Launceston General Hospital, Launceston, Tasmania, Australia.
School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Australas Psychiatry. 2024 Oct;32(5):470-476. doi: 10.1177/10398562241267149. Epub 2024 Jul 24.
The systematic review evaluated the association of subclinical hypothyroidism (SCH) with metabolic syndrome (MetS) and specific MetS components in people with major psychiatric disorders.
A systematic review and meta-analysis was conducted to evaluate the association of SCH with MetS and its components in people with major psychiatric conditions.
Five studies incorporating 24,158 participants met the inclusion criteria. All five studies comprised patients with depression and/or anxiety. Three studies incorporating 3365 participants were suitable for the meta-analysis. The pooled Odds Ratio (OR) of MetS was 3.46 (95% Confidence Interval/CI = 1.39-8.62) in major depressive disorder (MDD) and anxiety disorders patients with concurrent SCH compared to those without SCH. Meta-analysis showed a significant positive association between SCH and high body mass index (OR = 2.58, 95%CI = 1.33-5.01), high fasting plasma glucose (OR = 3.05, 95%CI = 1.79-5.18) and low high-density lipoprotein cholesterol (OR = 2.30, 95%CI = 1.82-2.92).
These findings suggest a significant positive association between MetS and SCH in people with MDD and anxiety disorders. This review informed the clinical implications of MetS in MDD with comorbid SCH and the importance of early diagnosis and treatment for SCH and MetS in psychiatric patients.
本系统评价评估了亚临床甲状腺功能减退症(SCH)与代谢综合征(MetS)及其在患有主要精神疾病的人群中的特定 MetS 成分之间的关联。
进行了系统评价和荟萃分析,以评估 SCH 与主要精神疾病人群中的 MetS 及其成分之间的关联。
符合纳入标准的五项研究共纳入 24158 名参与者。这五项研究均包含抑郁和/或焦虑症患者。三项研究共纳入 3365 名参与者适合进行荟萃分析。与无 SCH 的患者相比,伴有并发 SCH 的重度抑郁症(MDD)和焦虑障碍患者的 MetS 总比值比(OR)为 3.46(95%置信区间/CI = 1.39-8.62)。荟萃分析显示,SCH 与高体重指数(OR = 2.58,95%CI = 1.33-5.01)、高空腹血糖(OR = 3.05,95%CI = 1.79-5.18)和低高密度脂蛋白胆固醇(OR = 2.30,95%CI = 1.82-2.92)呈显著正相关。
这些发现表明 MDD 和焦虑障碍患者中 MetS 与 SCH 之间存在显著正相关。本综述说明了 MDD 合并 SCH 时 MetS 的临床意义,以及对精神科患者中 SCH 和 MetS 的早期诊断和治疗的重要性。