Prevalence and Risk Factors of Thyroid Dysfunction in Older Adults in the Community
Prevalence and Risk Factors of Thyroid Dysfunction in Older Adults in the Community
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DOI：
10.1038/s41598-019-49540-z
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发表时间：
2019-09-11
影响因子：
4.6
通讯作者：
Selvin, Elizabeth
中科院分区：
文献类型：
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作者：
Diab, Nermin;Daya, Natalie R.;Selvin, Elizabeth
甲状腺功能障碍的患病率估计和治疗目标的证据主要来自中年人的研究。我们进行了一项横断面分析，以确定在社区动脉粥样硬化风险（ARIC）研究（N = 5，392）中年龄≥ 65岁的参与者中甲状腺功能障碍的患病率和甲状腺检查异常的风险因素。我们测量了血清三碘甲状腺原氨酸（T3）、游离甲状腺素（FT4）、甲状腺过氧化物酶抗体（抗TPO）和促甲状腺激素（TSH）的浓度。在这一人群中（58%为女性，22%为黑人），17%报告使用药物治疗甲状腺功能障碍。在未接受治疗的人群中，显性和亚临床甲状腺功能减退症的患病率分别为0.82%和6.06%。显性和亚临床甲亢分别占0.26%和0.78%。多变量调整后的TSH，FT4和T3水平分别为25%，1.3%和3.9%，黑人相比，白人。与女性相比，男性抗TPO阳性的可能性较小（p < 0.001）。与目前吸烟相比，以前和从未吸烟与较低的T3和FT4水平相关。老年人甲状腺功能障碍的患病率接近25%。多种疾病可以相互作用，导致健康状况下降。建议对该年龄组的甲状腺功能障碍和筛查给予额外关注。
Prevalence estimates and evidence informing treatment targets for thyroid dysfunction largely come from studies of middle-aged adults. We conducted a cross-sectional analysis to determine the prevalence of thyroid dysfunction and risk factors for abnormal thyroid tests in participants aged >= 65 in the Atherosclerosis Risk in Communities (ARIC) study (N = 5,392). We measured serum concentrations of triiodothyronine (T3), free thyroxine (FT4), thyroid peroxidase antibody (Anti-TPO), and thyroid stimulating hormone (TSH). In this population (58% women, 22% black), 17% reported medication use for thyroid dysfunction. Among those not on treatment, the prevalence of overt and subclinical hypothyroidism was 0.82% and 6.06%, respectively. Overt and subclinical hyperthyroidism affected 0.26% and 0.78%, respectively. Multivariable adjusted TSH, FT4 and T3 levels were 25%, 1.3% and 3.9% lower in blacks compared to whites, respectively. Men were less likely to be anti-TPO positive compared to women (p < 0.001). Former and never smoking were associated with lower T3 and FT4 levels compared to current smoking. The prevalence of thyroid dysfunction in older adults is nearly 25%. Multiple illnesses can interact to contribute to declines in health. Additional attention to thyroid dysfunction and screening in this age group is recommended.