de Jong Frank Jan, Masaki Kamal, Chen Hepei, Remaley Alan T, Breteler Monique M B, Petrovitch Helen, White Lon R, Launer Lenore J
Department of Epidemiology & Biostatistics, Erasmus Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
Neurobiol Aging. 2009 Apr;30(4):600-6. doi: 10.1016/j.neurobiolaging.2007.07.019. Epub 2007 Sep 17.
Thyroid dysfunction is associated with cognitive impairment and dementia, including Alzheimer's disease (AD). It remains unclear whether thyroid dysfunction results from, or contributes to, Alzheimer pathology. We determined whether thyroid function is associated with dementia, specifically AD, and Alzheimer-type neuropathology in a prospective population-based cohort of Japanese-American men. Thyrotropin, total and free thyroxine were available in 665 men aged 71-93 years and dementia-free at baseline (1991), including 143 men who participated in an autopsy sub-study. During a mean follow-up of 4.7 (S.D.: 1.8) years, 106 men developed dementia of whom 74 had AD. Higher total and free thyroxine levels were associated with an increased risk of dementia and AD (age and sex adjusted hazard ratio (95% confidence interval) per S.D. increase in free thyroxine: 1.21 (1.04; 1.40) and 1.31 (1.14; 1.51), respectively). In the autopsied sub-sample, higher total thyroxine was associated with higher number of neocortical neuritic plaques and neurofibrillary tangles. No associations were found for thyrotropin. Our findings suggest that higher thyroxine levels are present with Alzheimer clinical disease and neuropathology.
甲状腺功能障碍与认知障碍和痴呆症相关，包括阿尔茨海默病（AD）。目前尚不清楚甲状腺功能障碍是由阿尔茨海默病病理引起的，还是对其有促成作用。我们在一个基于人群的日裔美国男性前瞻性队列中，确定甲状腺功能是否与痴呆症（特别是AD）以及阿尔茨海默病类型的神经病理学相关。在665名年龄在71 - 93岁且基线时（1991年）无痴呆症的男性中，可获取促甲状腺激素、总甲状腺素和游离甲状腺素的数据，其中143名男性参与了尸检子研究。在平均4.7（标准差：1.8）年的随访期间，106名男性患上痴呆症，其中74名患有AD。总甲状腺素和游离甲状腺素水平升高与痴呆症和AD风险增加相关（游离甲状腺素每增加一个标准差，年龄和性别调整后的风险比（95%置信区间）：分别为1.21（1.04；1.40）和1.31（1.14；1.51））。在尸检子样本中，总甲状腺素水平较高与新皮质神经炎性斑块和神经原纤维缠结数量较多相关。未发现促甲状腺激素有相关性。我们的研究结果表明，较高的甲状腺素水平与阿尔茨海默病临床疾病和神经病理学相关。
