碘缺乏地区亚临床甲状腺功能减退症患者及甲状腺功能正常者甲状腺功能与血压水平的关系  

Relationship between thyroid function and blood pressure level in subclinical hypothyroidism patients and the people with normal thyroid function in iodine deficiency areas

作　　者：衡婧雅 滕妍利 朱琳 杨金[1] 王改莉 马嘉俊 闫英洁 贾伟华[2] 李小烽[1] 李江敏[1] 何景阳[1] HENG Jingya;TENG Yanli;ZHU Lin;YANG Jin;WANG Gaili;MA Jiajun;YAN Yingjie;JIA Weihua;LI Xiaofeng;LI Jiangmin;HE Jingyang(Henan Center for Disease Control and Prevention,Zhengzhou,Henan 450016,China;Zhengzhou CenterforDisease Control and Prevention)

机构地区：[1]河南省疾病预防控制中心,河南郑州450016 [2]郑州市疾病预防控制中心

出　　处：《现代疾病预防控制》2025年第2期97-102,共6页MODERN DISEASE CONTROL AND PREVENTION

基　　金：河南省医学科技攻关计划(联合共建)项目(LHGJ20230618、LHGJ20240627)。

摘　　要：目的 研究碘缺乏地区亚临床甲状腺功能减退症(亚临床甲减)患者及甲状腺功能正常者甲状腺功能(甲功)与血压的关系。方法 2021年10—11月采用整群随机抽样法在河南省郑州市中牟县成年居民中招募1 131名研究对象,进行流行病学问卷调查,测量身高、体重、腰围、血压,采集静脉血样检测促甲状腺激素(TSH)、血清游离甲状腺素(FT_(4))、血清游离三碘甲状腺原氨酸(FT_(3)),甲状腺过氧化物酶抗体(TPO-Ab)、甲状腺球蛋白抗体(Tg-Ab)。将研究对象分为甲功正常组和亚临床甲减组,甲功正常组进一步按照TSH四分位数分为TSH第一四分位数(TSH-Q_(1))组(0.403~1.730μIU/mL),TSH第二四分位数(TSH-Q_(2))组(1.731~2.356μIU/mL),TSH第三四分位数(TSH-Q_(3))组(2.357~3.120μIU/mL)和TSH第四四分位数(TSH-Q_(4))组(3.121~5.486μIU/mL),应用logistic回归分析甲功正常者及亚临床甲减患者的甲功指标与血压水平的关系。结果共纳入891人,其中甲功正常者859人(96.4%),亚临床甲减患者32人(3.6%),甲功正常组与亚临床甲减组在年龄、腰围、体质量指数(BMI)、吸烟和饮酒所占比例方面差异均无统计学意义(P均>0.05)。亚临床甲减组的舒张压高于甲功正常组(t=-2.795,P<0.05),甲功正常组和亚临床甲减组的高血压患病率(分别为24.9%、28.1%)差异无统计学意义(χ^(2)=0.170,P>0.05)。不同血压水平甲状腺功能比较显示,高血压组的FT_(3)、FT_(4)、TSH水平高于血压正常组(t值分别为-5.350、-2.010、-2.541,P均<0.05)。logistic多元回归分析显示,年龄[以<40岁为参照,≥40岁组OR值(95%CI)为3.432(2.276~5.175)]、超重和肥胖[以体重正常者为参照,超重、肥胖OR值(95%CI)分别为1.620(1.047~2.508)、3.085(1.724~5.519)]、饮酒[以不饮酒者为参照,饮酒者OR值(95%CI)为2.394(1.377~4.161)]、高FT_(4)水平[以FT_(4)第一四分位数(FT_(4)-Q_(1))为参照,FT_(4)第三四分位数(FT_(4)-Q_(3))和第四四分位数(FT_(4)-Q_(4))OObjective To study the relationship between thyroid function and blood pressure level in the patients with subclinical thyroid dysfunction (subclinical hypothyroidism) and the people with normal thyroid function and blood pressure in regional subclinical thyroid dysfunction.Methods From October to November 2021,1 131 residents aged 18-75 years old in Zhongmu,Zhengzhou,Henan were recruited as study subjects cluster random sampling method;the epidemiological questionnaire survey was conducted,and the height,weight,waist circumference,and blood pressure were measured;the venous blood samples were collected for testing thyroid stimulating hormone (TSH),serum free thyroxine (FT_(4)),serum free triiodothyronine (FT_(3)),thyroid peroxidase antibody (TPO-Ab),and thyroid globulin antibody (TG-Ab).The study subjects were divided into normal thyroid function group and subclinical hypothyroidism group.The normal thyroid function group was further divided into TSH first quartile (TSH-Q_(1)) group (0.403-1.730μIU/mL),TSH second quartile (TSH-Q_(2)) group (1.731-2.356μIU/mL),TSH third quartile(TSH-Q_(3)) group (2.357-3.120μIU/mL) and TSH fourth quartile (TSH-Q_(4)) group (3.121-5.486μIU/mL) according to TSH quartiles.Logistic regression analysis was applied to explore the relationship between thyroid function indicators and blood pressure levels in normal thyroid function and subclinical hypothyroidism patients.Results A total of 891 study subjects were recruited,including 859 people (96.4%) with normal thyroid function and 32 patients (3.6%) with subclinical hypothyroidism.There was no statistically significant difference in age,waist circumference,body weight index (BMI),the proportion of smokers,and the proportion of drinkers between the two groups (all P>0.05).The diastolic blood pressure in the sub-clinical hypothyroidism group was higher than that in the normal group,and the difference was statistically significant (t=-2.795,P<0.05).The difference in hypertension prevalence between the normal group (24.9%) and the sub

关 键 词：亚临床甲状腺功能减退症 甲状腺功能正常 血压 甲状腺激素 

分 类 号：R581[医药卫生—内分泌]