Risk for ischemic heart disease and all-cause mortality in subclinical hypothyroidism
Risk for ischemic heart disease and all-cause mortality in subclinical hypothyroidism
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DOI：
10.1210/jc.2003-031089
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发表时间：
2004-07-01
影响因子：
5.8
通讯作者：
Eguchi, K
中科院分区：
文献类型：
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作者：
Imaizumi, M;Akahoshi, M;Eguchi, K
我们调查了亚临床甲状腺功能减退与动脉粥样硬化性疾病（缺血性心脏病和脑血管疾病）和死亡率之间的可能关联。在1984年至1987年间进行甲状腺疾病筛查的2856名参与者（平均年龄58.5岁）中，257名亚临床甲状腺功能减退（TSH为5.0 mU/l）和2293名对照组（TSH范围为0.6-5.0 mU/l）进行了分析。在基线横断面分析中，亚临床甲状腺功能减退与缺血性心脏病相关，与年龄、收缩压、体重指数、胆固醇、吸烟、红细胞沉降率或是否存在糖尿病无关[优势比（or）， 2.5；95%置信区间（95% CI）为1.1-5.4，OR为4.0；95% CI（男性为1.4-11.5），但女性没有。然而，与脑血管疾病没有关联（OR, 0.9; 95% CI, 0.4-2.4）。我们无法检测甲状腺抗体的存在对亚临床甲状腺功能减退和缺血性心脏病之间关系的影响。在一项直到1998年的10年随访研究中，基线测量后3-6年所有原因的死亡率在亚临床甲状腺功能减退的男性中明显增加（风险比为1.9-2.1），但在女性中没有，尽管具体的死亡原因尚未确定。我们的研究结果表明亚临床甲状腺功能减退与缺血性心脏病有关，并可能影响男性的全因死亡率。
We investigated possible associations between subclinical hypothyroidism and atherosclerotic diseases (ischemic heart disease and cerebrovascular disease) and mortality. Of 2856 participants (mean age 58.5 yr) in a thyroid disease screening between 1984 and 1987, 257 subjects with subclinical hypothyroidism (TSH>5.0 mU/liter) and 2293 control subjects (TSH range 0.6-5.0 mU/liter) were analyzed. In the baseline cross-sectional analysis, subclinical hypothyroidism was associated with ischemic heart disease independent of age, systolic blood pressure, body mass index, cholesterol, smoking, erythrocyte sedimentation rate, or presence of diabetes mellitus [odds ratio (OR), 2.5; 95% confidence interval (95% CI), 1.1-5.4 in total subjects and OR, 4.0; 95% CI, 1.4-11.5 in men] but not in women. However, there was no association with cerebrovascular disease (OR, 0.9; 95% CI, 0.4-2.4). We were unable to detect an influence of thyroid antibody presence on the association between subclinical hypothyroidism and ischemic heart disease. In a 10-yr follow-up study until 1998, increased mortalities from all causes in yr 3-6 after baseline measurement were apparent in men with subclinical hypothyroidism (hazard ratio, 1.9-2.1) but not in women, although specific causes of death were not determined. Our results indicate that subclinical hypothyroidism is associated with ischemic heart disease and might affect all-cause mortality in men.