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不同性别和年龄段的甲状腺刺激素与肌肉力量的关系——韩国(2014-2015 年第六次全国健康和营养调查)的研究

Different Relationships Between Thyrotropin and Muscle Strength According to Sex and Age in Euthyroid Koreans (The 6th Korea National Health and Nutritional Examination Survey 2014-2015).

机构信息

Department of Endocrinology and Metabolism, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea.

出版信息

Thyroid. 2020 Dec;30(12):1710-1717. doi: 10.1089/thy.2019.0601. Epub 2020 Jun 29.

Abstract

Changes in muscle mass and strength can be caused by multiple endocrine factors, including thyroid dysfunction. However, the relationship between thyroid function and muscle strength in euthyroid individuals is not clear. In the present study, we investigated the relationship between thyroid function and handgrip strength (HGS) in euthyroid Koreans, especially according to sex and age. This was a population-based, cross-sectional study from the 6th Korea National Health and Nutrition Examination Survey including 2894 Koreans (1487 men and 1407 women) aged ≥19 years. Serum thyrotropin (TSH) and free thyroxine (fT4) levels were measured. HGS was measured using a digital grip strength dynamometer. Serum TSH level, but not serum fT4 level, was significantly associated with HGS in men, but neither TSH nor fT4 level was associated with HGS in women. Serum TSH showed a negative association with HGS in men aged <65 years ( = 1376;  = -0.566,  = 0.008), but a positive association in men aged ≥65 years ( = 111;  = 1.158,  = 0.010) after adjusting for confounders. HGS decreased as TSH tertile increased in men aged <65 years ( for trend = 0.010), but increased with TSH tertile in men aged ≥65 years ( for trend = 0.009) after adjusting for confounders. Odds ratios (ORs) for the lowest quartile of HGS increased in the highest tertile of TSH among men aged <65 years (OR = 1.657 [95% confidence interval {CI} 1.099-2.500],  = 0.006) and decreased in the highest tertile of TSH among men aged ≥65 years (OR = 0.176 [CI 0.032-0.966],  = 0.034) after adjusting for confounders. In euthyroid Koreans, serum TSH levels were significantly associated with HGS only in men and this relationship was found to depend significantly on age. These findings suggest that age has a distinct influence on the effect of even subtle change of thyroid function on muscle strength in men.

摘要

肌肉质量和力量的变化可能由多种内分泌因素引起,包括甲状腺功能障碍。然而,甲状腺功能与甲状腺功能正常个体肌肉力量之间的关系尚不清楚。本研究旨在探讨甲状腺功能与甲状腺功能正常的韩国人握力(HGS)之间的关系,尤其是根据性别和年龄。这是一项基于人群的横断面研究,来自第 6 次韩国国家健康和营养检查调查,共纳入 2894 名韩国人(1487 名男性和 1407 名女性),年龄≥19 岁。测量血清促甲状腺激素(TSH)和游离甲状腺素(fT4)水平。使用数字握力测力计测量 HGS。在男性中,血清 TSH 水平与 HGS 显著相关,但血清 fT4 水平与 HGS 无关,而在女性中,TSH 和 fT4 水平均与 HGS 无关。在调整了混杂因素后,血清 TSH 与<65 岁男性的 HGS 呈负相关( = -0.566, = 0.008),但与≥65 岁男性的 HGS 呈正相关( = 1.158, = 0.010)。在<65 岁的男性中,随着 TSH 三分位的增加,HGS 呈下降趋势(趋势 = 0.010),但在调整了混杂因素后,随着 TSH 三分位的增加,HGS 呈上升趋势(趋势 = 0.009)。在<65 岁的男性中,TSH 最高三分位组的 HGS 最低四分位比的比值比(OR)增加(OR = 1.657 [95%置信区间 {CI} 1.099-2.500], = 0.006),而在≥65 岁的男性中,TSH 最高三分位组的 HGS 最低四分位比的比值比(OR)降低(OR = 0.176 [CI 0.032-0.966], = 0.034)。在甲状腺功能正常的韩国人中,血清 TSH 水平仅与男性的 HGS 显著相关,且这种关系明显取决于年龄。这些发现表明,年龄对甲状腺功能微小变化对男性肌肉力量的影响有明显影响。

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