Department of Internal Medicine B, Ernst Moritz Arndt University, Greifswald, Germany.
Clin Endocrinol (Oxf). 2010 Dec;73(6):821-6. doi: 10.1111/j.1365-2265.2010.03882.x.
Decreased serum TSH levels are associated with increased cardiovascular mortality in elderly, and subclinical hyperthyroidism (SCH) was associated with left ventricular hypertrophy (LVH) as a predictor of cardiovascular mortality in some cross-sectional and case-control studies. The aim was to assess whether SCH independently impacts development of LVH over time.
Of 3300 participants of the population-based Study of Health in Pomerania those with overt hyperthyroidism, hypothyroidism, possible thyroid disease or missing echocardiographic baseline data or follow-up were excluded, resulting in a study population of 1112 individuals (556 women) aged 45-81 years. Echocardiographic left ventricular mass divided by height(2·7) (LVMI(ht)), and LVH(ht) (LVMI(ht) > 44 g/m(2·7) in women and > 48 g/m(2·7) in men) was measured at baseline and after 5-year follow-up (median 5·00; range 4·92; 5·08). Comparison of subjects with (n = 107) and without (n = 1005) SCH were made by linear and logistic regression models adjusted for age, gender, smoking status, hypertension, and waist circumference.
At follow-up, LVMI(ht) did not differ between subjects with and without SCH (50·2 g/m(2·7), interquartile range (IQR) 41·2; 59·5 vs 47·8 g/m(2·7), IQR 39·3; 56·9; P = 0·29). LVH(ht) was present in 66 (61·7%) subjects with and 543 (54·0%) persons without SCH (P = 0·13). Analyses revealed no association between SCH and progression of LVMI(ht) (β = -0·18; 95%-confidence interval (CI) -2·34; -1·99; P = 0·873), and development of LVH(ht) (relative risk 0·86, 95%-CI 0·60; 1·26; P = 0·462), respectively.
In this population-based sample, SCH had no impact on progression of LVMI and development of LVH during 5-year follow-up in subjects aged 45 years or older.
血清 TSH 水平降低与老年人心血管死亡率增加有关,亚临床甲状腺功能亢进症(SCH)与左心室肥厚(LVH)有关,LVH 是心血管死亡率的预测因素,这在一些横断面和病例对照研究中得到了证实。本研究旨在评估 SCH 是否会独立影响 LVH 的随时间进展。
在基于人群的波罗的海健康研究中,排除了显性甲状腺功能亢进、甲状腺功能减退、可能的甲状腺疾病或缺乏超声心动图基线数据或随访的 3300 名参与者,最终纳入了 1112 名年龄在 45-81 岁的个体(556 名女性)进行研究。在基线和 5 年随访时(中位数为 5.00;范围为 4.92;5.08),使用超声心动图左心室质量除以身高的平方(LVMI(ht))和 LVH(ht)(女性 LVMI(ht)>44 g/m2.7,男性>48 g/m2.7)来测量。通过线性和逻辑回归模型对伴有(n = 107)和不伴有(n = 1005)SCH 的受试者进行比较,调整因素包括年龄、性别、吸烟状况、高血压和腰围。
在随访期间,伴有和不伴有 SCH 的受试者之间的 LVMI(ht)无差异(50.2 g/m2.7,四分位距(IQR)为 41.2;59.5 与 47.8 g/m2.7,IQR 为 39.3;56.9;P = 0.29)。伴有和不伴有 SCH 的受试者中,LVH(ht)的发生率分别为 66(61.7%)和 543(54.0%)(P = 0.13)。分析显示,SCH 与 LVMI(ht)的进展(β = -0.18;95%置信区间(CI)-2.34;-1.99;P = 0.873)和 LVH(ht)的发生(相对风险 0.86,95%CI 0.60;1.26;P = 0.462)之间均无关联。
在本基于人群的样本中,在年龄 45 岁及以上的受试者中,SCH 在 5 年随访期间对 LVMI 的进展和 LVH 的发生无影响。