Subclinical Thyroid Dysfunction and Depressive Symptoms among the Elderly: A Prospective Cohort Study
Subclinical Thyroid Dysfunction and Depressive Symptoms among the Elderly: A Prospective Cohort Study
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DOI：
10.1159/000437387
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发表时间：
2016-01-01
影响因子：
4.1
通讯作者：
Rodondi, Nicolas
中科院分区：
文献类型：
--
作者：
Blum, Manuel R.;Wijsman, Liselotte W.;Rodondi, Nicolas
背景资料：在横断面研究中，亚临床甲状腺功能减退症与抑郁症状相关，但关于亚临床甲状腺功能亢进症的前瞻性数据和数据很少。研究方法：在普伐他汀在高危老年人中的前瞻性研究（PROSPER）的莱顿子研究中，在基线时测量促甲状腺激素和游离T-4水平，并在6个月后重复测量70-82岁的既存心血管疾病或已知心血管风险因素的成人，以确定持续的甲状腺功能状态。主要结果测量抑郁症状，在基线和3年后用老年抑郁量表15（GDS-15）进行评估。所有分析均根据年龄、性别和教育进行调整。结果如下：606名参与者（41%的女性;平均年龄75岁）未使用抗抑郁药物，基线时GDS-15评分与亚临床甲状腺功能减退症患者无差异（n = 47; GDS-15评分1.75，95% CI 1.29-2.20，p = 0.53）或亚临床甲亢（n = 13; GDS-15评分1.64，95% CI 0.78-2.51，p = 0.96）与甲状腺功能正常的参与者（n = 546;平均GDS-15评分1.60，95% CI 1.46-1.73）相比。3年后，与甲状腺功能正常的参与者相比，亚临床甲状腺功能减退的参与者GDS-15评分的变化没有差异（Delta GDS-15评分-0.03，95% CI -0.50至0.44，p = 0.83），而亚临床甲亢与GDS评分增加相关（Delta GDS-15评分1.13，95% CI 0.32-1.93，p = 0.04）。持续性亚临床甲状腺功能障碍的所有结果相似。结论：在这项关于持续性亚临床甲状腺功能障碍与抑郁症相关性的最大规模前瞻性研究中，亚临床甲状腺功能减退症与心血管高危老年人的抑郁症状增加无关。持续性亚临床甲状腺功能亢进可能与抑郁症状增加有关，这需要在一个更大的前瞻性研究中证实。(C)2015 S. Karger AG，巴塞尔
Background: Subclinical hypothyroidism has been associated with depressive symptoms in cross-sectional studies, but prospective data and data on subclinical hyperthyroidism are scarce. Methods: In the Leiden substudy of the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER), thyroid-stimulating hormone and free T-4 levels were measured at baseline and repeated after 6 months in adults aged 70-82 years with preexisting cardiovascular disease or known cardiovascular risk factors to define persistent thyroid functional status. Main outcome measures were depressive symptoms, assessed with the Geriatric Depression Scale 15 (GDS-15) at baseline and after 3 years. All analyses were adjusted for age, gender and education. Results: In 606 participants (41% women; mean age 75 years) without antidepressant medication, GDS-15 scores at baseline did not differ for participants with subclinical hypothyroidism (n = 47; GDS-15 score 1.75, 95% CI 1.29-2.20, p = 0.53) or subclinical hyperthyroidism (n = 13; GDS-15 score 1.64, 95% CI 0.78-2.51, p = 0.96) compared to euthyroid participants (n = 546; mean GDS-15 score 1.60, 95% CI 1.46-1.73). After 3 years, compared to the euthyroid participants, changes in GDS-15 scores did not differ for participants with subclinical hypothyroidism (Delta GDS-15 score -0.03, 95% CI -0.50 to 0.44, p = 0.83), while subclinical hyperthyroidism was associated with an increase in GDS scores (Delta GDS-15 score 1.13, 95% CI 0.32-1.93, p = 0.04). All results were similar for persistent subclinical thyroid dysfunction. Conclusions: In this largest prospective study on the association of persistent subclinical thyroid dysfunction and depression, subclinical hypothyroidism was not associated with increased depressive symptoms among older adults at high cardiovascular risk. Persistent subclinical hyperthyroidism might be associated with increased depressive symptoms, which requires confirmation in a larger prospective study. (C) 2015 S. Karger AG, Basel