Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.
Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.
Biomed J. 2018 Feb;41(1):52-58. doi: 10.1016/j.bj.2018.02.002. Epub 2018 Mar 30.
Subclinical hypothyroidism (SCH) is defined as elevation in serum thyroid-stimulating hormone (TSH) levels despite normal serum levels of free thyroxine. It remains controversial whether people with SCH have higher total cholesterol and low-density lipoprotein cholesterol levels compared to normal-thyroid subjects. The aim of this study was to assess the metabolic risk factors for SCH.
Subjects were recruited from the health examination center of Chang Gung Memorial Hospital, Linkou, from January 1, 2010 to December 31, 2011. This was a cross-sectional review of medical records. The subjects were ethnic Taiwanese residents without known thyroid disease at baseline.
A total of 22,324 subjects received annual health examination at Chang Gung Memorial Hospital from 2010 to 2011. Among them, 15,943 subjects were included as the normal thyroid group (NG), and 203 subjects (101 men and 102 women) met the criteria for SCH. The prevalence of metabolic syndrome (MetS) in the NG was 26.2% in men and 18.7% in women, whereas that in the SCH group was 39.6% in men and 29.4% in women. Women in the SCH group showed significantly higher cholesterol, triglyceride, non-high density lipoprotein (HDL) and cholesterol/HDL levels than those in the NG (p < 0.05).
Because SCH is more prevalent in women and the risk increases with age, greater attention to the risk of MetS development is warranted. As for men, regardless of thyroid function, the risk of MetS development with age still warrants attention. Thus, our data suggest that national guidelines for screening for thyroid disease using serum TSH levels in the elderly are mandatory.
亚临床甲状腺功能减退症（SCH）定义为血清促甲状腺激素（TSH）水平升高，而游离甲状腺素水平正常。目前仍存在争议，即 SCH 患者的总胆固醇和低密度脂蛋白胆固醇水平是否高于正常甲状腺患者。本研究旨在评估 SCH 的代谢危险因素。
本研究于 2010 年 1 月 1 日至 2011 年 12 月 31 日期间从长庚纪念医院的健康检查中心招募研究对象。这是对病历的横断面回顾性研究。研究对象为在基线时无已知甲状腺疾病的台湾籍居民。
2010 年至 2011 年长庚纪念医院共有 22324 名患者接受年度健康检查。其中，15943 例患者被纳入正常甲状腺组（NG），203 例（101 例男性和 102 例女性）符合 SCH 标准。NG 组中男性和女性代谢综合征（MetS）的患病率分别为 26.2%和 18.7%，而 SCH 组中男性和女性分别为 39.6%和 29.4%。SCH 组女性的胆固醇、甘油三酯、非高密度脂蛋白（HDL）和胆固醇/HDL 水平明显高于 NG 组（p<0.05）。
由于 SCH 在女性中更为常见，且风险随年龄增长而增加，因此需要更加关注 SCH 患者发生 MetS 的风险。对于男性，无论甲状腺功能如何，年龄增长导致 MetS 发生的风险仍需关注。因此，我们的数据表明，对老年人进行甲状腺疾病筛查使用血清 TSH 水平的国家指南是必要的。
