Meng Zhaowei, Liu Ming, Zhang Qing, Liu Li, Song Kun, Tan Jian, Jia Qiang, Zhang Guizhi, Wang Renfei, He Yajing, Ren Xiaojun, Zhu Mei, He Qing, Wang Shen, Li Xue, Zheng Wei, Hu Tianpeng, Liu Na, Upadhyaya Arun, Zhou Pingping, Zhang Jianping
From the Department of Nuclear Medicine (ZM, JT, QJ, GZ, RW, YH, SW, XL, WZ, TH, NL, AU, PZ), Department of Endocrinology and Metabolism (ML, XR, MZ, QH), Department of Health Management, Tianjin Medical University General Hospital (QZ, LL, KS), and Department of Nuclear Medicine, Tianjin Third Central Hospital, Tianjin, P.R. China (JZ).
Medicine (Baltimore). 2015 Dec;94(49):e2186. doi: 10.1097/MD.0000000000002186.
The relationship between thyroid-stimulating hormone (TSH) and hyperlipidemia is still a topic of debate. We aimed to explore the impact of gender and age on the association between serum TSH and lipid profile in a large cohort of Chinese.This cross-sectional study enrolled 13,915 participants (8565 male, 5350 female), who self-reported as healthy without any known previous diseases. Clinical data including anthropometric measurements, thyroid function, and other serum parameters were collected. The associations between TSH and hyperlipidemia of males and females were analyzed separately after dividing TSH and age into subgroups. Odds ratio for hyperlipidemia was calculated by binary logistic regression models.Young males had significantly higher prevalence of hypercholesterolemia, hypertriglyceridemia, and high serum low-density lipoprotein-cholesterol than females, yet after menopause, females had higher prevalence than males. TSH was positively associated with hyperlipidemia independent of thyroid hormones. Males showed more reduced risks of hyperlipidemia in low TSH concentrations, while females demonstrated more enhanced risks of hyperlipidemia in high TSH concentrations. For instance, if TSH was lower than 0.3 μIU/mL, the risks of developing hypercholesterolemia and hypertriglyceridemia in males were only 0.198 (P < 0.01) and 0.425 (P < 0.05) of the reference TSH risks (between 2.0 and 3.0 μIU/mL), while in females the risks were 0.553 (P < 0.05) and 0.642 (P > 0.05), respectively. If TSH was higher than 4.0 μIU/mL, women displayed significantly higher risks of developing hypertriglyceridemia than the reference TSH risks (P < 0.05), yet, men did not demonstrate such significances.Our results showed thyroid hormone independent positive associations between serum TSH and lipids, which were substantially influenced by gender and age. Males demonstrated more protective effects of low TSH against hyperlipidemia, while females showed more detrimental effects of high TSH on hyperlipidemia.
促甲状腺激素（TSH）与高脂血症之间的关系仍是一个存在争议的话题。我们旨在探讨性别和年龄对一大群中国人群血清TSH与血脂谱之间关联的影响。这项横断面研究纳入了13915名参与者（男性8565名，女性5350名），他们自我报告为健康且既往无任何已知疾病。收集了包括人体测量、甲状腺功能及其他血清参数在内的临床数据。将TSH和年龄分为亚组后，分别分析男性和女性TSH与高脂血症之间的关联。通过二元逻辑回归模型计算高脂血症的比值比。年轻男性的高胆固醇血症、高甘油三酯血症及高血清低密度脂蛋白胆固醇患病率显著高于女性，但绝经后女性的患病率高于男性。TSH与高脂血症呈正相关，且独立于甲状腺激素。低TSH浓度时，男性发生高脂血症的风险降低更为明显，而高TSH浓度时，女性发生高脂血症的风险增加更为明显。例如，若TSH低于0.3 μIU/mL，男性发生高胆固醇血症和高甘油三酯血症的风险分别仅为参考TSH风险（2.0至3.0 μIU/mL）的0.198（P<0.01）和0.425（P<0.05），而女性的风险分别为0.553（P<0.05）和0.642（P>0.05）。若TSH高于4.0 μIU/mL，女性发生高甘油三酯血症的风险显著高于参考TSH风险（P<0.05），而男性则无此显著差异。我们的结果表明，血清TSH与血脂之间存在独立于甲状腺激素的正相关，且受性别和年龄的显著影响。低TSH对男性高脂血症具有更多的保护作用，而高TSH对女性高脂血症具有更多的有害作用。
