Li Meng, Zhang Xiuying, Zhou Xianghai, Han Xueyao, Zhang Rui, Fu Zuodi, Wang Lianying, Gao Ying, Li Yufeng, Ji Linong
Department of Endocrinology and Metabolism, Peking University People's Hospital, Peking University Diabetes Center, Beijing, People's Republic of China.
Department of Endocrinology and Metabolism, Capital Medical University Pinggu Hospital, Beijing, People's Republic of China.
Diabetes Metab Syndr Obes. 2020 Jun 16;13:2001-2011. doi: 10.2147/DMSO.S252154. eCollection 2020.
We aimed to ascertain the association between thyrotropin (TSH) levels in euthyroid state and the prevalence of metabolic syndrome (MetS) in a community-based Chinese population.
Based on a large and well-characterized community cohort in Beijing, China, 1831 men and 1742 women with serum TSH levels within the reference range (0.50-4.78 µIU/mL) were stratified by quartiles of TSH (Q1-4). MetS was identified according to the criteria of International Diabetes Federation guidelines. Poisson regression models were used to estimate the association between serum TSH and the prevalence of MetS and its components before and after adjustment for potential confounding factors. The reported association was measured using the prevalence ratio (PR) with its respective 95% confidence interval (95% CI).
The prevalence of MetS in euthyroid population across TSH quartiles (Q1-4) was 38.9%, 44.6%, 41.0%, and 47.7%, respectively, in men ( = 0.045), and 47.7%, 46.6%, 46.9%, and 54.6%, respectively, in women ( = 0.032). Compared with the reference group TSH-Q1, the prevalence of MetS was higher among TSH-Q4 group both in men (PR = 1.27; 95% CI: 1.09, 1.48, = 0.002) and women (PR = 1.21; 95% CI: 1.07, 1.37, = 0.003) even after adjustment for age, lifestyle factors, serum levels of free triiodothyronine (FT3), and free thyroxine (FT4). Most of the components of MetS were common in higher serum TSH levels within the normal range.
The prevalence of MetS and most of its components increased in the higher TSH group in euthyroid Chinese population.
我们旨在确定中国社区人群中甲状腺功能正常状态下促甲状腺激素（TSH）水平与代谢综合征（MetS）患病率之间的关联。
基于中国北京一个规模大且特征明确的社区队列，1831名男性和1742名血清TSH水平在参考范围（0.50 - 4.78 μIU/mL）内的女性按TSH四分位数（Q1 - 4）分层。根据国际糖尿病联盟指南标准确定代谢综合征。使用泊松回归模型估计血清TSH与代谢综合征患病率及其组分在调整潜在混杂因素前后的关联。报告的关联用患病率比（PR）及其各自的95%置信区间（95%CI）衡量。
男性TSH四分位数（Q1 - 4）甲状腺功能正常人群中代谢综合征的患病率分别为38.9%、44.6%、41.0%和47.7%（P = 0.045），女性分别为47.7%、46.6%、46.9%和54.6%（P = 0.032）。与参考组TSH - Q1相比，即使在调整年龄、生活方式因素、血清游离三碘甲状腺原氨酸（FT3）和游离甲状腺素（FT4）水平后，男性TSH - Q4组（PR = 1.27；95%CI：1.09，1.48，P = 0.002）和女性TSH - Q4组（PR = 1.21；95%CI：1.07，1.37，P = 0.003）代谢综合征的患病率仍较高。代谢综合征的大多数组分在正常范围内较高血清TSH水平时较为常见。
甲状腺功能正常的中国人群中，TSH较高组代谢综合征及其大多数组分的患病率增加。
