老年人甲状腺功能减退症与轻度认知障碍风险的关系：一项基于人群的研究。
Hypothyroidism and risk of mild cognitive impairment in elderly persons: a population-based study.
机构信息
Department of Psychiatry and Behavior Sciences, The University of Texas Medical School, Houston2Mayo Alzheimer's Disease Research Center, Mayo Clinic, Rochester, Minnesota3Department of Neurology, Mayo Clinic, Rochester, Minnesota.
Mayo Alzheimer's Disease Research Center, Mayo Clinic, Rochester, Minnesota3Department of Neurology, Mayo Clinic, Rochester, Minnesota4Department of Clinical Neuroscience, School of Medicine and Health Sciences, University of North Dakota, Fargo.
出版信息
JAMA Neurol. 2014 Feb;71(2):201-7. doi: 10.1001/jamaneurol.2013.5402.
IMPORTANCE
An association of clinical and subclinical hypothyroidism with mild cognitive impairment (MCI) has not been established.
OBJECTIVE
To evaluate the association of clinical and subclinical hypothyroidism with MCI in a large population-based cohort.
DESIGN, SETTING, AND PARTICIPANTS: A cross-sectional, population-based study was conducted in Olmsted County, Minnesota. Randomly selected participants were aged 70 to 89 years on October 1, 2004, and were without documented prevalent dementia [CORRECTED]. A total of 2050 participants were evaluated and underwent in-person interview, neurologic evaluation, and neuropsychological testing to assess performance in memory, attention/executive function, and visuospatial and language domains. Participants were categorized by consensus as being cognitively normal, having MCI, or having dementia according to published criteria. Clinical and subclinical hypothyroidism were ascertained from a medical records linkage system.
MAIN OUTCOMES AND MEASURES
Association of clinical and subclinical hypothyroidism with MCI.
RESULTS
Among 1904 eligible participants, the frequency of MCI was 16% in 1450 individuals with normal thyroid function, 17% in 313 persons with clinical hypothyroidism, and 18% in 141 individuals with subclinical hypothyroidism. After adjusting for covariates (age, educational level, sex, apolipoprotein E ε4, depression, diabetes mellitus, hypertension, stroke, body mass index, and coronary artery disease) we found no significant association between clinical or subclinical hypothyroidism and MCI (odds ratio [OR], 0.99 [95% CI, 0.66-1.48] and 0.88 [0.38-2.03], respectively). No effect of sex interaction was seen on these effects. In stratified analysis, the odds of MCI with clinical and subclinical hypothyroidism among men was 1.02 (95% CI, 0.57-1.82) and 1.29 (0.68-2.44) and, among women, was 1.04 (0.66-1.66) and 0.86 (0.37-2.02), respectively.
CONCLUSIONS AND RELEVANCE
In this population-based cohort of elderly people, neither clinical nor subclinical hypothyroidism was associated with MCI. Our findings need to be validated in a separate setting using the published criteria for MCI and confirmed in a longitudinal study.
重要性
尚未确定临床和亚临床甲状腺功能减退症与轻度认知障碍（MCI）之间的关联。
目的
在大型基于人群的队列中评估临床和亚临床甲状腺功能减退症与 MCI 的相关性。
设计、地点和参与者：横断面、基于人群的研究在明尼苏达州奥姆斯特德县进行。2004 年 10 月 1 日，随机选择年龄在 70 至 89 岁之间且没有记录到明显痴呆的参与者。共有 2050 名参与者接受了评估，并进行了面对面访谈、神经评估和神经心理学测试，以评估记忆、注意力/执行功能以及视空间和语言领域的表现。根据已发表的标准，通过共识将参与者归类为认知正常、患有 MCI 或患有痴呆症。通过病历链接系统确定临床和亚临床甲状腺功能减退症。
主要结果和措施
临床和亚临床甲状腺功能减退症与 MCI 的关系。
结果
在 1904 名合格参与者中，1450 名甲状腺功能正常者中有 16%患有 MCI，313 名临床甲状腺功能减退症患者中有 17%患有 MCI，141 名亚临床甲状腺功能减退症患者中有 18%患有 MCI。调整了协变量（年龄、教育水平、性别、载脂蛋白 E ε4、抑郁、糖尿病、高血压、中风、体重指数和冠状动脉疾病）后，我们发现临床或亚临床甲状腺功能减退症与 MCI 之间没有显著关联（比值比 [OR]，0.99 [95%CI，0.66-1.48] 和 0.88 [0.38-2.03]）。没有发现性别交互作用对这些影响有影响。在分层分析中，男性中临床和亚临床甲状腺功能减退症与 MCI 的比值比为 1.02（95%CI，0.57-1.82）和 1.29（0.68-2.44），而女性分别为 1.04（0.66-1.66）和 0.86（0.37-2.02）。
结论和相关性
在这项基于人群的老年队列研究中，临床和亚临床甲状腺功能减退症均与 MCI 无关。我们的研究结果需要在使用发表的 MCI 标准的单独环境中进行验证，并在纵向研究中得到证实。
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