,P=0.01),an increase in free triiodothyronine decreased left-(β=-0.06,SE=0.02,P=9.5×10^(-5))and right-handed grip strength(β=-0.07,SE=0.02,P=9.3×10^(-5)),and subclinical hyperthyroidism decreased gait speed(β=-4.4×10^(-3),SE=1.7×10^(-3),P=0.01).The sensitivity analysis results were basically consistent with the main analysis results.To conclude,an increase in thyroid-stimulating hormone is a protective factor for sarcopenia,and elevation of free triiodothyronine and subclinical hyperthyroidism may increase the risk of sarcopenia.

关 键 词：孟德尔随机化 因果关系 甲状腺功能 促甲状腺激素 游离三碘甲状腺原氨酸 肌少症 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R581