Sun Banruo, Wang Xuanping, McLarnon Michael Edmund David, Ding Yu, Liu Miao, Dai Wei, Wang Gangshi
Department of Endocrinology, Second Medical Center, Chinese People's Liberation Army General Hospital, National Clinical Research Center for Geriatric Diseases, Beijing, China.
School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom.
Front Med (Lausanne). 2021 Jul 8;8:682116. doi: 10.3389/fmed.2021.682116. eCollection 2021.
It is currently unclear whether the infection leads to associated alterations in thyroid functions and thyroidal illnesses. This study aims to analyse this relationship in an elderly male cohort over a five-year period. A case retrospective study. A longitudinal study was designed to collect subjects (≥65 years old) receiving both a thyroid examination and infection status determined by C-urea breath test in 2013 at our unit. Subjects were followed every 1 to 2 years until December 2017 for laboratory results, visits to outpatient clinics/emergency departments etc. Blood tests and thyroid ultrasonography were performed to determine thyroid function and morphology. 356 male subjects with mean age 78.5 ± 9.8 years were included. Active infection was positive in 88 subjects (24.7%). Thyroid function tests and ultrasonography showed similar patterns between positive and negative groups. Non-thyroidal-illness syndrome (NTIS) was diagnosed in 30/210 (14%) patients who experienced acute illnesses and hospitalization over five-year follow-up. Notably, NTIS demonstrated significantly higher prevalence in the positive group compared to the negative group (17.1 vs. 5.6%, = 0.001). Multivariate analysis showed that when age, APACHE II score and hemoglobin levels were adjusted, status still has significant interrelationship with NTIS (OR = 3.497, = 0.003). There is a positive association between chronic active infection and NTIS prevalence in this elderly male cohort. Further studies are needed to elucidate the role of infection on NTIS in elderly male patients.
目前尚不清楚该感染是否会导致甲状腺功能及甲状腺疾病的相关改变。本研究旨在分析一个老年男性队列在五年期间的这种关系。一项病例回顾性研究。设计了一项纵向研究,收集2013年在我们科室接受甲状腺检查以及通过C尿素呼气试验确定感染状况的受试者(≥65岁)。每1至2年对受试者进行随访,直至2017年12月,获取实验室检查结果、门诊/急诊科就诊等情况。进行血液检查和甲状腺超声检查以确定甲状腺功能和形态。纳入了356名平均年龄为78.5±9.8岁的男性受试者。88名受试者(24.7%)活动性感染呈阳性。甲状腺功能检查和超声检查在阳性组和阴性组之间显示出相似模式。在五年随访期间经历急性疾病和住院治疗的210名患者中,有30名(14%)被诊断为非甲状腺疾病综合征(NTIS)。值得注意的是,NTIS在阳性组中的患病率显著高于阴性组(17.1%对5.6%,P = 0.001)。多因素分析表明,在调整年龄、急性生理与慢性健康状况评分系统(APACHE)II评分和血红蛋白水平后,感染状况与NTIS仍有显著的相关性(比值比[OR]=3.497,P = 0.003)。在这个老年男性队列中,慢性活动性感染与NTIS患病率之间存在正相关。需要进一步研究以阐明感染在老年男性患者NTIS中的作用。