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[西班牙卡斯蒂利亚-莱昂地区机会性抽样人群中亚临床甲状腺功能减退症的患病率及临床特征]

[Prevalence and clinical characteristics of subclinical hypothyroidism in an opportunistic sample in the population of Castile-León (Spain)].

作者信息

Mariscal Hidalgo Ana Isabel, Lozano Alonso José E, Vega Alonso Tomás

机构信息

Centro de Salud Cristóbal Acosta, Burgos, España.

Dirección General de Salud Pública, Consejería de Sanidad, Valladolid, España.

出版信息

Gac Sanit. 2015 Mar-Apr;29(2):105-11. doi: 10.1016/j.gaceta.2014.10.007. Epub 2014 Dec 15.

Abstract

OBJECTIVE

To describe the distribution of thyroid-stimulating hormone (TSH) values and to estimate the prevalence of subclinical hypothyroidism in the adult population of Castile and León (Spain).

METHOD

An observational study was conducted in an opportunistic sample of 45 primary care centers in Castile and León. TSH was determined in people aged ≥35 years that attended a primary care physician and had a blood test for any reason. Confirmatory analysis included free thyroxine and anti-thyroid peroxidase antibody determination.

RESULTS

A total of 3957 analyses were carried out, 63% in women. The mean age was 61.5 years. The median TSH value was 2.3 μIU/mL (2.5 μIU/mL in women and 2.1 μIU/mL in men), with a rising trend with age. TSH values were higher in undiagnosed or untreated subclinical hypothyroidism than in patients under treatment. The lowest levels were found in euthyroidism. The prevalence of subclinical hypothyroidism was 9.2% (95%CI: 8.3-10.2), and hypothyroidism was three times higher in women than in men (12.4% versus 3.7%). Hypothyroidism increased with age, reaching a peak of 16.9% in women aged 45 to 64 years.

CONCLUSIONS

The prevalence of subclinical hypothyroidism in our sample was high and in the upper limits of values found in previous studies. Proper diagnosis and treatment are important because of the risk of progression to hypothyroidism and the association with multiple diseases and other risk factors.

摘要

目的

描述促甲状腺激素(TSH)值的分布情况,并估算西班牙卡斯蒂利亚-莱昂自治区成年人群中亚临床甲状腺功能减退症的患病率。

方法

在卡斯蒂利亚-莱昂自治区45个基层医疗中心的机会性样本中开展了一项观察性研究。对年龄≥35岁、因任何原因就诊于基层医疗医生并接受血液检测的人群测定TSH。确证分析包括游离甲状腺素和抗甲状腺过氧化物酶抗体测定。

结果

共进行了3957次分析,其中63%为女性。平均年龄为61.5岁。TSH值中位数为2.3 μIU/mL(女性为2.5 μIU/mL,男性为2.1 μIU/mL),且随年龄呈上升趋势。未诊断或未治疗的亚临床甲状腺功能减退症患者的TSH值高于接受治疗的患者。甲状腺功能正常者的TSH值最低。亚临床甲状腺功能减退症的患病率为9.2%(95%CI:8.3 - 10.2),甲状腺功能减退症在女性中的患病率是男性的三倍(12.4%对3.7%)。甲状腺功能减退症随年龄增加,在45至64岁女性中达到峰值16.9%。

结论

我们样本中亚临床甲状腺功能减退症的患病率较高,处于既往研究发现的值的上限范围内。由于存在进展为甲状腺功能减退症的风险以及与多种疾病和其他危险因素相关,因此正确诊断和治疗很重要。

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