老年男性甲状腺功能与客观及主观睡眠质量的关联：男性骨质疏松性骨折（MrOS）研究
Association Between Thyroid Function and Objective and Subjective Sleep Quality in Older Men: The Osteoporotic Fractures in Men (MrOS) Study.
作者信息
Akatsu Haruko, Ewing Susan K, Stefanick Marcia L, Fink Howard A, Stone Katie L, Barrett-Connor Elizabeth, Mehra Reena, Ancoli-Israel Sonia, Redline Susan, Hoffman Andrew R
机构信息
Division of Endocrinology, Gerontology and Metabolism, Stanford University School of Medicine, Stanford, California.
Department of Epidemiology and Biostatistics, University of California, San Francisco, California.
出版信息
Endocr Pract. 2014 Jun;20(6):576-86. doi: 10.4158/EP13282.OR.
OBJECTIVE
To determine the association between thyroid hormone levels and sleep quality in community-dwelling men.
METHODS
Among 5,994 men aged ≥65 years in the Osteoporotic Fractures in Men (MrOS) study, 682 had baseline thyroid function data, normal free thyroxine (FT4) (0.70 ≤ FT4 ≤ 1.85 ng/dL), actigraphy measurements, and were not using thyroid-related medications. Three categories of thyroid function were defined: subclinical hyperthyroid (thyroid-stimulating hormone [TSH] <0.55 mIU/L), euthyroid (TSH, 0.55 to 4.78 mIU/L), and subclinical hypothyroid (TSH >4.78 mIU/L). Objective (total hours of nighttime sleep [TST], sleep efficiency [SE], wake after sleep onset [WASO], sleep latency [SL], number of long wake episodes [LWEP]) and subjective (TST, Pittsburgh Sleep Quality Index score, Epworth Sleepiness Scale score) sleep quality parameters were measured. The association between TSH and sleep quality was examined using linear regression (continuous sleep outcomes) and log-binomial regression (categorical sleep outcomes).
RESULTS
Among the 682 men examined, 15 had subclinical hyperthyroidism and 38 had subclinical hypothyroidism. There was no difference in sleep quality between subclinical hypothyroid and euthyroid men. Compared to euthyroid men, subclinical hyperthyroid men had lower mean actigraphy TST (adjusted mean difference [95% confidence interval (CI)], -27.4 [-63.7 to 8.9] minutes), lower mean SE (-4.5% [-10.3% to 1.3%]), and higher mean WASO (13.5 [-8.0 to 35.0] minutes]), whereas 41% had increased risk of actigraphy-measured TST <6 hours (relative risk [RR], 1.41; 95% CI, 0.83 to 2.39), and 83% had increased risk of SL ≥60 minutes (RR, 1.83; 95% CI, 0.65 to 5.14) (all P>.05).
CONCLUSION
Neither subclinical hypothyroidism nor hyperthyroidism is significantly associated with decreased sleep quality.
目的
确定社区居住男性甲状腺激素水平与睡眠质量之间的关联。
方法
在男性骨质疏松性骨折（MrOS）研究中年龄≥65岁的5994名男性中，682人有基线甲状腺功能数据、游离甲状腺素（FT4）正常（0.70≤FT4≤1.85 ng/dL）、有活动记录仪测量数据且未使用甲状腺相关药物。定义了三类甲状腺功能：亚临床甲状腺功能亢进（促甲状腺激素[TSH]<0.55 mIU/L）、甲状腺功能正常（TSH，0.55至4.78 mIU/L）和亚临床甲状腺功能减退（TSH>4.78 mIU/L）。测量客观（夜间总睡眠时间[TST]、睡眠效率[SE]、睡眠开始后觉醒时间[WASO]、睡眠潜伏期[SL]、长时间觉醒发作次数[LWEP]）和主观（TST、匹兹堡睡眠质量指数评分、爱泼华嗜睡量表评分）睡眠质量参数。使用线性回归（连续睡眠结果）和对数二项回归（分类睡眠结果）检验TSH与睡眠质量之间的关联。
结果
在接受检查的682名男性中，15人患有亚临床甲状腺功能亢进，38人患有亚临床甲状腺功能减退。亚临床甲状腺功能减退男性与甲状腺功能正常男性的睡眠质量没有差异。与甲状腺功能正常的男性相比，亚临床甲状腺功能亢进的男性平均活动记录仪TST较低（调整后平均差异[95%置信区间（CI）]，-27.4[-63.7至8.9]分钟），平均SE较低（-4.5%[-10.3%至1.3%]），平均WASO较高（13.5[-8.0至35.0]分钟），而41%的人活动记录仪测量的TST<6小时的风险增加（相对风险[RR]，1.4；95%CI <0.83至2.39），83%的人SL≥60分钟的风险增加（RR，1.83；95%CI，0.65至5.14）（所有P>.05）。
结论
亚临床甲状腺功能减退和甲状腺功能亢进均与睡眠质量下降无显著关联。
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