The influence of age on the relationship between subclinical hypothyroidism and ischemic heart disease: A metaanalysis
The influence of age on the relationship between subclinical hypothyroidism and ischemic heart disease: A metaanalysis
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DOI：
10.1210/jc.2008-0167
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发表时间：
2008-08-01
影响因子：
5.8
通讯作者：
Pearce, Simon H. S.
中科院分区：
文献类型：
--
作者：
Razvi, Salman;Shakoor, Abdul;Pearce, Simon H. S.
内容：亚临床甲状腺功能减退症（SCH）是一种常见的疾病，在一些研究中与缺血性心脏病（IHD）相关，但不是所有研究。这可能是由于研究设计和参与者特征的差异。目的：我们的目的是调查年龄和性别是否影响SCH患者的IHD患病率、发病率和死亡率。（PubMed，EMBASE，and科克伦图书馆）和手动检索到2007年5月的英文文献。研究选择：流行病学研究，量化甲状腺状态和IHD事件在adult.Data提取：两名作者独立审查的文章和摘要的数据。根据研究参与者的最小年龄（小于65岁和65岁或以上）比较两组的结果。数据综合：共有15项研究纳入分析，其中包括2，531名SCH参与者和26，491名甲状腺功能正常的个体。SCH受试者的IHD发生率和患病率高于研究中甲状腺功能正常的受试者，研究包括年龄小于65岁的受试者，但年龄大于65岁的受试者的研究则无此差异[比值比（95%置信区间）]：1.57（1.19-2.06）vs. 1.01（0.87-1.18）和1.68（1.27-2.23）vs. 1.02（0.85-1.22）。心血管/全因死亡率在年龄小于65岁的研究参与者中也有所升高，但在老年人研究中没有：比值比1.37（1.04-1.79）vs. 0.85（0.56-1.29）。流行IHD是较高的SCH参与者的两种性别，虽然这是统计学显着的只有在women.Conclusions：SCH是与增加IHD（患病率和发病率）和心血管死亡率仅在受试者从年轻的人群。这些数据表明，血管风险增加可能只存在于年轻的SCH患者中。
Context: Subclinical hypothyroidism (SCH) is a common condition that has been associated with ischemic heart disease (IHD) in some, but not all, studies. This may be due to differences in study design and the characteristics of participants.Objective: Our objective was to investigate whether age and gender influence IHD prevalence, incidence, and mortality in people with SCH.Data Sources: Computerized (PubMed, EMBASE, and Cochrane Library) and manual searches of the literature to May 2007, published in English, were performed.Study Selection: Epidemiological studies that quantified thyroid status and IHD events in adults were performed.Data Extraction: Two authors independently reviewed articles and abstracted data. Results were compared across two groups based on the minimum age of participants studied (younger than 65 yr and 65 yr or older).Data Synthesis: There were 15 studies included for analysis with 2,531 SCH participants and 26,491 euthyroid individuals. IHD incidence and prevalence were higher in SCH subjects compared with euthyroid participants from studies including those younger than 65 yr, but not studies of subjects aged older than 65 yr [odds ratio (95% confidence interval)]: 1.57 (1.19-2.06) vs. 1.01 (0.87-1.18) and 1.68 (1.27-2.23) vs. 1.02 (0.85-1.22), respectively. Cardiovascular/all-cause mortality was also elevated in participants from the younger than 65-yr studies, but not from the studies of older people: odds ratio 1.37 (1.04-1.79) vs. 0.85 (0.56-1.29). Prevalent IHD was higher in SCH participants of both genders, although this was statistically significant only in women.Conclusions: SCH is associated with increased IHD (both prevalence and incidence) and cardiovascular mortality only in subjects from younger populations. These data suggest that increased vascular risk may only be present in younger individuals with SCH.