Bagchi N, Brown T R, Parish R F
Department of Internal Medicine, Wayne State University, Detroit, Mich.
Arch Intern Med. 1990 Apr;150(4):785-7.
The prevalence of thyroid dysfunction was determined in a healthy urban population over the age of 55 years. A highly sensitive serum thyrotropin assay was used initially to screen 968 subjects. Elevated values (greater than 6 mU/L) were found in 7.3%, while suppressed values (less than 0.1 mU/L) were present in 2.5% subjects. Protirelin stimulation testing demonstrated exaggerated responses in 95% of the subjects with elevated thyrotropin levels and subnormal responses in 81% of the subjects with suppressed thyrotropin levels. Thyroid dysfunction, as defined by abnormalities of both serum thyrotropin level and protirelin response, was calculated to be present in 8.9% of the population. The prevalence was greater in whites (vs blacks), in women, and in subjects older than 75 years as compared with the 55- to 64-year age group. Hypothyroidism was calculated to be present in 6.9% subjects. Despite an increased prevalence of thyroid autoantibodies in these subjects, only 8.5% of them had subnormal serum thyroxine concentrations. Hyperthyroidism was calculated to be present in 2.0% of the population, two thirds of whom were taking thyroid hormone preparations. These results suggest a significant prevalence of thyroid dysfunction in the elderly, with important sex and racial differences.
在55岁以上的健康城市人群中测定甲状腺功能障碍的患病率。最初使用高灵敏度血清促甲状腺激素测定法对968名受试者进行筛查。促甲状腺激素水平升高（大于6 mU/L）的受试者占7.3%，而促甲状腺激素水平降低（小于0.1 mU/L）的受试者占2.5%。促甲状腺素释放激素刺激试验显示，促甲状腺激素水平升高的受试者中有95%反应过度，促甲状腺激素水平降低的受试者中有81%反应低于正常水平。根据血清促甲状腺激素水平和促甲状腺素释放激素反应异常定义的甲状腺功能障碍在该人群中的发生率为8.9%。与55至64岁年龄组相比，白人（与黑人相比）、女性以及75岁以上受试者的患病率更高。甲状腺功能减退症在6.9%的受试者中被计算存在。尽管这些受试者中甲状腺自身抗体的患病率有所增加，但只有8.5%的受试者血清甲状腺素浓度低于正常水平。甲状腺功能亢进症在2.0%的人群中被计算存在，其中三分之二正在服用甲状腺激素制剂。这些结果表明老年人中甲状腺功能障碍的患病率很高，且存在重要的性别和种族差异。
