Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan.
Parkinsonism Relat Disord. 2020 May;74:28-32. doi: 10.1016/j.parkreldis.2020.04.001. Epub 2020 Apr 3.
Hypothyroidism has been implicated in many other disease conditions, including neurodegenerative diseases. Parkinson's disease (PD) is one of the most common neurodegenerative diseases. The purpose of this study was to investigate the risk of PD in patients with hypothyroidism.
A total of 4725 patients with hypothyroidism and 4725 controls (without hypothyroidism) matched by age, gender, index year, and Charlson Comorbidity Index (CCI) score were enrolled between 2000 and 2012. Patients were then followed until the end of 2013 using Taiwan's National Health Insurance Research Database, at which time participants who developed PD were identified. Cox regression analysis was used to calculate the hazard ratio (HR) with a 95% confidence interval (CI) of PD incidence rate between patients with hypothyroidism and unaffected controls.
Patients with hypothyroidism had a significantly increased risk of PD compared with unaffected controls (2.00 versus 1.10 per 1,000 person-years, HR: 1.77, 95% CI: 1.13-2.76) after adjusting for age, gender, CCI score, physical comorbidities (brain injury, cerebrovascular disease, hypertension, dyslipidemia, and diabetes mellitus), and duration of levothyroxine use. Also, older age (≥50 vs. <50 - HR:14.83), higher CCI score (CCI score 1-2 & ≥3 vs. 0 - HR: 1.66-1.74), and specific comorbidities (brain injury (HR: 1.78) and cerebrovascular disease (HR: 2.46)) significantly increased the risk of PD after adjusting for the variables mentioned above.
Patients with hypothyroidism have an increased risk of developing PD. Other prospective studies that take into account genetic vulnerability and environmental exposures are warranted to confirm their relationship.
甲状腺功能减退症与许多其他疾病有关，包括神经退行性疾病。帕金森病（PD）是最常见的神经退行性疾病之一。本研究旨在探讨甲状腺功能减退症患者患 PD 的风险。
本研究共纳入 2000 年至 2012 年间 4725 名甲状腺功能减退症患者和 4725 名年龄、性别、索引年份和 Charlson 合并症指数（CCI）评分匹配的对照组（无甲状腺功能减退症）。然后使用台湾国家健康保险研究数据库对患者进行随访，直至 2013 年底，在此期间确定患有 PD 的参与者。使用 Cox 回归分析计算甲状腺功能减退症患者与无影响对照组之间 PD 发生率的风险比（HR）和 95%置信区间（CI）。
调整年龄、性别、CCI 评分、身体合并症（脑损伤、脑血管疾病、高血压、血脂异常和糖尿病）和左甲状腺素使用时间后，与无影响对照组相比，甲状腺功能减退症患者 PD 的发病风险显著增加（2.00 比 1.10/1000 人年，HR：1.77，95%CI：1.13-2.76）。此外，年龄较大（≥50 岁比<50 岁- HR：14.83）、CCI 评分较高（CCI 评分 1-2 和≥3 比 0- HR：1.66-1.74）和特定合并症（脑损伤（HR：1.78）和脑血管疾病（HR：2.46））在调整上述变量后显著增加 PD 的发病风险。
甲状腺功能减退症患者患 PD 的风险增加。需要进行其他前瞻性研究，以考虑遗传易感性和环境暴露因素，以确认他们之间的关系。
