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亚临床甲状腺功能减退与血压之间的关联——观察性研究的荟萃分析

Association between subclinical hypothyroidism and blood pressure--a meta-analysis of observational studies.

作者信息

Ye Yicong, Xie Hongzhi, Zeng Yong, Zhao Xiliang, Tian Zhuang, Zhang Shuyang

机构信息

Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100730, China.

出版信息

Endocr Pract. 2014 Feb;20(2):150-8. doi: 10.4158/EP13237.OR.

Abstract

OBJECTIVE

This meta-analysis aimed to examine the relationship between subclinical hypothyroidism (SCH) and blood pressure (BP).

METHODS

A systematic search of MEDLINE and EMBASE databases was performed to identify all related cross-sectional studies and baseline data in prospective cohort studies in the general population. Weighted mean differences (WMDs) of systolic blood pressure (SBP) and diastolic blood pressure (DBP) between SCH and euthyroid groups were calculated. Subgroup analyses and meta-regression were used to explore potential heterogeneities among studies.

RESULTS

Twenty studies with 50,147 individuals were included. The WMDs of SBP and DBP were 1.47 mm Hg (95% confidence interval [CI] 0.54-2.39 mm Hg, P = .002) and 0.44 mm Hg [95% CI: -0.15-1.02 mm Hg, P = .142] between SCH and euthyroid groups, respectively. Significant heterogeneity was indentified among the included studies. Subgroup analysis showed that differences in study design, gender, and thyroid-stimulating hormone (TSH) cutoff level were not associated with the WMD of SBP, except for age difference between SCH and euthyroid groups. Meta-regression revealed a significant association between WMDs of SBP and age difference between the 2 groups (P = .015).

CONCLUSION

In this meta-analysis, SCH was associated with slightly higher SBP, which could be attributed to the age difference between SCH and euthyroid groups in the general population. However, this study could not exclude an association between SCH and BP. Prospective studies are needed to confirm these findings.

摘要

目的

本荟萃分析旨在研究亚临床甲状腺功能减退(SCH)与血压(BP)之间的关系。

方法

对MEDLINE和EMBASE数据库进行系统检索,以识别普通人群中所有相关的横断面研究和前瞻性队列研究的基线数据。计算SCH组和甲状腺功能正常组之间收缩压(SBP)和舒张压(DBP)的加权平均差(WMD)。采用亚组分析和Meta回归来探讨研究间潜在的异质性。

结果

纳入了20项研究,共50147名个体。SCH组和甲状腺功能正常组之间SBP和DBP的WMD分别为1.47 mmHg(95%置信区间[CI] 0.54 - 2.39 mmHg,P = .002)和0.44 mmHg [95% CI:-0.15 - 1.02 mmHg,P = .142]。纳入的研究之间存在显著异质性。亚组分析表明,研究设计、性别和促甲状腺激素(TSH)临界值水平的差异与SBP的WMD无关,但SCH组和甲状腺功能正常组之间的年龄差异除外。Meta回归显示SBP的WMD与两组之间的年龄差异存在显著关联(P = .015)。

结论

在本荟萃分析中,SCH与略高的SBP相关,这可能归因于普通人群中SCH组和甲状腺功能正常组之间的年龄差异。然而,本研究不能排除SCH与BP之间的关联。需要前瞻性研究来证实这些发现。

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