Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York 10467, USA.
Curr Opin Endocrinol Diabetes Obes. 2013 Oct;20(5):455-9. doi: 10.1097/01.med.0000433055.99570.52.
As life expectancy increases and population age advances, diagnosis and treatment of diseases common in the geriatric population assume an increasingly important role in modern medicine. In the last few years, the emergence of age-specific reference ranges for thyroid-stimulating hormone (TSH) has added to the complexity of diagnosis of thyroid dysfunction in this age group, especially in the 'subclinical' category.
The recent studies confirm an increase in population TSH distribution with age, both in cross-sectional and longitudinal studies. Conclusive evidence about adverse cardiovascular, metabolic, and cognitive consequences of subclinical hypothyroidism in the elderly remains elusive. The transient nature of subtle degrees of thyroid dysfunction in a significant proportion of elderly patients has also been reproduced in the recent publications.
A growing body of literature in the last few years, reviewed here, highlights the importance of employing additional caution before assigning diagnoses of hypothyroidism or hyperthyroidism to elderly patients and initiation of treatment modalities that can have long-lasting effects.
随着预期寿命的延长和人口老龄化的推进，老年人群中常见疾病的诊断和治疗在现代医学中显得愈发重要。在过去几年中，促甲状腺激素（TSH）的年龄特异性参考范围的出现增加了该年龄段甲状腺功能障碍诊断的复杂性，尤其是在“亚临床”类别中。
最近的研究证实，无论是在横断面研究还是纵向研究中，人群 TSH 分布随年龄增长而增加。关于老年人亚临床甲状腺功能减退症对心血管、代谢和认知的不良后果的明确证据仍难以捉摸。在最近的出版物中也重现了相当一部分老年患者中甲状腺功能轻度障碍的暂时性。
近年来，这里回顾的大量文献强调了在为老年患者做出甲状腺功能减退或甲状腺功能亢进的诊断以及开始可能产生长期影响的治疗方法之前，谨慎行事的重要性。
