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在中国老年患者中,甲状腺状态与认知障碍有关联吗?

Is thyroid status associated with cognitive impairment in elderly patients in China?

作者信息

Hu Yao, Wang Zhi-cheng, Guo Qi-hao, Cheng Wei, Chen Yan-wen

机构信息

Department of Laboratory Medicine, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China.

Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology, Shanghai Medical College, Fudan University, Shanghai, 200040, China.

出版信息

BMC Endocr Disord. 2016 Feb 20;16:11. doi: 10.1186/s12902-016-0092-z.

Abstract

BACKGROUND

The relationship between alterations in thyroid function and cognitive deficits has been investigated in several previous studies. Hypo-or hyperthyroidism and, to a lesser extent, subclinical thyroid dysfunction can negatively affect cognitive performance. However, limited data are available on the potential association of thyroid function with mild cognitive impairment (MCI) and Alzheimer's disease (AD) in the elderly Chinese population.

METHODS

In the present study focusing on a population of elderly Chinese individuals ≥ 50 years of age, 77 cognitively normal controls, 64 patients with MCI, and 154 patients diagnosed with AD underwent assessment of thyroid status using thyroid stimulating hormone (TSH), free triiodothyronine (fT3) and free thyroxine (fT4) levels as variables. Cognitive function was evaluated with the aid of comprehensive neuropsychological tests, such as the Mini-Mental State Examination (MMSE) and Memory and Executive Screening (MES).

RESULTS

Overall, 88.1 % of the subjects displayed normal thyroid function, 4.7 % were diagnosed with clinical hypothyroidism, 3.1 % with subclinical hypothyroidism, and 4.1 % with subclinical hyperthyroidism. After adjusting for covariates (age, sex, education years and body mass index), no association was evident between mild cognitive impairment or AD and thyroid dysfunction. However, lower serum TSH was correlated with risk of AD (odds ratio [OR]: 2.78, 95 % confidence interval [95% CI]: 1.11-6.99).

CONCLUSION

Neither hypothyroidism nor subclinical hyperthyroidism was associated with AD and MCI in this population-based elderly Chinese cohort. Our findings need to be confirmed in a longitudinal study.

摘要

背景

此前已有多项研究探讨了甲状腺功能改变与认知缺陷之间的关系。甲状腺功能减退或亢进,以及程度较轻的亚临床甲状腺功能障碍,均会对认知表现产生负面影响。然而,关于甲状腺功能与中国老年人群轻度认知障碍(MCI)和阿尔茨海默病(AD)之间潜在关联的数据有限。

方法

在本项针对年龄≥50岁的中国老年人群的研究中,77名认知正常对照者、64名MCI患者和154名被诊断为AD的患者接受了甲状腺功能评估,以促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(fT3)和游离甲状腺素(fT4)水平作为变量。借助综合神经心理学测试,如简易精神状态检查表(MMSE)和记忆与执行筛查(MES)对认知功能进行评估。

结果

总体而言,88.1%的受试者甲状腺功能正常,4.7%被诊断为临床甲状腺功能减退,3.1%为亚临床甲状腺功能减退,4.1%为亚临床甲状腺功能亢进。在对协变量(年龄、性别、受教育年限和体重指数)进行校正后,轻度认知障碍或AD与甲状腺功能障碍之间无明显关联。然而,较低的血清TSH与AD风险相关(优势比[OR]:2.78,95%置信区间[95%CI]:1.11 - 6.99)。

结论

在这个基于人群的中国老年队列中,甲状腺功能减退和亚临床甲状腺功能亢进均与AD和MCI无关。我们的研究结果需要在纵向研究中得到证实。

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