Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Thyroid. 2022 Jul;32(7):819-827. doi: 10.1089/thy.2021.0544. Epub 2022 May 16.
Women are more likely to experience thyroid diseases than men. However, thyroid dysfunction risk in women undergoing the menopausal transition remains largely unknown. We explored the prevalence of thyroid dysfunction across menopausal stages. We conducted a cross-sectional study of 53,230 women aged 40 years or older who underwent health screening between 2014 and 2018. Menopausal stages were categorized into 4 based on the Stages of Reproductive Aging Workshop +10 criteria. A multinomial logistic regression model was used to estimate the prevalence ratios (PRs) with confidence intervals [CIs] for thyroid dysfunction in menopausal stages compared with that in premenopause. The prevalence of overt hypothyroidism was significantly increased during late transition and postmenopause; it remained significant after further adjustments for potential confounders (age, center, year of examination, age at menarche, parity, education level, smoking status, alcohol consumption, physical activity, and body mass index) with corresponding multivariable-adjusted PRs [CI] of 1.61 [1.12-2.30] and 1.66 [1.16-2.37] in the late transition and postmenopausal stages, respectively. A significant increase in the prevalence of subclinical hypothyroidism was also observed in the late transition and postmenopausal stage with multivariable-adjusted PRs [CI] of 1.22 [1.06-1.40] and 1.24 [1.07-1.44], respectively. In contrast, subclinical and overt hyperthyroidism were not significantly associated with menopausal stages. In this study of pre- and perimenopausal Korean women, the prevalence of overt and subclinical hypothyroidism was significantly elevated in the late menopausal transition. Future prospective studies are warranted to investigate the clinical and prognostic significance of thyroid dysfunction in women during menopausal transition.
女性比男性更容易患甲状腺疾病。然而,处于绝经过渡阶段的女性发生甲状腺功能障碍的风险在很大程度上尚不清楚。我们探讨了不同绝经阶段甲状腺功能障碍的患病率。
我们对 2014 年至 2018 年期间接受健康筛查的 53230 名年龄在 40 岁或以上的女性进行了一项横断面研究。根据生殖衰老研讨会+10 标准,将绝经阶段分为 4 个阶段。使用多变量逻辑回归模型来估计绝经阶段与绝经前相比甲状腺功能障碍的患病率比(PR)及其置信区间(CI)。显性甲状腺功能减退症的患病率在晚期过渡和绝经后显著增加;在进一步调整潜在混杂因素(年龄、中心、检查年份、初潮年龄、产次、教育程度、吸烟状况、饮酒、身体活动和体重指数)后,这一结果仍然显著,相应的多变量调整后的 PR(CI)分别为 1.61(1.12-2.30)和 1.66(1.16-2.37)。亚临床甲状腺功能减退症的患病率在晚期过渡和绝经后阶段也显著增加,多变量调整后的 PR(CI)分别为 1.22(1.06-1.40)和 1.24(1.07-1.44)。相比之下,亚临床和显性甲状腺功能亢进与绝经阶段没有显著关联。
在这项对韩国绝经前和绝经后女性的研究中,绝经后期过渡时显性和亚临床甲状腺功能减退症的患病率显著升高。需要进一步进行前瞻性研究,以探讨女性在绝经过渡期间甲状腺功能障碍的临床和预后意义。