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甲状腺功能减退症患者的健康相关生活质量-基于人群的研究,世界卫生组织 MONICA 项目。

Health-related quality of life in hypothyroidism-A population-based study, the WHO MONICA Project.

机构信息

The Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Department of Respiratory Medicine and Allergology, Sahlgrenska University Hospital, Gothenburg, Sweden.

出版信息

Clin Endocrinol (Oxf). 2021 Jul;95(1):197-208. doi: 10.1111/cen.14448. Epub 2021 Mar 24.

Abstract

OBJECTIVE

To explore health-related quality of life (HRQoL) among subjects with hypothyroidism compared to subjects without hypothyroidism in the general population. HRQoL is important in clinical practice. Hypothyroidism is prevalent, mainly found in women, and increasing with age.

DESIGN

Cohort study of random population sample.

PATIENTS

Women and men, n = 414 (39-78 years) from the WHO MONICA project, Gothenburg, Sweden, participated. Hypothyroidism was defined as subjects having levothyroxine supplementation or serum thyroid-stimulating hormone (S-TSH) >4.2 mU/L.

MEASUREMENTS

Health-related quality of life was measured with Psychological General Well-Being Index (PGWB), Nottingham Health Profile (NHP), Short Form 36 Health Survey (SF-36) and a single item self-rated health scale (0-100), and stress was rated 1-6. The results were adjusted for age, sex and comorbidity using analysis of covariance (ANCOVA).

RESULTS

Hypothyroidism was found in 70 subjects (17%). They scored worse HRQoL than controls regarding Sleep (p < .001), Social isolation (p = .01) and Total NHP (p < .05), and had more medication in general 2.7 ± 2.5 vs. 1.8 ± 2.1, p < .05. Subjects with levothyroxine (n = 40) showed similar results as the total hypothyroid group. Subjects unaware of their newly detected elevated STSH (n = 30) showed lower HRQoL in Sleep (p < .01) and Pain (p < .05) in NHP. HRQoL was similar in subjects with and without positive thyroperoxidase antibodies (TPO-Ab) either in those with hypothyroidism (44% TPO-Ab) or controls (9% TPO-Ab).

CONCLUSION

Men and women with hypothyroidism in the general population reported having more issues with Sleep and Social isolation than those without hypothyroidism irrespective of TPO-Ab. Scores were similar in all of the other HRQoL domains measuredAQ5.

摘要

目的

探讨甲状腺功能减退症患者与普通人群中无甲状腺功能减退症患者的健康相关生活质量(HRQoL)。HRQoL 在临床实践中很重要。甲状腺功能减退症很常见,主要发生在女性中,且随着年龄的增长而增加。

设计

随机人群样本的队列研究。

患者

来自瑞典哥德堡世界卫生组织 MONICA 项目的 414 名女性和男性(39-78 岁)参与了研究。甲状腺功能减退症的定义为服用左甲状腺素补充剂或血清促甲状腺激素(S-TSH)>4.2mU/L 的患者。

测量方法

使用心理一般健康指数(PGWB)、诺丁汉健康概况(NHP)、健康调查简表 36 项(SF-36)和自我评估健康量表(0-100)测量健康相关生活质量,压力评分 1-6 分。使用协方差分析(ANCOVA)对年龄、性别和合并症进行调整。

结果

70 名(17%)患者被诊断为甲状腺功能减退症。与对照组相比,他们在睡眠(p<0.001)、社会隔离(p=0.01)和总 NHP(p<0.05)方面的 HRQoL 评分更差,一般来说服用更多药物(2.7±2.5 对 1.8±2.1,p<0.05)。服用左甲状腺素(n=40)的患者与总甲状腺功能减退组表现出相似的结果。30 名(30%)未意识到其新发现的促甲状腺激素升高的患者在 NHP 中的睡眠(p<0.01)和疼痛(p<0.05)方面 HRQoL 较低。在甲状腺过氧化物酶抗体(TPO-Ab)阳性的甲状腺功能减退症患者(44%TPO-Ab)或对照组(9%TPO-Ab)中,无论 TPO-Ab 阳性与否,HRQoL 在其他所有测量的 HRQoL 领域均相似。

结论

无论 TPO-Ab 阳性与否,普通人群中男性和女性甲状腺功能减退症患者的睡眠和社会隔离问题比无甲状腺功能减退症患者更严重。在所有其他测量的 HRQoL 领域,评分均相似。

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