Department of Obstetrics and Gynaecology, PEDEGO Research Unit, Oulu University Hospital and University of Oulu, OYS, Finland.
Medical Research Centre Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
Menopause. 2021 May 17;28(9):1053-1059. doi: 10.1097/GME.0000000000001800.
We investigated whether more advanced climacteric stage in the mid-40s is associated with thyroid autoimmunity and dysfunction.
This cross-sectional cohort study included 2,569 46-year-old women. Thyroid hormone, thyroid peroxidase antibodies, and follicle-stimulating hormone levels were determined. Using menstrual history and follicle-stimulating hormone levels, the participants were divided into climacteric (n = 340) and preclimacteric (n = 2,229) groups. Women diagnosed with premature ovarian insufficiency (menopause by 40 y of age) were excluded. The use of thyroid medication was evaluated from the medication reimbursement register. The prevalence of thyroid medication use, laboratory-based thyroid dysfunction, and thyroid peroxidase antibody positivity was compared between the two groups. The association between climacteric status and thyroid disorders was investigated using a logistic regression model including smoking and thyroid antibody status.
At 46 years old, climacteric women used thyroid medication more often than preclimacteric women (9.1% vs 6.1%; P = 0.04). There was no difference in the prevalence of subclinical or clinical hypothyroidism and hyperthyroidism in nonmedicated participants (5.5% vs 5.0%; P = 0.7) or thyroid peroxidase antibody positivity (14.0% vs 15.0%, P = 0.7). In the regression model, being climacteric (OR = 1.6; 95% CI 1.1-2.3; P = 0.02) and antibody positivity (OR 4.9; 95% CI 3.6-6.6; P < 0.001) were associated with a higher prevalence of thyroid dysfunction.
More advanced climacteric stage in the mid-40s was slightly associated with thyroid dysfunction but not thyroid autoimmunity.
本研究旨在探讨 40 多岁时更接近绝经过渡期是否与甲状腺自身免疫和功能障碍有关。
本横断面队列研究纳入了 2569 名 46 岁女性。检测甲状腺激素、甲状腺过氧化物酶抗体和卵泡刺激素水平。根据月经史和卵泡刺激素水平，将参与者分为绝经期（n=340）和绝经前期（n=2229）组。排除被诊断为卵巢早衰（40 岁前绝经）的女性。通过药物报销登记评估甲状腺药物的使用情况。比较两组之间甲状腺药物使用、基于实验室的甲状腺功能障碍和甲状腺过氧化物酶抗体阳性的患病率。使用包括吸烟和甲状腺抗体状态的逻辑回归模型研究绝经期状态与甲状腺疾病之间的关系。
在 46 岁时，绝经期女性使用甲状腺药物的频率高于绝经前期女性（9.1% vs. 6.1%；P=0.04）。在未服用甲状腺药物的参与者中，亚临床或临床甲状腺功能减退症和甲状腺功能亢进症的患病率（5.5% vs. 5.0%；P=0.7）或甲状腺过氧化物酶抗体阳性率（14.0% vs. 15.0%；P=0.7）均无差异。在回归模型中，处于绝经期（OR=1.6；95%CI 1.1-2.3；P=0.02）和抗体阳性（OR 4.9；95%CI 3.6-6.6；P<0.001）与甲状腺功能障碍的患病率增加相关。
40 多岁时更接近绝经过渡期与甲状腺功能障碍有轻微关联，但与甲状腺自身免疫无关。
