甲状腺功能障碍与帕金森病风险：系统评价和荟萃分析。
Thyroid Dysfunction and Risk of Parkinson's Disease: A Systematic Review and Meta-Analysis.
机构信息
Department of Medicine, Mount Auburn Hospital, Harvard Medical School, Cambridge, MA, United States.
Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
出版信息
Front Endocrinol (Lausanne). 2022 May 4;13:863281. doi: 10.3389/fendo.2022.863281. eCollection 2022.
OBJECTIVE
Studies have suggested that patients with thyroid dysfunction may have an increased risk of developing Parkinson's disease (PD). However, the results from existing studies are inconsistent. Therefore, we aimed to investigate the association of hypothyroidism and hyperthyroidism with risk of PD using the method of systematic review and meta-analysis.
METHODS
Potentially eligible studies were identified from Medline and EMBASE databases from inception to December 2021 using search strategy that comprised of terms for "Thyroid" and "Parkinson's Disease". Eligible cohort study must consist of one cohort of patients with hypothyroidism/hyperthyroidism and another cohort of individuals without hypothyroidism/hyperthyroidism. Then, the study must report effect estimates with 95% confidence intervals (95% CIs) comparing incident PD between the groups. Eligible case-control studies must include cases with PD and controls without PD. Then, the study must explore their history of hypothyroidism/hyperthyroidism. Odds ratio (OR) with 95% CIs of the association between presence of hypothyroidism/hyperthyroidism and PD must be reported. Point estimates with standard errors were retrieved from each study and were combined together using the generic inverse variance method.
RESULTS
A total of 3,147 articles were identified. After two rounds of independent review by three investigators, 3 cohort studies and 6 case-control studies met the eligibility criteria and were included into the meta-analysis. Pooled analysis showed an increased likelihood of PD in both patients with hypothyroidism (pooled OR 1.56; 95%CI, 1.38 - 1.77; with moderate heterogeneity, I 66.9%) and patients with hyperthyroidism (pooled OR 1.57; 95%CI, 1.40 - 1.77; with insignificant heterogeneity, I 0.0%). Funnel plots for both meta-analyses were fairly symmetric, which did not indicate presence of publication bias.
CONCLUSION
This systematic review and meta-analysis found a significant association of both hypothyroidism and hyperthyroidism with an increased risk of PD.
目的
研究表明，甲状腺功能障碍患者发生帕金森病（PD）的风险可能增加。然而，现有研究的结果并不一致。因此，我们旨在通过系统评价和荟萃分析的方法，研究甲状腺功能减退症和甲状腺功能亢进症与 PD 风险的相关性。
方法
从 Medline 和 EMBASE 数据库中，检索从建库至 2021 年 12 月的关于“甲状腺”和“帕金森病”的文献，采用包含“甲状腺”和“帕金森病”术语的检索策略。合格的队列研究必须包含一组甲状腺功能减退症/甲状腺功能亢进症患者和另一组无甲状腺功能减退症/甲状腺功能亢进症的个体。然后，该研究必须报告两组之间发生 PD 的发病率的效应估计值和 95%置信区间（95%CI）。合格的病例对照研究必须包括 PD 病例和无 PD 的对照。然后，该研究必须探讨他们的甲状腺功能减退症/甲状腺功能亢进症病史。必须报告存在甲状腺功能减退症/甲状腺功能亢进症与 PD 之间的关联的比值比（OR）和 95%CI。从每项研究中检索点估计值和标准误差，并使用通用逆方差法将它们合并在一起。
结果
共检索到 3147 篇文章。经过三位研究者两轮独立审查，有 3 项队列研究和 6 项病例对照研究符合纳入标准并纳入荟萃分析。汇总分析显示，甲状腺功能减退症患者（汇总 OR 1.56；95%CI，1.38-1.77；具有中度异质性，I²66.9%）和甲状腺功能亢进症患者（汇总 OR 1.57；95%CI，1.40-1.77；异质性不显著，I²0.0%）发生 PD 的可能性增加。这两项荟萃分析的漏斗图都相当对称，这表明没有发表偏倚。
结论
本系统评价和荟萃分析发现，甲状腺功能减退症和甲状腺功能亢进症均与 PD 风险增加显著相关。
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