Unidad de Investigación en Epidemiología Clínica, Hospital General Regional No 1 Carlos McGregor Sánchez Navarro, Gabriel Mancera 222, Colonia Del Valle, Delegación, Benito Juárez, 03100, México, DF, Mexico.
High Studies (FES) Zaragoza, National Autonomous University of Mexico, Mexico City, Mexico.
J Endocrinol Invest. 2017 Sep;40(9):945-952. doi: 10.1007/s40618-017-0654-6. Epub 2017 Mar 25.
Subclinical thyroid dysfunction is a possible risk factor for cognitive impairment in old age, but results are inconsistent. Aim of the present study was to evaluate the prevalence of thyroid dysfunction among older community-dwelling adults and to see whether thyroid function impacts the cognitive status of the elderly.
We included 1750 participants from the Study on Aging and Dementia in Mexico (SADEM). All subjects were evaluated clinically via specific interviews. TSH levels were analyzed by chemiluminescent immunometry assay. We classified participants into five thyroid state groups: (1) normal TSH levels (0.40-4.0 IU/L) were considered euthyroid; (2) Overt hyperthyroidism: TSH <0.3 IU/l and FT4 >23 pmol/l; (3) Overt hypothyroidism: TSH >4.8 IU/l, FT4 <13 pmol/l; (4) Subclinical hyperthyroidism: TSH <0.3 IU/l, FT4: 13-23 pmol/l; (5) Subclinical hypothyroidism: TSH >4.8 IU/l, FT4: 13-23 pmol/l.
The overall estimated prevalence of thyroid dysfunction in Mexican population was 23.7% (95% CI, 22.66-26.77). Of these, 15.4% older adults were classified as subclinical hypothyroidism, 7.2% overt hypothyroidism, 0.5% subclinical hyperthyroidism, and 0.6% overt hyperthyroidism. The association of thyroid dysfunction with cognitive impairment was most evident in overt hypothyroidism OR = 1.261 (1.185-1.343).
The present study demonstrated a high prevalence of thyroid dysfunction in Mexican elderly people living in the community. A relationship between cognitive impairment and the presence of hypothyroidism was also shown, and to a lesser degree in hyperthyroidism.
亚临床甲状腺功能障碍是老年认知障碍的一个潜在危险因素，但结果并不一致。本研究旨在评估老年社区居民中甲状腺功能障碍的患病率，并观察甲状腺功能是否对老年人的认知状态产生影响。
我们纳入了来自墨西哥衰老和痴呆研究（SADEM）的 1750 名参与者。所有受试者均通过特定访谈进行临床评估。TSH 水平通过化学发光免疫测定法进行分析。我们将参与者分为五组甲状腺状态组：（1）正常 TSH 水平（0.40-4.0 IU/L）被认为是甲状腺功能正常；（2）显性甲亢：TSH<0.3 IU/l 和 FT4>23 pmol/l；（3）显性甲减：TSH>4.8 IU/l，FT4<13 pmol/l；（4）亚临床甲亢：TSH<0.3 IU/l，FT4：13-23 pmol/l；（5）亚临床甲减：TSH>4.8 IU/l，FT4：13-23 pmol/l。
墨西哥人群中甲状腺功能障碍的总体估计患病率为 23.7%（95%CI，22.66-26.77）。其中，15.4%的老年人被归类为亚临床甲状腺功能减退，7.2%为显性甲状腺功能减退，0.5%为亚临床甲状腺功能亢进，0.6%为显性甲状腺功能亢进。甲状腺功能障碍与认知障碍的相关性在显性甲状腺功能减退症中最为明显，OR=1.261（1.185-1.343）。
本研究表明，墨西哥社区老年人甲状腺功能障碍的患病率较高。还表明认知障碍与甲状腺功能减退症的存在之间存在相关性，而在甲状腺功能亢进症中相关性较弱。
