Hellenic National Center for Research, Prevention and Treatment of Diabetes Mellitus and its Complications (HNDC), Athens, Greece.
Maturitas. 2011 Sep;70(1):5-9. doi: 10.1016/j.maturitas.2011.05.016. Epub 2011 Jun 29.
Several changes in thyroid hormone secretion, metabolism, and action occur with the increase in age. Aging is often associated with a decrease in serum thyroid stimulating hormone and T3 levels, whereas serum free T4 levels usually remain unchanged. The prevalence of thyroid dysfunction is higher in the elderly as compared to the younger population. In elderly individuals the non-specific clinical manifestations of thyroid hormone excess or deprivation can cause confusion in the clinical setup; while some of the symptoms of thyroid disease are similar to those in younger patients, it is not uncommon for both hyperthyroidism and hypothyroidism to be manifested in subtle ways in older patients, often mimicking symptoms of aging or masquerading as diseases of the cardiovascular, gastrointestinal, or nervous system. In addition, diagnosis of thyroid disorders is commonly complicated, due to chronic, non-thyroidal illness or medication therapy. Early diagnosis and treatment of overt thyroid disorders is crucial, since these disorders are associated with increased morbidity and mortality in the elderly, usually due to common coexistent diseases such as diminished cardiovascular reserve. Treatment of subclinical thyroid disease should also be considered, based on a combination of age, symptoms and risk factors in the individual patients. In addition, both prevalence and aggressiveness of thyroid cancer increase with age. This review summarizes the changes of thyroid function, as well as the clinical manifestations and treatment of thyroid disorders with advancing age.
随着年龄的增长，甲状腺激素的分泌、代谢和作用会发生几种变化。衰老通常与血清促甲状腺激素和 T3 水平降低有关，而血清游离 T4 水平通常保持不变。与年轻人相比，老年人甲状腺功能障碍的患病率更高。在老年人中，甲状腺激素过多或不足的非特异性临床表现可能会在临床环境中造成混淆；虽然甲状腺疾病的一些症状与年轻患者相似，但老年患者中甲状腺功能亢进和甲状腺功能减退的表现往往不明显，常模仿衰老的症状或伪装为心血管、胃肠道或神经系统疾病。此外，由于慢性非甲状腺疾病或药物治疗，甲状腺疾病的诊断通常很复杂。显性甲状腺疾病的早期诊断和治疗至关重要，因为这些疾病与老年人的发病率和死亡率增加有关，通常是由于常见的共存疾病，如心血管储备减少。应根据个体患者的年龄、症状和危险因素来考虑亚临床甲状腺疾病的治疗。此外，随着年龄的增长，甲状腺癌的患病率和侵袭性都会增加。本综述总结了随着年龄增长甲状腺功能的变化，以及甲状腺疾病的临床表现和治疗。
