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甲状腺状态以及基线时的功能和认知状态与 3 年随访后的生存情况:OCTABAIX 研究。

Thyroid status and functional and cognitive status at baseline and survival after 3 years of follow-up: the OCTABAIX study.

机构信息

Geriatric Unit, Internal Medicine Service, IDIBELL, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, 08907 Llobregat, Barcelona, Spain.

出版信息

Eur J Endocrinol. 2013 Nov 22;170(1):69-75. doi: 10.1530/EJE-13-0722. Print 2014 Jan.

Abstract

OBJECTIVE

Subclinical thyroid disorders are common in older individuals. Health risks associated with subclinical hypothyroidism in older adults are unclear. The aim of the study is to evaluate whether thyroid status in elderly subjects correlates with physical and cognitive function at baseline and with 3-year mortality.

DESIGN

A population-based, prospective cohort of the OCTABAIX study (307 inhabitants aged 85 years at baseline).

METHODS

Chronic drug prescription, functional status (Barthel and Lawton indices) and cognitive status according to the Spanish version of the Mini-Mental State Examination were recorded. Quality of life was assessed using the visual analogue scale of the quality of life test. Concentrations of TSH and thyroxine were measured. Participants were classified in accordance with clinical categories of thyroid function.

RESULTS

Twenty (6.5%) individuals had subclinical hypothyroidism and five (1.6%) had subclinical hyperthyroidism. Compared with euthyroid subjects (n=280; 91.8%), subclinical hypo- and hyperthyroidism subjects were not significantly associated with poor physical or cognitive function at baseline. Fifty-one (15.1%) subjects died during the 36 months of follow-up. TSH values and subclinical hypo- and hyperthyroidism were not associated with an increased overall mortality risk (hazard ratio (HR) 1.086, 95% CI 0.987-1.196 and HR 0.905, 95% CI 0.902-1.053 respectively).

CONCLUSIONS

This study does not support the association of TSH or thyroid disorders with physical or cognitive function at baseline or with 3-year mortality in the oldest old subjects.

摘要

目的

亚临床甲状腺疾病在老年人中很常见。老年人亚临床甲状腺功能减退症相关的健康风险尚不清楚。本研究旨在评估老年受试者的甲状腺功能是否与基线时的身体和认知功能以及 3 年死亡率相关。

设计

基于人群的 OCTABAIX 研究的前瞻性队列(基线时年龄为 85 岁的 307 名居民)。

方法

记录慢性药物处方、功能状态(Barthel 和 Lawton 指数)和根据西班牙版简易精神状态检查表评估的认知状态。使用生活质量测试的视觉模拟量表评估生活质量。测量 TSH 和甲状腺素的浓度。根据甲状腺功能的临床分类对参与者进行分类。

结果

20 名(6.5%)患者患有亚临床甲状腺功能减退症,5 名(1.6%)患有亚临床甲状腺功能亢进症。与甲状腺功能正常的受试者(n=280;91.8%)相比,亚临床甲状腺功能减退和甲状腺功能亢进的受试者在基线时的身体或认知功能并无明显差异。在 36 个月的随访期间,51 名(15.1%)受试者死亡。TSH 值和亚临床甲状腺功能减退症或甲状腺功能亢进症与整体死亡率风险增加无关(危险比(HR)为 1.086,95%CI 为 0.987-1.196,HR 为 0.905,95%CI 为 0.902-1.053)。

结论

本研究不支持 TSH 或甲状腺疾病与最年长的受试者基线时的身体或认知功能或 3 年死亡率相关。

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