Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, People's Republic of China.
School of Biological Sciences & Medical Engineering, Southeast University, Nanjing, 210096, People's Republic of China.
Endocrine. 2021 May;72(2):479-485. doi: 10.1007/s12020-020-02490-3. Epub 2020 Oct 16.
Sex differences in depressive disorder (DD) and subclinical hypothyroidism (SCH) have been well recognized. However, few studies focus on the sex differences in DD patients with SCH. The purpose of this study is to address the sex differences in DD inpatients with SCH and further investigate the clinical characteristics and associations between DD and SCH among female and male depressed inpatients.
A total of 1787 hospitalized patients with a diagnosis of DD were recruited. Depression was assessed using the Hamilton Depression Rating Scale-17 items (HAMD), and anxiety was assessed using the Hamilton Anxiety Rating Scale. Blood test, including serum thyroid hormone levels, was measured. According to different genders, associations between DD and the presence of SCH were estimated using binary logistic regression.
In the 1787 hospitalized patients with DD, the prevalence of SCH was 11.8%; the prevalence of SCH in female depressed inpatients is approximately two times that of male inpatients (14.6 vs. 7.4%, P < 0.05). Logistic regression showed that recurrent episodes and high BMI were associated with SCH in female inpatients (both P < 0.05). Spearman correlation analysis showed that thyroid stimulating hormone levels were associated with BMI (P < 0.05), total cholesterol levels (P < 0.05), and low-density lipoprotein cholesterol levels (P < 0.05) in female inpatients.
Our present study showed that the prevalence of SCH among female hospitalized patients with depression is approximately two times that of male inpatients. Recurrent and high-BMI female depressed inpatients are at high risk to develop SCH. More attention should be paid to the thyroid function of female inpatients with DD in future clinical work.
抑郁症（DD）和亚临床甲状腺功能减退症（SCH）的性别差异已得到充分认识。然而，很少有研究关注 SCH 伴发 DD 的性别差异。本研究旨在探讨 SCH 伴发 DD 住院患者的性别差异，并进一步调查女性和男性抑郁住院患者中 DD 与 SCH 之间的临床特征和关联。
共纳入 1787 例确诊为 DD 的住院患者。使用汉密尔顿抑郁评定量表-17 项（HAMD）评估抑郁，使用汉密尔顿焦虑评定量表评估焦虑。检测血样，包括血清甲状腺激素水平。根据不同性别，使用二项逻辑回归估计 DD 与 SCH 并存的相关性。
在 1787 例 DD 住院患者中，SCH 的患病率为 11.8%；女性抑郁住院患者 SCH 的患病率约为男性的两倍（14.6%对 7.4%，P<0.05）。Logistic 回归显示，复发次数和高 BMI 与女性住院患者的 SCH 相关（均 P<0.05）。Spearman 相关分析显示，甲状腺刺激激素水平与 BMI（P<0.05）、总胆固醇水平（P<0.05）和低密度脂蛋白胆固醇水平（P<0.05）在女性住院患者中相关。
本研究显示，女性抑郁住院患者 SCH 的患病率约为男性的两倍。反复发作和 BMI 较高的女性抑郁住院患者发生 SCH 的风险较高。未来临床工作中应更加关注女性 DD 住院患者的甲状腺功能。
