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亚临床甲状腺功能减退症的代谢心血管疾病危险因素及其聚集。

Metabolic cardiovascular disease risk factors and their clustering in subclinical hypothyroidism.

机构信息

Saiseikai Nagasaki Hospital, Nagasaki, Japan.

出版信息

Clin Endocrinol (Oxf). 2010 May;72(5):689-95. doi: 10.1111/j.1365-2265.2009.03697.x.

Abstract

OBJECTIVE

A possible association between subclinical hypothyroidism and cardiovascular disease (CVD) has been reported. Monitoring of atomic-bomb survivors for late effects of radiation exposure at the Radiation Effects Research Foundation has provided the opportunity to examine associations between subclinical hypothyroidism and metabolic CVD risk factors. The objective of the study was to evaluate associations between subclinical hypothyroidism and metabolic CVD risk factors, and a cluster of these factors.

DESIGN AND PARTICIPANTS

This was a cross-sectional study of 3549 subjects (mean age 70 years; 1221 men and 2328 women) between 2000 and 2003 comprising 306 subjects with subclinical hypothyroidism and 3243 control euthyroid subjects in Japan.

MEASUREMENTS

We investigated associations between subclinical hypothyroidism and metabolic CVD risk factors such as hypertension, diabetes mellitus, dyslipidaemia and hyperuricaemia, and a cluster of these factors.

RESULTS

Subclinical hypothyroidism was not significantly associated with either hypertension, diabetes mellitus or hyperuricaemia defined by taking into account the use of medications in both men and women, but in men it was associated with dyslipidaemia (P = 0.02). We observed a significantly increased odds ratio (OR) for the presence of three or more metabolic CVD risk factors in men with subclinical hypothyroidism after adjusting for age, body mass index (BMI), and smoking status [OR: 1.83, 95% confidence interval (CI): 1.13-2.94, P = 0.01]. The significant associations remained after an additional adjustment for atomic-bomb radiation dose.

CONCLUSIONS

There appears to be a significant increase in a cluster of metabolic CVD risk factors among people with subclinical hypothyroidism.

摘要

目的

已有报道称亚临床甲状腺功能减退症与心血管疾病(CVD)之间可能存在关联。放射影响研究所对原子弹爆炸幸存者进行的辐射暴露晚期效应监测为研究亚临床甲状腺功能减退症与代谢性 CVD 危险因素之间的关联提供了机会。本研究的目的是评估亚临床甲状腺功能减退症与代谢性 CVD 危险因素及其簇之间的关联。

设计和参与者

这是一项在 2000 年至 2003 年间对日本 3549 名受试者(平均年龄 70 岁;男性 1221 名,女性 2328 名)进行的横断面研究,其中包括 306 名亚临床甲状腺功能减退症患者和 3243 名对照甲状腺功能正常的受试者。

测量

我们调查了亚临床甲状腺功能减退症与代谢性 CVD 危险因素(如高血压、糖尿病、血脂异常和高尿酸血症)及其簇之间的关联。

结果

在男性和女性均考虑药物使用的情况下,亚临床甲状腺功能减退症与高血压、糖尿病或高尿酸血症均无显著相关性,但与血脂异常有关(P=0.02)。在调整年龄、体重指数(BMI)和吸烟状况后,我们观察到男性亚临床甲状腺功能减退症患者存在三种或更多代谢性 CVD 危险因素的可能性显著增加(OR:1.83,95%置信区间[CI]:1.13-2.94,P=0.01)。在进一步调整原子弹爆炸剂量后,这些显著关联仍然存在。

结论

亚临床甲状腺功能减退症患者中代谢性 CVD 危险因素簇的发生率似乎显著增加。

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