Sowers MaryFran, Luborsky Judy, Perdue Craig, Araujo Katy L B, Goldman Marlene B, Harlow Siobán D
Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109-2029, USA.
Clin Endocrinol (Oxf). 2003 Mar;58(3):340-7. doi: 10.1046/j.1365-2265.2003.01718.x.
We evaluated menopausal symptoms, menstrual cycle bleeding characteristics and reproductive hormones for their associations with thyroid stimulating hormone (TSH) concentrations in women at the mid-life from five ethnic groups.
This report is from the baseline evaluation of the Study of Women's Health Across the Nation (SWAN), a community-based multiethnic study of the natural history of the menopausal transition. Enrollees were 42-52 years old (pre- and early perimenopausal) African American, Caucasian, Chinese, Hispanic and Japanese women (n = 3242). Enrollees were interviewed about self-reported diagnosed hypo- and hyperthyroidism or thyroid treatment, menopausal symptoms and menstrual cycle bleeding characteristics. Serum was assayed for TSH, oestradiol, testosterone, FSH and SHBG.
There were 6.2% of women with TSH > 5.0 mIU/ml and 3.2% with TSH < 0.5 IU/ml, cutpoints that have been used to encompass clinical and subclinical hypo- and hyperthyroidism, respectively. African American women had significantly lower mean TSH concentrations than Caucasian, Hispanic and Chinese women. Of the more than 15 menopause symptoms evaluated, only fearfulness was associated with having a TSH value > 5.0 mIU/ml (P < 0.008) or < 0.5 mIU/ml (P < 0.02). Women with TSH values outside the range of 0.5-5.0 mIU/ml were more likely to report shorter or longer menstrual periods (P = 0.004 for both) than women within that range. FSH, SHBG, dehydroepiandrosterone sulphate (DHEA-S), testosterone, and oestradiol concentrations were not associated with TSH concentrations.
In mid-aged women, there was a 9.6% prevalence of TSH values outside the euthyroid range of 0.5-5.0 mIU/ml. Although TSH was associated with bleeding length and self-reported fearfulness, it was not associated with indicators of the menopausal transition, including menopausal stage defined by bleeding regularity, menopausal symptoms or reproductive hormone concentrations.
我们评估了来自五个种族的中年女性的更年期症状、月经周期出血特征及生殖激素与促甲状腺激素（TSH）浓度之间的关联。
本报告来自全国女性健康研究（SWAN）的基线评估，这是一项基于社区的多民族更年期过渡自然史研究。参与者为42 - 52岁（绝经前和围绝经期早期）的非裔美国、白人、中国、西班牙裔和日本女性（n = 3242）。对参与者进行访谈，了解其自我报告的已确诊的甲状腺功能减退和亢进或甲状腺治疗情况、更年期症状及月经周期出血特征。检测血清中的TSH、雌二醇、睾酮、促卵泡激素（FSH）和性激素结合球蛋白（SHBG）。
TSH>5.0 mIU/ml的女性占6.2%，TSH<0.5 IU/ml的女性占3.2%，这两个切点分别用于涵盖临床和亚临床甲状腺功能减退及亢进。非裔美国女性的平均TSH浓度显著低于白人、西班牙裔和中国女性。在评估的15种以上更年期症状中，只有恐惧与TSH值>5.0 mIU/ml（P<0.008）或<0.5 mIU/ml（P<0.02）有关。TSH值不在0.5 - 5.0 mIU/ml范围内的女性比该范围内的女性更有可能报告月经周期较短或较长（两者P均 = 0.004）。FSH浓度、SHBG浓度、硫酸脱氢表雄酮（DHEA - S）、睾酮和雌二醇浓度与TSH浓度无关。
在中年女性中，TSH值超出正常范围0.5 - 5.0 mIU/ml的患病率为9.6%。虽然TSH与出血时长和自我报告的恐惧有关，但它与更年期过渡指标无关，包括根据出血规律定义的更年期阶段、更年期症状或生殖激素浓度。
