Age-Related Changes in Thyroid Function: A Longitudinal Study of a Community-Based Cohort
Age-Related Changes in Thyroid Function: A Longitudinal Study of a Community-Based Cohort
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DOI：
10.1210/jc.2011-3020
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发表时间：
2012-05-01
影响因子：
5.8
通讯作者：
Walsh, John P.
中科院分区：
文献类型：
--
作者：
Bremner, Alexandra P.;Feddema, Peter;Walsh, John P.
背景：在横断面研究中，血清TSH浓度随年龄增加而升高。方法：我们检测了1981年和1994年Busselton健康调查中1100名参与者的血清TSH、游离T-4、甲状腺过氧化物酶和甲状腺球蛋白抗体，并得出了908名没有甲状腺疾病或甲状腺抗体的参照组。结果：随访13年时，平均血清TSH值从1.49升至1.81mU/L，平均变化0.32mU/L[95%可信区间(CI)0.27，0.38，P<；0.001]，而游离T-4浓度无明显变化(16.6pmol/L，P=0.7)。TSH的增加在老年人中最为明显，经性别调整的Delta TSH每10年基线年龄增加0.08亩/升(95%CI 0.04，0.11)。基线TSH值高的人TSH升高的比例较小，基线TSH每增加1.0 mU/升，Delta TSH(年龄和性别调整后)下降0.13 mU/L(95%可信区间0.09，0.16)。结论：增龄与血清TSH浓度升高有关，而游离T-4浓度无明显变化。TSH升高幅度最大的是基线时TSH最低的人群。这表明TSH升高是由于年龄相关的TSH设定点改变或TSH生物活性降低引起的，而不是隐匿性甲状腺疾病。(临床内分泌代谢酶97：1554-1562,2012)
Context: In cross-sectional studies, serum TSH concentrations increase with age. This has not been examined longitudinally, and it is uncertain whether the TSH increase reflects healthy aging or occult thyroid failure.Methods: We measured serum TSH, free T-4, thyroid peroxidase, and thyroglobulin antibodies in 1100 participants in the 1981 and 1994 Busselton Health Surveys and derived a reference group of 908 individuals without thyroid disease or thyroid antibodies. We examined changes in thyroid function longitudinally and, in 781 participants, explored associations with the CAPZB polymorphism rs10917469.Results: At 13 yr follow-up, mean serum TSH increased from 1.49 to 1.81 mU/liter, a change in mean TSH (Delta TSH) of 0.32 mU/liter [95% confidence interval (CI) 0.27, 0.38, P < 0.001], whereas mean free T-4 concentration was unchanged (16.6 vs. 16.6 pmol/liter, P = 0.7). The TSH increase was most marked in the elderly, such that gender-adjusted Delta TSH increased by 0.08 mU/liter (95% CI 0.04, 0.11) for each decade of baseline age. People with higher baseline TSH values had proportionally smaller increases in TSH, with each additional 1.0 mU/liter of baseline TSH associated with a 0.13 mU/liter decrease (age and gender adjusted) in Delta TSH (95% CI 0.09, 0.16). The Delta TSH did not differ significantly by CAPZB genotype.Conclusions: Aging is associated with increased serum TSH concentrations, with no change in free T-4 concentrations. The largest TSH increase is in people with the lowest TSH at baseline. This suggests that the TSH increase arises from age-related alteration in the TSH set point or reduced TSH bioactivity rather than occult thyroid disease. (J Clin Endocrinol Metab 97: 1554-1562, 2012)