Department of Neurology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Republic of Korea.
Department of Neurology, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam, Republic of Korea.
J Alzheimers Dis. 2022;88(2):757-762. doi: 10.3233/JAD-220302.
Although thyroid dysfunction has been considered as a cause of reversible cognitive impairment, association between subclinical hypothyroidism and cognitive impairment is controversial.
We compared cognitive profiles of patients in an euthyroid or subclinical hypothyroid (sHypo) state, as well as their disease progression from mild cognitive impairment (MCI) to dementia within 3 years.
We included 2,181 patients in a euthyroid and 284 in a sHypo state over 60 years of age who underwent an extensive cognitive assessment at Seoul National University Bundang Hospital but were not prescribed levothyroxine, methimazole, carbimazole, or propylthiouracil. After propensity score matching for age, sex, and education level, 1,118 patients in a euthyroid and 283 patients in a sHypo state were included. Attention, language, memory, visuocontructive, and executive functions were compared between the groups using Student's t-test or the Mann-Whitney U test. To investigate the association between disease progression and subclinical hypothyroidism, a Cox regression analyses was performed in 379 patients with MCI. Patients with thyroid-stimulating hormone levels over 10 mlU/L was classified as the "sHypo10", and hazard ratios for sHypo or sHypo10 were assessed.
There was no difference in attention, language, memory, visuoconstructive, and executive functions between the patient groups. Progression from MCI to dementia was not associated with sHypo or sHypo10.
There was no difference in cognitive profile between euthyroid and sHypo patients, and no association between subclinical hypothyroidism and disease progression. This might suggest a clue of strategies regarding hormone therapy in subclinical hypothyroidism with cognitive impairment.
尽管甲状腺功能障碍被认为是认知障碍可逆的原因，但亚临床甲状腺功能减退症与认知障碍之间的关联仍存在争议。
我们比较了甲状腺功能正常和亚临床甲状腺功能减退症（sHypo）患者的认知特征，以及他们在 3 年内从轻度认知障碍（MCI）进展为痴呆的疾病进展情况。
我们纳入了 2181 名年龄在 60 岁以上的甲状腺功能正常患者和 284 名 sHypo 患者，他们在首尔国立大学盆唐医院接受了广泛的认知评估，但未服用左甲状腺素、甲巯咪唑、卡比马唑或丙硫氧嘧啶。经过年龄、性别和教育程度的倾向评分匹配后，纳入了 1118 名甲状腺功能正常患者和 283 名 sHypo 患者。使用学生 t 检验或曼-惠特尼 U 检验比较两组的注意力、语言、记忆、视空间构建和执行功能。为了研究疾病进展与亚临床甲状腺功能减退症之间的关系，对 379 名 MCI 患者进行了 Cox 回归分析。将甲状腺刺激激素水平超过 10mlU/L 的患者分为“sHypo10”，并评估 sHypo 或 sHypo10 的危险比。
两组患者的注意力、语言、记忆、视空间构建和执行功能均无差异。从 MCI 进展为痴呆与 sHypo 或 sHypo10 无关。
甲状腺功能正常和 sHypo 患者的认知特征无差异，亚临床甲状腺功能减退症与疾病进展无关。这可能提示了亚临床甲状腺功能减退症伴认知障碍患者激素治疗策略的线索。
