Strich David, Karavani Gilad, Edri Shalom, Chay Cherut, Gillis David
Endocr Pract. 2017 Jul;23(7):803-807. doi: 10.4158/EP171776.OR. Epub 2017 Apr 27.
Normal changes in free triiodothyronine (FT3), free thyroxine (FT4), and thyroid-stimulating hormone (TSH) levels over the lifespan and differences between sexes are not well documented, mainly because even the largest-scale studies available include relatively small cohorts. The aim of this study was to define age-related trends including sex differences based on reliable data.
A large database including serum thyroid tests drawn in community clinics was studied. FT3, FT4, and TSH levels from 527,564 sera samples taken from patients age 1 year or greater were included. After highly extensive exclusion criteria applied to remove all samples that may have been taken from unhealthy people, 27,940 samples remained. These were stratified by decades of age and by sex.
FT3 decreases throughout life, significantly more so among females, with equalization between sexes with greater age. FT4 declines to a lesser extent, also more among females than among males. Among the very old, females have higher levels of FT4. In contrast, TSH declines until age 50 and then increases slightly in both sexes.
This study provides reliable data regarding trends in hormonal levels by age and sex, with the major finding being higher FT3 in males throughout life except in the very young and very old. These results have important implications for diagnosing and treating thyroid conditions.
ANOVA = analysis of variance; BMI = body mass index; FT3 = free triiodothyronine; FT4 = free thyroxine.
游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)和促甲状腺激素(TSH)水平在整个生命周期中的正常变化以及性别差异尚未得到充分记录,主要是因为即使是现有最大规模的研究纳入的队列相对较小。本研究的目的是基于可靠数据确定与年龄相关的趋势,包括性别差异。
研究了一个包含社区诊所血清甲状腺检测结果的大型数据库。纳入了1岁及以上患者的527,564份血清样本的FT3、FT4和TSH水平。在应用高度广泛的排除标准以去除所有可能取自不健康人群的样本后,剩余27,940份样本。这些样本按年龄十年和性别进行分层。
FT3在整个生命过程中下降,女性下降幅度更大,随着年龄增长性别差异趋于平衡。FT4下降幅度较小,女性下降幅度也大于男性。在高龄人群中,女性的FT4水平较高。相比之下,TSH在50岁之前下降,然后在两性中略有上升。
本研究提供了关于激素水平随年龄和性别的趋势的可靠数据,主要发现是除了非常年轻和非常年老的人群外,男性一生中的FT3水平较高。这些结果对甲状腺疾病的诊断和治疗具有重要意义。
ANOVA = 方差分析;BMI = 体重指数;FT3 = 游离三碘甲状腺原氨酸;FT4 = 游离甲状腺素