Subclinical Hypothyroidism Might Worsen the Effects of Aging on Serum Lipid Profiles: A Population-Based Case-Control Study
Subclinical Hypothyroidism Might Worsen the Effects of Aging on Serum Lipid Profiles: A Population-Based Case-Control Study
复制标题
亚临床甲状腺功能减退症可能会加剧衰老对血清脂质谱的影响：一项基于人群的病例对照研究
DOI：
10.1089/thy.2014.0219
复制
发表时间：
2015-05-01
期刊：
影响因子：
6.6
通讯作者：
Zhao, Jiajun
中科院分区：
文献类型：
--
作者：
Zhao, Meng;Yang, Tao;Zhao, Jiajun
背景
血脂异常是一个重要的全球性健康问题，特别是在老年人群中。传统上，老年人血脂异常的高患病率被认为是一种“自然状态”。值得注意的是，亚临床甲状腺功能减退症（SCH）是血脂异常最重要的危险因素之一。很少有研究评估SCH是否在年龄相关性血脂异常增加中发挥作用。本研究旨在探讨不同年龄组SCH与血脂的关系。
方法
这是一项大规模、基于人群的病例对照研究。该人群来源于在中国开展的REACTION研究。共有17，046名40岁或以上的个体（8827例病例和8219例对照）入组最终分析。在调整甲状腺激素和常见混杂因素后，评估各年龄组SCH与血脂参数的关系。
结果
在整个人群中，促甲状腺素（TSH），SCH的关键指标，与胆固醇参数（总胆固醇[TC]和低密度脂蛋白胆固醇[LDL-C]）在60岁时呈正相关。在调整常见混杂因素和甲状腺激素后，在40-49岁和60-69岁的个体中，TSH每增加1 mIU/L，估计TC水平分别升高0.0147 mmol/L和0.0551 mmol/L。同样，TSH每增加1 mIU/L，LDL-C水平往往随着年龄的增加而逐渐增加。在中老年受试者（60-69岁）中，与年轻受试者相比，轻度（TSH≤10 mIU/L）和显著（TSH>10 mIU/L）SCH分别使TC浓度增加约1.03倍和1.36倍，LDL-C浓度增加约1.19倍和1.65倍。
结论
TSH对中老年人TC和LDL-C水平的影响强于年轻人。SCH可能会增加和加重衰老对血脂谱的影响。
BACKGROUND
Dyslipidemia is an important global health problem, particularly in the elderly population. Traditionally, the high prevalence of dyslipidemia in elderly people is considered a "natural condition." Notably, subclinical hypothyroidism (SCH) is one of the most important risk factors for dyslipidemia. Few studies have assessed whether SCH plays a role in the increase in age-related dyslipidemia. This study aimed to explore the association between SCH and lipid profiles in different age groups.
METHODS
This was a large-scale, population-based, case-control study. The population was derived from the REACTION study conducted across China. A total of 17,046 individuals (8827 cases and 8219 controls) aged 40 years or older were enrolled in the final analyses. The relationships between SCH and serum lipid parameters in each age group were evaluated after adjustment for thyroid hormones and common confounding factors.
RESULTS
In the entire population, thyrotropin (TSH), the key indicator of SCH, was positively associated with cholesterol parameters (total cholesterol [TC] and low-density lipoprotein cholesterol [LDL-C]) through the sixth decade of life. After adjusting for common confounding factors and thyroid hormones, each 1 mIU/L increase in TSH was estimated to elevate the TC level by 0.0147 mmol/L and 0.0551 mmol/L, respectively, in individuals aged 40-49 years and 60-69 years. Similarly, with each 1 mIU/L increase in TSH, the LDL-C level tended to show gradually greater increases as age increased. In moderately old subjects (60-69 years), mild (TSH≤10 mIU/L) and significant (TSH>10 mIU/L) SCH increased the concentration of TC approximately 1.03- and 1.36-fold, and the concentration of LDL-C approximately 1.19- and 1.65-fold, respectively, when compared with younger subjects.
CONCLUSIONS
TSH exhibited a stronger effect on the TC and LDL-C level in moderately old subjects than in younger subjects. SCH might augment and worsen the effects of aging on serum lipid profiles.