原发性甲状腺功能减退与代谢综合征之间的关联及C反应蛋白的作用：一项来自印度南部的横断面研究。
Association between primary hypothyroidism and metabolic syndrome and the role of C reactive protein: a cross-sectional study from South India.
作者信息
Shantha Ghanshyam Palamaner Subash, Kumar Anita A, Jeyachandran Vijay, Rajamanickam Deepan, Rajkumar K, Salim Shihas, Subramanian Kuyilan Karai, Natesan Senthilkumar
机构信息
Department of General Medicine, Sri Ramachandra University, Chennai, India.
出版信息
Thyroid Res. 2009 Mar 9;2(1):2. doi: 10.1186/1756-6614-2-2.
BACKGROUND
Hypothyroidism (sub-clinical and overt) and metabolic syndrome are recognized risk factors for atherosclerotic cardiovascular disease. This study is an effort to identify the proposed association between these two disease entities and the risk factors involved in this association.
METHODS
A cross - sectional study from a tertiary care teaching hospital in Chennai city, South India. 420 patients with metabolic syndrome (NCEP - ATP III criteria) were included in the study group. 406 appropriately age and sex matched controls having no features of metabolic syndrome (0 out of the 5 criteria) were compared with the study group. The study extended over a 5 year period. TSH, FT4 were measured for both the groups using electrochemiluminescence immuno assay. HsCRP was measured for all the patients in the study group. The baseline characteristics between the groups were compared with Student's't' test. Chi-square test was used to analyze the association between metabolic syndrome and hypothyroidism (overt and sub-clinical). Logistic regression analysis was applied to identify the association between hypothyroidism and the patient characteristics in the study group.
RESULTS
Of the 420 patients in the study group, 240 were females (57.1%), 180 were males (42.9%) with mean age 51 +/- 9.4 years. Of the 406 patients in the control group, 216 were females (53.2%), 190 males (46.8%) with mean age 49 +/- 11.2 years. In the study group, 92 had sub-clinical hypothyroidism (SCH) (21.9%), 31 were overtly hypothyroid (7.4%) and 297 were euthyroid (70.7%). In the control group 27 patients had sub-clinical hypothyroidism (6.6%), 9 patients had overt hypothyroidism (2.2%) and 370 patients were euthyroid (91.2%). On comparison SCH (P < 0.001) and overt hypothyroidism (P < 0.001) were significantly associated with the study group as compared to the control group. Logistic regression analysis recognized the association between female gender (P = 0.021) and HsCRP (P = 0.014) with sub-clinical hypothyroidism and female gender (P = 0.01) with overt hypothyroidism in the study group.
CONCLUSION
Hypothyroidism is associated with metabolic syndrome and females are more at risk. Metabolic syndrome patients with a raised HsCRP are at significant risk of having sub-clinical hypothyroidism.
背景
甲状腺功能减退（亚临床和临床显性）与代谢综合征是公认的动脉粥样硬化性心血管疾病的危险因素。本研究旨在确定这两种疾病实体之间的假定关联以及该关联中涉及的危险因素。
方法
一项来自印度南部金奈市一家三级护理教学医院的横断面研究。研究组纳入了420例符合代谢综合征（NCEP-ATP III标准）的患者。将406例年龄和性别匹配、无代谢综合征特征（5项标准中0项符合）的对照者与研究组进行比较。研究持续了5年。两组均采用电化学发光免疫分析法测定促甲状腺激素（TSH）、游离甲状腺素（FT4）。对研究组所有患者测定超敏C反应蛋白（HsCRP）。两组间的基线特征采用学生t检验进行比较。采用卡方检验分析代谢综合征与甲状腺功能减退（临床显性和亚临床）之间的关联。应用逻辑回归分析确定甲状腺功能减退与研究组患者特征之间的关联。
结果
研究组的420例患者中，女性240例（57.1%），男性180例（42.9%），平均年龄51±9.4岁。对照组的406例患者中，女性216例（53.2%），男性190例（46.8%），平均年龄49±11.2岁。在研究组中，92例有亚临床甲状腺功能减退（SCH）（21.9%），31例为临床显性甲状腺功能减退（7.4%），297例甲状腺功能正常（70.7%）。对照组中，27例有亚临床甲状腺功能减退（6.6%），9例为临床显性甲状腺功能减退（2.2%），370例甲状腺功能正常（91.2%）。相比之下，与对照组相比，研究组中亚临床甲状腺功能减退（P<0.001）和临床显性甲状腺功能减退（P<0.001）与研究组显著相关。逻辑回归分析确定研究组中女性性别（P = 0.021）和HsCRP（P = 0.014）与亚临床甲状腺功能减退相关，女性性别（P = 0.01）与临床显性甲状腺功能减退相关。
结论
甲状腺功能减退与代谢综合征相关，女性风险更高。HsCRP升高的代谢综合征患者患亚临床甲状腺功能减退的风险显著增加。
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