Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China.
Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; Department of Toxicology and Sanitary Chemistry, School of Public Health, Tianjin Medical University, Tianjin, China.
Endocr Pract. 2021 Apr;27(4):291-297. doi: 10.1016/j.eprac.2020.10.009. Epub 2021 Jan 30.
Thyroid hormones (THs) play an important role in both serum uric acid (SUA) excretion and purine nucleotide metabolism. Past research mainly focused on the relationships between thyroid dysfunction and hyperuricemia. Although most subjects at risk for hyperuricemia are euthyroid, few studies have investigated the predictive values of THs on incident hyperuricemia in euthyroid adults. This study aimed to examine how free triiodothyronine, thyroxine, and thyroid-stimulating hormone are related to incident hyperuricemia in euthyroid subjects.
Participants without baseline hyperuricemia were recruited from Tianjin Chronic Low-grade Systemic Inflammation and Health Cohort Study and followed up for ∼6 years. Thyroid function was determined by chemiluminescence immunoassay methods. Hyperuricemia was defined as SUA ≥416.5 μmol/L for males and ≥357.0 μmol/L for females. Thyroid function and SUA were assessed yearly during follow-up. Adjusted Cox proportional hazards regression models were used to assess the relationship between thyroid function and hyperuricemia.
The incidence rates of hyperuricemia were 109 and 50 per 1000 person-years in males and females, respectively. In males, compared with the lowest quartile, the multivariable-adjusted hazards ratios for hyperuricemia in the highest quartiles of triiodothyronine, thyroxine, and thyroid-stimulating hormone were 0.57 (0.50-0.66), 0.63 (0.54-0.73), and 1.03 (0.90-1.19) (P for trend < .0001, < .0001, and .51), respectively. However, no statistically significant correlations between thyroid function and incident hyperuricemia in females were found.
This cohort study is the first to demonstrate that higher THs are related to lower risk of incident hyperuricemia in a male population with euthyroid status.
甲状腺激素（THs）在血清尿酸（SUA）排泄和嘌呤核苷酸代谢中都起着重要作用。过去的研究主要集中在甲状腺功能障碍与高尿酸血症之间的关系上。尽管大多数高尿酸血症的高危人群都是甲状腺功能正常的，但很少有研究调查 THs 对甲状腺功能正常成年人新发高尿酸血症的预测价值。本研究旨在探讨游离三碘甲状腺原氨酸、甲状腺素和促甲状腺激素与甲状腺功能正常人群新发高尿酸血症之间的关系。
本研究从天津慢性低度系统性炎症与健康队列研究中招募了无基线高尿酸血症的参与者，并进行了约 6 年的随访。采用化学发光免疫分析方法测定甲状腺功能。高尿酸血症定义为男性 SUA≥416.5 μmol/L，女性 SUA≥357.0 μmol/L。在随访期间，每年评估甲状腺功能和 SUA。采用调整后的 Cox 比例风险回归模型评估甲状腺功能与高尿酸血症之间的关系。
男性和女性的高尿酸血症发生率分别为 109 和 50 例/1000 人年。在男性中，与最低四分位相比，三碘甲状腺原氨酸、甲状腺素和促甲状腺激素最高四分位的高尿酸血症多变量调整风险比分别为 0.57（0.50-0.66）、0.63（0.54-0.73）和 1.03（0.90-1.19）（趋势 P 值<.0001，<.0001 和.51）。然而，在女性中，未发现甲状腺功能与新发高尿酸血症之间存在统计学显著相关性。
本队列研究首次表明，在甲状腺功能正常的男性人群中，较高的 THs 与新发高尿酸血症的风险降低相关。
