Department of Internal Medicine, Division of Rheumatology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
J Rheumatol. 2012 May;39(5):954-8. doi: 10.3899/jrheum.111076. Epub 2012 Feb 15.
To determine the frequency of hypothyroidism in patients with rheumatoid arthritis (RA), and to elucidate the association of hypothyroidism and development of cardiovascular disease (CVD) in these patients.
A retrospective medical record review was performed using all incident cases of adult-onset RA from Olmsted County, MN, USA, that fulfilled criteria for RA in the years 1988-2007. Patients with and without thyroid disease were followed longitudinally for the development of CVD.
A cohort of 650 patients with RA and an age and sex-matched comparison cohort of 650 patients without RA was assembled (both cohorts mean age 55.8 yrs; 69% were women). There was no significant difference between cohorts in the presence of hypothyroid disease or subclinical hypothyroidism at time of RA diagnosis. No significant difference was found in the cumulative incidence of hypothyroid disease between the 2 cohorts. Hypothyroid disease was found to be significantly associated with CVD in patients with RA (hazard ratio 2.0; 95% CI 1.1, 3.6). This difference remained significant and unchanged after adjustment for traditional CV risk factors (HR 2.0; 95% CI 1.1, 3.6).
No significant difference was found in either incidence or prevalence of hypothyroidism between patients with and those without RA. Hypothyroid disease was significantly associated with CVD in patients with RA, even after adjustment for other traditional CV risk factors.
确定类风湿关节炎（RA）患者中甲状腺功能减退症的频率，并阐明这些患者中甲状腺功能减退症与心血管疾病（CVD）发展的关系。
使用美国明尼苏达州奥姆斯特德县在 1988-2007 年期间符合 RA 标准的所有成年发病的 RA 病例，进行回顾性病历回顾。对有和无甲状腺疾病的患者进行纵向随访，以了解 CVD 的发展情况。
组建了一个由 650 例 RA 患者和一个年龄和性别匹配的 650 例无 RA 患者的队列（两个队列的平均年龄为 55.8 岁；69%为女性）。在 RA 诊断时，两个队列之间在甲状腺功能减退症或亚临床甲状腺功能减退症的存在方面没有显著差异。在两个队列之间，未发现甲状腺功能减退症的累积发病率有显著差异。在 RA 患者中，甲状腺功能减退症与 CVD 显著相关（风险比 2.0；95%CI 1.1，3.6）。在调整了传统 CV 危险因素后，这种差异仍然显著且不变（HR 2.0；95%CI 1.1，3.6）。
在有和无 RA 的患者之间，甲状腺功能减退症的发生率或患病率均无显著差异。甲状腺功能减退症与 RA 患者的 CVD 显著相关，即使在调整了其他传统 CV 危险因素后也是如此。
