The First Clinical Medical College, Lanzhou University, Lanzhou, China.
Department of Endocrinology, First Hospital of Lanzhou University, Lanzhou, China.
Ann Med. 2023 Dec;55(1):643-651. doi: 10.1080/07853890.2023.2178668.
To investigate the prevalence and related influencing factors of subclinical hypothyroidism (SCH) in a pre-diabetes (PreDM) population.
A multi-stage stratified cluster random sampling method was used to select the adult Han population in Gansu Province for investigation. General data and related biochemical indices were recorded and SPSS software was used for statistical analyses.
This study selected 2876 patients, including 548 with SCH and 433 with PreDM. In the PreDM population, the levels of thyroid stimulating hormone (TSH), serum phosphorus, TPOAb and TgAb in the SCH group were higher than those in the euthyroid group ( < 0.05). The level of TPOAb in females of SCH group was higher than that in males ( < 0.05). The positive rates of TPOAb and TgAb in females were higher than those in males in the total population and SCH population. The prevalence of SCH in the PreDM group under 60 was significantly higher than that in the normal glucose tolerance (NGT) group (26.02% vs. 20.40%, = 5.150, < 0.05). We defined SCH as a TSH level of >4.20 mIU/L. Using this criterion, the prevalence of SCH in the total population of PreDM was higher than that in the NGT population ( = 8.611, < 0.05), the prevalence of SCH in the PreDM population generally showed an upward trend. However, we performed a separate analysis considering the accepted impact of age on TSH redefining SCH as TSH >8.86 mIU/L (for individuals over age 65). However, allowing for the expected rise in TSH levels in individuals over age 65, the prevalence of SCH in the elderly over 65 years of age decreased significantly (NGT population from 27.48% to 9.16%, PreDM population from 34.18% to 6.33%, < 0.05). Logistic regression analysis showed that the risk factors for SCH in the PreDM population were female gender, fasting plasma glucose and TSH (all < 0.05). Risk factors for SCH in the impaired fasting glucose (IFG) population were female gender, OGTT 2 h, TSH and TPOAb (all < 0.05).
The prevalence of SCH in the PreDM population not considering the known physiological increase in age related TSH was relatively high and was significant in female and the IFG population. However, the effect of age on these findings needs to attract more attention.
探讨亚临床甲状腺功能减退症（SCH）在糖尿病前期（PreDM）人群中的患病率及相关影响因素。
采用多阶段分层整群随机抽样方法，选取甘肃省成年汉族人群进行调查。记录一般资料和相关生化指标，采用 SPSS 软件进行统计学分析。
本研究共纳入 2876 例患者，其中 SCH 患者 548 例，PreDM 患者 433 例。在 PreDM 人群中，SCH 组的促甲状腺激素（TSH）、血清磷、TPOAb 和 TgAb 水平高于甲状腺功能正常组（ < 0.05）。SCH 组女性的 TPOAb 水平高于男性（ < 0.05）。在总人群和 SCH 人群中，女性的 TPOAb 和 TgAb 阳性率均高于男性。PreDM 组 60 岁以下人群的 SCH 患病率明显高于正常糖耐量（NGT）组（26.02%比 20.40%， = 5.150， < 0.05）。我们将 SCH 定义为 TSH 水平>4.20 mIU/L。采用这一标准，PreDM 患者的 SCH 患病率高于 NGT 人群（ = 8.611， < 0.05），PreDM 人群的 SCH 患病率呈上升趋势。但是，我们考虑到年龄对 TSH 的影响，重新定义了 SCH 为 TSH>8.86 mIU/L（65 岁以上人群）。然而，考虑到 65 岁以上人群 TSH 水平的预期升高，65 岁以上老年人 SCH 的患病率显著下降（NGT 人群从 27.48%降至 9.16%，PreDM 人群从 34.18%降至 6.33%， < 0.05）。Logistic 回归分析显示，PreDM 人群 SCH 的危险因素为女性、空腹血糖和 TSH（均 < 0.05）。IFG 人群 SCH 的危险因素为女性、OGTT 2 h、TSH 和 TPOAb（均 < 0.05）。
不考虑与年龄相关的 TSH 生理性升高，PreDM 人群 SCH 的患病率相对较高，且在女性和 IFG 人群中更为显著。但是，年龄对这些发现的影响需要引起更多关注。
Zotero 插件