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甲状腺功能减退是梅尼埃病的独立危险因素:一项基于人群的队列研究。

Hypothyroidism is an independent risk factor for Menière's disease: A population-based cohort study.

作者信息

Lin Wen-Ling, Chen Chih-Yu, Hsu Tai-Yi, Chen Wei-Kung, Lin Cheng-Li, Chen Hang-Cheng

机构信息

Department of Emergency Medicine.

College of Medicine, China Medical University.

出版信息

Medicine (Baltimore). 2019 Apr;98(15):e15166. doi: 10.1097/MD.0000000000015166.

Abstract

The relationship of hypothyroidism and Menière's disease (MD) has been discussed before, yet not well documented. Our study aims to investigate the correlation of both diseases.This is a retrospective cohort study based on data from the LHID2000 (Longitudinal Health Insurance Database 2000), a subset of the Taiwan National Research Health Insurance Database that contains claims data for the 2000 to 2011 period. A total of 27,050 patients were included in this study, 5410 of whom had received a hypothyroidism diagnosis. The prevalence of MD was high in patients with hypothyroidism (95% confidence interval [CI]: 1.14-1.51), especially in those older than 50 years old (P < .001). Although comorbidities such as hypertension or cirrhosis are significant risk factors for Menière's disease (P < .001, P < .05), the incidence rate of Menière's disease in patients with hypothyroidism differs significantly between groups without these comorbidities (95% CI: 1.14-1.95). Regarding the timing for the occurrence of Menière's disease in patients with hypothyroidism, there was a significant time interval of <5 years (P < .05). The risk of MD decreased after treatment with thyroxine and did not differ from that of the nonhypothyroidism cohort (adjusted HR [aHR] = 0.85, 95% CI: 0.66-1.11).The study demonstrates a significant association between hypothyroidism and Menière's disease, especially in elderly female patients. Physicians should consider verifying the thyroid function when encountering these patients.

摘要

甲状腺功能减退症与梅尼埃病(MD)之间的关系此前已有讨论,但记录并不充分。我们的研究旨在调查这两种疾病之间的相关性。这是一项基于2000年纵向健康保险数据库(LHID2000)数据的回顾性队列研究,LHID2000是台湾全民健康保险研究数据库的一个子集,包含2000年至2011年期间的理赔数据。本研究共纳入27050名患者,其中5410名被诊断为甲状腺功能减退症。甲状腺功能减退症患者中梅尼埃病的患病率较高(95%置信区间[CI]:1.14 - 1.51),尤其是50岁以上的患者(P <.001)。尽管高血压或肝硬化等合并症是梅尼埃病的重要危险因素(P <.001,P <.05),但甲状腺功能减退症患者中梅尼埃病的发病率在无这些合并症的组间差异显著(95% CI:1.14 - 1.95)。关于甲状腺功能减退症患者中梅尼埃病发生的时间,存在一个显著的<5年的时间间隔(P <.05)。甲状腺素治疗后梅尼埃病的风险降低,与非甲状腺功能减退症队列无差异(调整后风险比[aHR] = 0.85,95% CI:0.66 - 1.11)。该研究表明甲状腺功能减退症与梅尼埃病之间存在显著关联,尤其是在老年女性患者中。医生在遇到这些患者时应考虑检查甲状腺功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23a5/6485829/83a6355f1b34/medi-98-e15166-g005.jpg

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