Department of Family Medicine, China Medical University Hospital, 2, Yuh-Der Road, Taichung, 404, Taiwan.
Endocrine. 2013 Dec;44(3):716-22. doi: 10.1007/s12020-013-9915-0. Epub 2013 Mar 7.
Subjects with subclinical hypothyroidism (SCH) are at increased risk for cardiovascular disease (CVD). High-sensitivity C-reactive protein (hsCRP) is one of the inflammatory markers related to CVD. It is unclear whether inflammation is a mechanistic intermediary between SCH and CVD. We aimed to investigate the association between SCH and hsCRP in a Taiwanese population. A baseline cohort of 2,494 participants over the age of 19 was recruited in Taiwan from 2006 to 2008. SCH was defined as a serum thyroid-stimulating hormone (TSH) level of 5.61-19.9 mIU/L with normal thyroxine concentrations (a total T4 level of 4.9-12.0 μg/dL). Euthyroidism was defined as a serum TSH level of 0.34-5.60 mIU/L. HsCPR was grouped using quartiles. Multiple logistic and linear regression analyses were used to evaluate the relationship between hsCRP and SCH. After adjusting for gender and betel nut chewing, stepwise multiple logistic regression analyses revealed that hsCRP groups were significantly associated with SCH. Compared to the lowest hsCRP quartile, the adjusted odds ratio of having SCH for hsCRP quartile II, III, and IV were 1.38 (0.48-3.98), 1.48 (0.56-3.96), and 2.59 (1.01-6.67), respectively. The significant increase in odds ratios for SCH in progressive hsCRP quartiles reveals a dose-response effect (p < 0.05). Moreover, stepwise multiple linear regression analyses showed that hsCRP was significantly positively associated with serum TSH level after adjusting for potential confounders. Adult Taiwanese with SCH were associated with elevated hsCRP quartiles.
亚临床甲状腺功能减退症(SCH)患者发生心血管疾病(CVD)的风险增加。高敏 C 反应蛋白(hsCRP)是与 CVD 相关的炎症标志物之一。炎症是否是 SCH 与 CVD 之间的机制中介尚不清楚。我们旨在研究台湾人群中 SCH 与 hsCRP 之间的相关性。2006 年至 2008 年,在台湾招募了年龄在 19 岁以上的 2494 名参与者作为基线队列。SCH 定义为血清促甲状腺激素(TSH)水平为 5.61-19.9 mIU/L,同时甲状腺素浓度正常(总 T4 水平为 4.9-12.0 μg/dL)。甲状腺功能正常定义为血清 TSH 水平为 0.34-5.60 mIU/L。采用四分位法对 hsCRP 进行分组。采用多元逻辑回归和线性回归分析评估 hsCRP 与 SCH 之间的关系。在调整性别和咀嚼槟榔后,逐步多元逻辑回归分析显示,hsCRP 组与 SCH 显著相关。与 hsCRP 最低四分位组相比,hsCRP 四分位 II、III 和 IV 组发生 SCH 的校正比值比分别为 1.38(0.48-3.98)、1.48(0.56-3.96)和 2.59(1.01-6.67)。hsCRP 四分位呈递增趋势,SCH 的比值比显著增加(p < 0.05),表明存在剂量反应关系。此外,逐步多元线性回归分析显示,在调整潜在混杂因素后,hsCRP 与血清 TSH 水平呈显著正相关。
需要注意的是,原文中“betel nut”为槟榔,是一种中药,同时也是一种咀嚼物。