Thyroid hormones, dementia, and atrophy of the medial temporal lobe
Thyroid hormones, dementia, and atrophy of the medial temporal lobe
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DOI：
10.1210/jc.2006-0449
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发表时间：
2006-07-01
影响因子：
5.8
通讯作者：
Breteler, Monique M. B.
中科院分区：
文献类型：
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作者：
de Jong, Frank Jan;den Heijer, Tom;Breteler, Monique M. B.
背景：甲状腺功能与阿尔茨海默病(AD)有关，但目前尚不清楚甲状腺功能障碍是否导致或促进了AD的发展。目的：本研究的目的是确定甲状腺功能与脑磁共振成像(MRI)上的内侧颞叶萎缩作为AD的早期征兆和痴呆风险之间的关系。设计和参与者：这是一项基于人群的队列研究，研究对象：1077名年龄在60-90岁且无痴呆的老年人(1995-1996年)。主要观察指标：非空腹血清TSH、游离T-4(FT(4))、T-3、而RT(3)在1025名受试者中可用，这些受试者在2005年之前对痴呆症事件进行了跟踪调查。在489名非痴呆老年人的子组中，我们在脑MRI上评估了海马体和杏仁核的体积。结果：在5657人年(平均5.5年)的随访中，63名受试者被诊断为痴呆症，其中46名为阿尔茨海默病。TSH和甲状腺激素与患痴呆症或AD的风险无关。TSH和T3也与脑萎缩无关，而在MRI上，FT(4)水平较高的非痴呆组有更多的海马区和杏仁核萎缩。在RT3中也发现了类似的关联。排除甲状腺疾病或早期AD的受试者不会改变结果。结论：在我们的研究中，TSH既不与AD的风险相关，也不与其早期的MRI标志物相关，认为甲状腺功能在AD的发生发展中起着重要作用。在MRI上，FT4和RT3水平升高与脑萎缩是否具有功能意义仍有待阐明。
Context: Thyroid function has been related to Alzheimer disease (AD), but it remains unclear whether thyroid dysfunction results from or contributes to developing AD.Objective: The objective of the study was to determine the association between thyroid function and both medial temporal lobe atrophy on brain magnetic resonance imaging (MRI) as putative early sign of AD and risk of dementia.Design and Participants: This was a population-based cohort study among 1077 elderly subjects aged 60-90 yr and dementia free at baseline (1995-1996).Main Outcome Measures: Nonfasting serum levels of TSH, free T-4 (fT(4)), T-3, and rT(3) were available in 1025 subjects followed up for incident dementia until 2005. In a subset of 489 nondemented elderly, we assessed volumes of the hippocampus and amygdala on brain MRI. Subjects using thyroid medication were excluded.Results: During 5657 person-years of follow-up (mean 5.5 yr), 63 subjects were diagnosed with dementia (46 with AD). TSH and thyroid hormones were not associated with risk of dementia or AD. TSH and T3 were also not related to brain atrophy, whereas nondemented subjects with higher fT(4) levels had more hippocampal and amygdalar atrophy on MRI. Similar associations were found for rT3. Excluding subjects with thyroid disorders or incipient AD did not change the results.Conclusion: In our study, TSH was related neither to risk of AD nor with early MRI markers thereof, arguing against an important role of thyroid function in the development of AD. Whether the association of higher fT4 and rT3 levels with brain atrophy on MRI has functional significance remains to be elucidated.