Department of Internal Medicine and Endocrinology EMGO Institute for Health and Care Research Department of Psychiatry, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands.
Eur J Endocrinol. 2011 Oct;165(4):545-54. doi: 10.1530/EJE-11-0430. Epub 2011 Jul 18.
To what extent endogenous subclinical thyroid disorders contribute to impaired physical and cognitive function, depression, and mortality in older individuals remains a matter of debate.
A population-based, prospective cohort of the Longitudinal Aging Study Amsterdam.
TSH and, if necessary, thyroxine and triiodothyronine levels were measured in individuals aged 65 years or older. Participants were classified according to clinical categories of thyroid function. Participants with overt thyroid disease or use of thyroid medication were excluded, leaving 1219 participants for analyses. Outcome measures were physical and cognitive function, depressive symptoms (cross-sectional), and mortality (longitudinal)
Sixty-four (5.3%) individuals had subclinical hypothyroidism and 34 (2.8%) individuals had subclinical hyperthyroidism. Compared with euthyroidism (n=1121), subclinical hypo-, and hyper-thyroidism were not significantly associated with impairment of physical or cognitive function, or depression. On the contrary, participants with subclinical hypothyroidism did less often report more than one activity limitation (odds ratio 0.44, 95% confidence interval (CI) 0.22-0.86). After a median follow-up of 10.7 years, 601 participants were deceased. Subclinical hypo- and hyper-thyroidism were not associated with increased overall mortality risk (hazard ratio 0.89, 95% CI 0.59-1.35 and 0.69, 95% CI 0.40-1.20 respectively).
This study does not support disadvantageous effects of subclinical thyroid disorders on physical or cognitive function, depression, or mortality in an older population.
内源性亚临床甲状腺疾病在多大程度上导致老年人身体和认知功能受损、抑郁和死亡，仍存在争议。
阿姆斯特丹纵向老龄化研究的一项基于人群的前瞻性队列研究。
测量年龄在 65 岁或以上的个体的 TSH，如有必要，还测量甲状腺素和三碘甲状腺原氨酸水平。根据甲状腺功能的临床分类对参与者进行分类。排除有显性甲状腺疾病或使用甲状腺药物的参与者，留下 1219 名参与者进行分析。结局指标为身体和认知功能、抑郁症状（横断面）和死亡率（纵向）。
64 名（5.3%）个体患有亚临床甲状腺功能减退症，34 名（2.8%）个体患有亚临床甲状腺功能亢进症。与甲状腺功能正常（n=1121）相比，亚临床甲状腺功能减退和甲状腺功能亢进与身体或认知功能受损或抑郁无关。相反，亚临床甲状腺功能减退症患者报告的活动受限次数较少（比值比 0.44，95%置信区间 0.22-0.86）。中位随访 10.7 年后，601 名参与者死亡。亚临床甲状腺功能减退和甲状腺功能亢进与总死亡率增加无关（风险比 0.89，95%置信区间 0.59-1.35 和 0.69，95%置信区间 0.40-1.20）。
本研究不支持亚临床甲状腺疾病对老年人身体和认知功能、抑郁或死亡率产生不利影响。
