Weiwei Dong, Bei Wu, Hong Wang, Cailan Wu, Hailin Shao, Donghong Xu, Xiaolai Wang, Zhaohu Hao, Shijun Li, Jian Tan, Qiang Jia
Department of Nuclear Medicine, Tianjin Fourth Central Hospital, The Fourth Central Clinical School, Tianjin Medical University, Tianjin 300140, China.
Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin Medical University, Tianjin 300052, China.
Int J Endocrinol. 2022 Jan 7;2022:5720875. doi: 10.1155/2022/5720875. eCollection 2022.
This study aimed to determine whether and how stress-induced thyroid hormone changes occur during the COVID-19 pandemic in the northern area of Tianjin.
This study comprised two groups of study subjects in Tianjin: before (2019) and during (2020) the COVID-19 outbreak. Subjects were included if they had FT3, FT4, and TSH concentrations and thyroid TPOAb or TgAb information available. People who were pregnant, were lactating, or had mental illness were excluded. We used propensity score matching to form a cohort in which patients had similar baseline characteristics, and their anxiety level was measured by the Hamilton Anxiety Rating Scale (HAMA).
Among the 1395 eligible people, 224 in Group A and 224 in Group B had similar propensity scores and were included in the analyses. The detection rate of abnormal thyroid function was decreased in pandemic Group B (69.2% vs. 93.3%, = 42.725, < 0.01), especially for hypothyroidism (14.29% vs. 35.71%, = 27.429, < 0.01) and isolated thyroid-related antibodies (25.89% vs. 38.39%, = 8.023, < 0.01). The level of FT4 ( = -2.821, < 0.01) and HAMA score (7.63 ± 2.07 vs. 5.40 ± 1.65, = 16.873, < 0.01) went up in Group B; however, TSH ( = -5.238, < 0.01), FT3 ( = -3.089, =0.002), TgAb ( = -11.814, < 0.01), and TPOAb ( = -9.299, < 0.01) were lower, and HAMA was positive with FT3 ( = 0.208, < 0.01) and FT4 ( = 0.247, < 0.01).
People in the northern area of Tianjin during the COVID-19 outbreak were at an increased risk of higher FT4, lower FT3, and lower TSH. The HAMA scores increased in emergency situations and were positively correlated with the levels of FT3 and FT4.
本研究旨在确定天津北部地区在新冠疫情期间是否以及如何发生应激诱导的甲状腺激素变化。
本研究包括天津的两组研究对象：新冠疫情爆发前（2019年）和爆发期间（2020年）。若受试者有游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）、促甲状腺激素（TSH）浓度以及甲状腺过氧化物酶抗体（TPOAb）或甲状腺球蛋白抗体（TgAb）信息，则纳入研究。排除怀孕、哺乳期或患有精神疾病的人群。我们使用倾向得分匹配法形成一个队列，其中患者具有相似的基线特征，并通过汉密尔顿焦虑量表（HAMA）测量他们的焦虑水平。
在1395名符合条件的人群中，A组224人和B组224人具有相似的倾向得分，并纳入分析。疫情期间的B组甲状腺功能异常检出率下降（69.2%对93.3%，χ² = 42.725，P < 0.01），尤其是甲状腺功能减退（14.29%对35.71%，χ² = 27.429，P < 0.01）和单纯甲状腺相关抗体（25.89%对38.39%，χ² = 8.023，P < 0.01）。B组的FT4水平（χ² = -2.821，P < 0.01）和HAMA评分（7.63 ± 2.07对5.40 ± 1.65，t = 16.873，P < 0.01）升高；然而，TSH（t = -5.238，P < 0.01）、FT3（t = -3.089，P = 0.002）、TgAb（t = -11.814，P < 0.01）和TPOAb（t = -9.299，P < 0.01）较低，且HAMA与FT3（r = 0.208，P < 0.01）和FT4（r = 0.247，P < 0.01）呈正相关。
新冠疫情期间天津北部地区的人群FT4升高、FT3降低和TSH降低的风险增加。紧急情况下HAMA评分升高，且与FT3和FT4水平呈正相关。
