Endocrine Research Center (Firouzgar), Institute of Endocrinology and Metabolism, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
Arch Med Sci. 2012 Dec 20;8(6):1096-101. doi: 10.5114/aoms.2012.32423. Epub 2012 Dec 19.
Subclinical hypothyroidism has been reported to be associated with disturbed cognitive function. In this study, changes of subtests of the Wechsler Memory Scale and memory quotient were investigated in subjects with subclinical hypothyroidism following treatment with levothyroxine. The aim of the study was a randomized double blind placebo-controlled clinical trial.
Sixty subjects (51 females and 9 males) with subclinical hypothyroidism were enrolled. Memory quotient was evaluated at the beginning of the study and three months after enrollment, using Wechsler's memory test. Subclinical hypothyroidism was defined as serum TSH level between 4.5 mU/l and 10 mU/l in the presence of normal free-T4 (0.8-2 ng/dl) and positive anti-TPO-Ab. The intervention and control groups received levothyroxine and placebo respectively for 3 months. Re-evaluation was done using the Wechsler Memory Scale at the end of the study.
The mean age was 34 ±10 years, mean TSH level was 8.25 ±3.64 muIU/l. Memory quotient was similar in both groups at the beginning of the study: 105.70 ±2.1 in intervention group vs. 105.87 ±2.1 in control group (p = 0.89). At the end of the study, the memory quotient rose by 9.3 points in the intervention group and by 3.23 in the controls (p = 0.002). Analysis of the scores of Wechsler Memory subtests in the intervention group indicated significant improvement of mental control (p = 0.002), logical memory (p < 0.001), associate learning (p = 0.014), age corrected score (p = 0.002), and memory quotient (p < 0.001).
This study showed the efficacy of levothyroxine for cognitive function of subjects with subclinical hypothyroidism.
亚临床甲状腺功能减退症与认知功能障碍有关。在这项研究中,我们研究了左甲状腺素治疗后亚临床甲状腺功能减退症患者韦氏记忆量表亚测验和记忆商数的变化。本研究的目的是一项随机双盲安慰剂对照临床试验。
共纳入 60 例(女性 51 例,男性 9 例)亚临床甲状腺功能减退症患者。采用韦氏记忆测验于研究开始时和入组 3 个月后评估记忆商数。亚临床甲状腺功能减退症定义为血清 TSH 水平在 4.5mU/L 至 10mU/L 之间,游离-T4(0.8-2ng/dl)正常,抗 TPO-Ab 阳性。干预组和对照组分别接受左甲状腺素和安慰剂治疗 3 个月。研究结束时使用韦氏记忆量表进行重新评估。
平均年龄为 34 ±10 岁,平均 TSH 水平为 8.25 ±3.64mIU/L。两组在研究开始时的记忆商数相似:干预组为 105.70 ±2.1,对照组为 105.87 ±2.1(p=0.89)。研究结束时,干预组记忆商数增加 9.3 分,对照组增加 3.23 分(p=0.002)。干预组韦氏记忆测验各亚测验评分分析表明,精神控制(p=0.002)、逻辑记忆(p<0.001)、联想学习(p=0.014)、年龄校正评分(p=0.002)和记忆商数(p<0.001)显著改善。
本研究表明左甲状腺素治疗可改善亚临床甲状腺功能减退症患者的认知功能。