Chen Juan, Zhou Weihong, Pan Fenghui, Cui Wenxia, Li Man, Hu Yun
Department of Geriatrics, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China.
Department of Endocrinology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, China.
Endocr J. 2018 Nov 29;65(11):1075-1082. doi: 10.1507/endocrj.EJ18-0113. Epub 2018 Aug 1.
This cross-sectional study aimed to examine changes in thyroid-stimulating hormone (TSH) concentration over age in China and investigate relationship between TSH and risk factors for cardiovascular disease (CVD) among euthyroid subjects. TSH, free triiodothyronine (FT3), free thyroxine (FT4), blood lipid, and glucose were measured. 7,693 individuals were subdivided into different age groups. Associations between TSH and CVD risk factors [age, body mass index (BMI), systolic and diastolic blood pressure, total cholesterol (TC), triglycerides, low density lipoprotein-cholesterol (LDL-C) and high density lipoprotein-cholesterol (HDL-C) and fasting plasma glucose (FPG)] were evaluated with Pearson correlation analysis. Results showed that 2.5th percentile for TSH was consistent across age groups, whereas 97.5th percentile increased in subjects older than 40 years with upper limit being 6.83 mIU/L in subjects aged 60-69 years and 8.07 mIU/L in those older than 70 years. The age-specific upper limits reclassification rate was higher in all age bands as compared to the common cut-off value. TSH was positively associated with age, SBP, DBP, TC and LDL-C and negatively with FT3 and FT4. Serum TSH within new reference range had a linear correlation with SBP, TC and LDL-C in subjects aged <60 years. There were no significant differences in BMI, blood pressure, lipid profile or FPG among subjects 60-69 and older than or equal to 70 years. Elevated TSH within new reference range is associated with risk factors for CVD in subjects aged <60 years. Thus, there might be age-related difference in the relationship between CVD risk factors and elevated serum TSH.
这项横断面研究旨在探讨中国甲状腺刺激激素（TSH）浓度随年龄的变化，并调查甲状腺功能正常受试者中TSH与心血管疾病（CVD）危险因素之间的关系。测量了TSH、游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）、血脂和血糖。7693名个体被分为不同年龄组。采用Pearson相关分析评估TSH与CVD危险因素[年龄、体重指数（BMI）、收缩压和舒张压、总胆固醇（TC）、甘油三酯、低密度脂蛋白胆固醇（LDL-C）和高密度脂蛋白胆固醇（HDL-C）以及空腹血糖（FPG）]之间的关联。结果显示，TSH的第2.5百分位数在各年龄组中一致，而第97.5百分位数在40岁以上的受试者中增加，60-69岁受试者的上限为6.83 mIU/L，70岁以上受试者的上限为8.07 mIU/L。与通用临界值相比，所有年龄组的年龄特异性上限重新分类率更高。TSH与年龄、收缩压、舒张压、TC和LDL-C呈正相关，与FT3和FT4呈负相关。新参考范围内的血清TSH与<60岁受试者的收缩压、TC和LDL-C呈线性相关。60-69岁以及70岁及以上受试者在BMI、血压、血脂谱或FPG方面无显著差异。新参考范围内TSH升高与<60岁受试者的CVD危险因素相关。因此，CVD危险因素与血清TSH升高之间的关系可能存在年龄相关差异。
