Jorde R, Sundsfjord J
Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway.
Exp Clin Endocrinol Diabetes. 2006 Jul;114(7):343-7. doi: 10.1055/s-2006-924264.
Cigarette smoking has a number of effects on the thyroid gland including the development of Graves' disease and thyroid multinodularity. However, the effect of smoking on thyroid function is more uncertain.
The present cross-sectional study included 6,085 subjects (1,744 smokers) without thyroxine medication and 441 subjects (92 smokers) with thyroxine medication that attended the 5th Tromsø study in 2001, and 460 subjects (114 smokers) that attended follow-up studies after the 5th Tromsø study. Serum TSH was measured in the 5th Tromsø study, and serum TSH, free T4, and free T3 in the follow-up studies. Comparisons between smokers and non-smokers were performed with a general linear model with age, BMI, (and gender) as covariables.
Serum TSH levels were significantly lower in the smokers than in the non-smokers, both in males (1.63 +/- 0.88 vs. 1.95 +/- 1.04 mIU/L [p < 0.01]), and in females (1.55 +/- 0.86 vs. 1.86 +/- 1.01 mIU/L [p < 0.01]). Serum free T4 and free T3 levels were significantly higher in smokers than non-smokers (14.0 +/- 2.2 vs. 13.4 +/- 2.4 pmol/L for free T4 [p < 0.05], and 3.89 +/- 0.79 vs. 3.72 +/- 0.67 pmol/L for free T3 [p < 0.01], males and females analyzed together). There was no association between number of cigarettes smoked and the serum TSH level.
Smokers have lower serum TSH and higher free T4 and free T3 levels than non-smokers, which may be of importance when evaluating subjects with subclinical hypothyroidism.
吸烟对甲状腺有多种影响，包括引发格雷夫斯病和甲状腺多结节性。然而，吸烟对甲状腺功能的影响更不确定。
本横断面研究纳入了2001年参加第五次特罗姆瑟研究的6085名未服用甲状腺素药物的受试者（1744名吸烟者）和441名服用甲状腺素药物的受试者（92名吸烟者），以及第五次特罗姆瑟研究后参加随访研究的460名受试者（114名吸烟者）。在第五次特罗姆瑟研究中测量血清促甲状腺激素（TSH），在随访研究中测量血清TSH、游离甲状腺素（FT4）和游离三碘甲状腺原氨酸（FT3）。以年龄、体重指数（以及性别）作为协变量，采用一般线性模型对吸烟者和非吸烟者进行比较。
吸烟者的血清TSH水平显著低于非吸烟者，男性中（分别为1.63±0.88与1.95±1.04 mIU/L [p<0.01]）以及女性中（分别为1.55±0.86与1.86±1.01 mIU/L [p<0.01]）均如此。吸烟者的血清游离FT4和游离FT3水平显著高于非吸烟者（游离FT4分别为14.0±2.2与13.4±2.4 pmol/L [p<0.05]，游离FT3分别为3.89±0.79与3.72±0.67 pmol/L [p<0.01]，男性和女性合并分析）。吸烟数量与血清TSH水平之间无关联。
吸烟者的血清TSH水平较低，游离FT4和游离FT3水平较高，这在评估亚临床甲状腺功能减退患者时可能具有重要意义。
