Association of Elevated Thyroid Stimulating Hormone with Atherosclerotic Cardiovascular Disease and Its Mortality in Elderly Community-Dwelling Chinese.
Association of Elevated Thyroid Stimulating Hormone with Atherosclerotic Cardiovascular Disease and Its Mortality in Elderly Community-Dwelling Chinese.
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DOI：
10.2147/cia.s368219
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发表时间：
2022
影响因子：
3.6
通讯作者：
中科院分区：
文献类型：
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随着人口老龄化的加剧，老年人动脉粥样硬化性心血管疾病（ASCVD）和血清促甲状腺激素（TSH）升高的患病率呈上升趋势。据报道，高TSH水平与ASCVD和CVD死亡率相关;然而，在中国人群中，特别是老年人中，研究很少。本研究旨在调查中国社区老年人群中血清TSH和ASCVD升高的患病率，并探讨高血清TSH与ASCVD或CVD死亡率的关系。我们对3814名年龄在60岁以上的成年人进行了研究。2014年收集了患者的病历、体格检查和实验室血液样本，并对心血管和全因死亡率进行了78个月的随访，直至2020年12月。Logistic回归分析TSH与ASCVD的关系。我们使用考克斯模型评估血清TSH变化对全因和CVD死亡率的风险比（HR）。本研究中，血清TSH升高的患病率为19.8%，女性明显高于男性（24.5%比13.9%，P < 0.001）。ASCVD的患病率为21.7%。在Logistic回归模型中，在调整70岁以上人群ASCVD的危险因素后，TSH升高与ASCVD相关（调整OR 1.054，P = 0.014）。随访6.5年，全因死亡441例（11.6%），CVD死亡174例（4.6%）。在考克斯回归模型中，TSH与老年人群的全因死亡率和CVD死亡率均无显著相关性。在老年人群中，血清TSH和ASCVD升高的患病率很高。TSH升高似乎与全因或CVD死亡风险无关。
With increase of population aging, the prevalence of atherosclerotic cardiovascular disease (ASCVD) and elevated serum thyroid stimulating hormone (TSH) in elderly is increasing. High TSH level was reported to be associated with ASCVD and CVD mortality; however, few are studied in Chinese population, especially in the elderly. This study aimed to investigate the prevalence of elevated serum TSH and ASCVD in an elderly population of Chinese community and to explore the association between high serum TSH and ASCVD or CVD mortality. We conducted a study involving 3814 adults who were at least 60 years of age. Questionnaires, physical examinations, and laboratory blood samples were collected in 2014, and a 78-months follow-up for cardiovascular and all-cause mortality was performed till December of 2020. Logistics regression was used to analyze the association between TSH and ASCVD. We used Cox models to assess the hazard ratios (HRs) for all-cause and CVD mortality across changes in serum TSH. In this study, the prevalence of the elevated serum TSH was 19.8%, and significantly higher in women than in men (24.5% vs 13.9%, p < 0.001). The prevalence of ASCVD was 21.7%. In logistics regression models, elevated TSH was associated with ASCVD after adjusting for the risk factors of ASCVD in people over the age of 70 years (adjusted OR 1.054, P = 0.014). After a follow-up of 6.5 years, total 441 (11.6%) all-cause death and 174 (4.6%) death of CVD were observed. In Cox regression model, no significant correlation was found between TSH and all-cause mortality or CVD mortality in the elderly population. In the elderly population, there is high prevalence of elevated serum TSH and ASCVD. Elevated TSH seemed to be not associated with risk of all-cause or CVD mortality.