Gessl Alois, Lemmens-Gruber Rosa, Kautzky-Willer Alexandra
Department of Internal Medicine III, Medical University Of Vienna, Vienna, Austria.
Handb Exp Pharmacol. 2012(214):361-86. doi: 10.1007/978-3-642-30726-3_17.
All forms of thyroid diseases are much more frequently observed in women than men, although the reasons are still not completely elucidated.Hyperthyroidism is defined by elevated circulating free thyroid hormones. The prevalence is about 2 % in women and 0.2 % in men. The most frequent causes are various forms of thyroid autonomy in elderly women and Graves' disease, which occurs mostly in younger women.Hypothyroidism is defined by a lack of thyroid hormones. It is a common endocrine disorder caused by autoimmune thyroiditis (Hashimoto thyroiditis), iodine deficiency or following surgery or radioiodine therapy. Thyroxine requirements depend on fat-free mass and are, therefore, somewhat higher in males who are more often undersubstituted. In pregnancy lower TSH-reference ranges have to be considered and thyroid function should be monitored throughout pregnancy to avoid harm to the foetus caused by maternal thyroid dysfunctions. If overtreated women more often feature fractures, whereas males more often develop atrial fibrillation.
虽然甲状腺疾病各种形式的发病原因仍未完全阐明,但女性比男性更易患甲状腺疾病。甲状腺功能亢进症是由循环中游离甲状腺激素升高所定义的。女性患病率约为2%,男性为0.2%。最常见的病因是老年女性的各种形式的甲状腺自主性和主要发生在年轻女性中的格雷夫斯病。甲状腺功能减退症是由甲状腺激素缺乏所定义的。它是一种常见的内分泌疾病,由自身免疫性甲状腺炎(桥本甲状腺炎)、碘缺乏或手术后或放射性碘治疗引起。甲状腺素需求量取决于去脂体重,因此,甲状腺功能减退替代治疗不足在男性中更为常见,他们的甲状腺素需求量也略高。在怀孕期间,必须考虑更低的促甲状腺激素参考范围,并且在整个孕期都应监测甲状腺功能,以避免母体甲状腺功能障碍对胎儿造成伤害。甲状腺功能亢进治疗过度的女性更常出现骨折,而男性则更常发生心房颤动。