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甲状腺疾病与帕金森病的关联:一项基于全国健康筛查队列的巢式病例对照研究。

Association Between Thyroid Diseases and Parkinson's Disease: A Nested Case-Control Study Using a National Health Screening Cohort.

机构信息

Department of Neurosurgery, Hallym University College of Medicine, Anyang, Korea.

Department of Otorhinolaryngology, Hallym University College of Medicine, Anyang, Korea.

出版信息

J Parkinsons Dis. 2021;11(1):211-220. doi: 10.3233/JPD-202265.

Abstract

BACKGROUND

Although the dopaminergic system is interconnected with the hypothalamic-pituitary-thyroid axis, few studies have explained the causal relationship between thyroid disease and Parkinson's disease (PD).

OBJECTIVE

The goal of this study was to investigate the association between thyroid diseases and PD in Korean residents.

METHODS

The Korean National Health Insurance Service-National Sample Cohort, which includes individuals aged ≥40 years, was assessed from 2002 to 2015. A total of 5,586 PD patients were matched by age, sex, income, and the region of residence with 22,344 control participants at a ratio of 1:4. In the PD and control groups, previous histories of levothyroxine treatment, goiter, hypothyroidism, thyroiditis, and hyperthyroidism were investigated.

RESULTS

The rates of levothyroxine treatment for more than 3 months, hypothyroidism, and hyperthyroidism were higher in the PD group than the control group (3.2%, 3.8%, and 2.8% vs. 2.5%, 2.9%, and 1.9%, respectively, p < 0.05). The adjusted odds ratios (ORs) in model 2, which was adjusted for all potential confounders, for hypothyroidism and hyperthyroidism in the PD group were 1.25 (95% confidence interval (CI) 1.01-1.55, p = 0.044) and 1.37 (95% CI 1.13-1.67, p = 0.002), respectively. In subgroup analyses, the association between hypothyroidism and PD was maintained in men older than 70 years and the association between hyperthyroidism and PD was maintained in women younger than 70 years.

CONCLUSION

Both hyperthyroidism and hypothyroidism were associated with higher risk of PD, particularly for women younger than 70 years and men older than 70 years, respectively.

摘要

背景

尽管多巴胺能系统与下丘脑-垂体-甲状腺轴相互连接,但很少有研究解释甲状腺疾病与帕金森病(PD)之间的因果关系。

目的

本研究旨在探讨韩国居民中甲状腺疾病与 PD 之间的关联。

方法

评估了 2002 年至 2015 年期间年龄≥40 岁的韩国国民健康保险服务-国家抽样队列。共纳入 5586 例 PD 患者,并按照年龄、性别、收入和居住地与 22344 名对照参与者以 1:4 的比例进行匹配。在 PD 组和对照组中,调查了左旋甲状腺素治疗、甲状腺肿、甲状腺功能减退、甲状腺炎和甲状腺功能亢进的既往病史。

结果

PD 组接受超过 3 个月的左旋甲状腺素治疗、甲状腺功能减退和甲状腺功能亢进的比例高于对照组(分别为 3.2%、3.8%和 2.8%比 2.5%、2.9%和 1.9%,p<0.05)。在模型 2 中进行调整所有潜在混杂因素后,PD 组中甲状腺功能减退症和甲状腺功能亢进症的调整后优势比(OR)分别为 1.25(95%置信区间(CI)1.01-1.55,p=0.044)和 1.37(95%CI 1.13-1.67,p=0.002)。在亚组分析中,甲状腺功能减退症与 PD 之间的关联在年龄大于 70 岁的男性中仍然存在,而甲状腺功能亢进症与 PD 之间的关联在年龄小于 70 岁的女性中仍然存在。

结论

甲状腺功能亢进症和甲状腺功能减退症均与 PD 的发病风险增加相关,尤其是对于年龄大于 70 岁的男性和年龄小于 70 岁的女性。

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