Department of Medicine, Inha University College of Medicine, Incheon, Korea.
Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea.
J Korean Med Sci. 2017 Oct;32(10):1626-1632. doi: 10.3346/jkms.2017.32.10.1626.
Subclinical hyperthyroidism and subclinical hypothyroidism are characterized by abnormal thyroid stimulating hormone (TSH) with normal free thyroxine. Subclinical thyroid diseases, to date, have received less attention compared with other thyroid diseases since they are asymptomatic. This study aimed to verify the association between subclinical thyroid diseases and cardiovascular diseases (CVDs) risk score in the Korean population. This was a population-based cohort study using data collected from 3,722 subjects (aged ≥ 30 years) during the 6th Korea National Health and Nutrition Examination Survey (KNHANES VI; 2013-2015). Gender-specific Framingham risk scores were calculated to identify the association between subclinical thyroid diseases and 10-year CVD risk score. Complex survey, with consideration of sampling weight, was analyzed using generalized linear models after stratification by gender. The TSH reference range was between 0.61 and 6.91 mIU/L in this study. TSH showed a positive association with the 10-year CVD risk score only in the female population (P = 0.001). There were significant differences in the least squares means of 10-year CVD risk score by the effect of subclinical hypothyroidism compared with euthyroidism (normal group) in females, after adjusting for body mass index, white blood cell, and urine iodine (P = 0.006 and Bonferroni corrected P = 0.012). In conclusion, subclinical hypothyroidism is associated with increased 10-year CVD risk score in the female Korean population aged 30 years or more. Therefore, we recommend to clinically checkup major CVD risk factors in female patients with subclinical hypothyroidism aged 30 years or more.
亚临床甲状腺功能亢进症和亚临床甲状腺功能减退症的特征是甲状腺刺激激素（TSH）异常，游离甲状腺素正常。与其他甲状腺疾病相比，亚临床甲状腺疾病至今受到的关注较少，因为它们没有症状。本研究旨在验证亚临床甲状腺疾病与韩国人群心血管疾病（CVD）风险评分之间的关系。这是一项基于人群的队列研究，使用了 2013 年至 2015 年第 6 次韩国国家健康和营养检查调查（KNHANES VI）中 3722 名（年龄≥30 岁）受试者的数据。计算了性别特异性弗雷明汉风险评分，以确定亚临床甲状腺疾病与 10 年 CVD 风险评分之间的关系。考虑到抽样权重，采用广义线性模型进行分层分析，对复杂调查进行分析。在本研究中，TSH 的参考范围在 0.61 到 6.91 mIU/L 之间。仅在女性人群中，TSH 与 10 年 CVD 风险评分呈正相关（P=0.001）。在调整了体重指数、白细胞和尿碘后，与甲状腺功能正常组（正常组）相比，亚临床甲状腺功能减退症对女性人群 10 年 CVD 风险评分的最小二乘均值有显著差异（P=0.006 和 Bonferroni 校正后 P=0.012）。总之，在年龄在 30 岁及以上的韩国女性人群中，亚临床甲状腺功能减退症与 10 年 CVD 风险评分增加有关。因此，我们建议在年龄在 30 岁及以上的女性亚临床甲状腺功能减退症患者中，临床检查主要 CVD 风险因素。
