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甲状腺功能障碍与不同类型痴呆症的风险:系统评价和荟萃分析。

Thyroid dysfunction and risk of different types of dementia: A systematic review and meta-analysis.

机构信息

Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.

出版信息

Medicine (Baltimore). 2024 Aug 23;103(34):e39394. doi: 10.1097/MD.0000000000039394.

Abstract

BACKGROUND

The impact of thyroid function on the risk of various types of dementia, including Alzheimer's disease (AD) and vascular dementia (VD), remains unclear. This meta-analysis investigates the association between thyroid dysfunction and the risk of these dementia types, aiming to inform strategies for dementia prevention.

METHODS

A comprehensive search was conducted in PubMed, Embase, and the Cochrane Library for studies published up to February 2023, focusing on the risk of thyroid dysfunction in dementia. We excluded duplicates, studies without full text, those with incomplete data, animal studies, case reports, and reviews. Data analysis was performed using STATA 15.1 software.

RESULTS

Our analysis indicated that overt hyperthyroidism significantly increases the risk of all studied dementia types (OR = 1.18, 95% CI: 1.04-1.35). In contrast, overt hypothyroidism was associated with a decreased risk of AD (OR = 0.73, 95% CI: 0.55-0.98) and VD (OR = 0.71, 95% CI: 0.62-0.82). Subclinical hyperthyroidism also showed a significant association with an increased risk of any dementia (OR = 1.26, 95% CI: 1.09-1.46) and specifically VD (OR = 6.70; 95% CI: 1.38-32.58).

CONCLUSION

This study suggests that overt hypothyroidism may reduce the risk of dementia, including AD and VD, whereas overt and subclinical hyperthyroidism are linked to an increased risk. These findings highlight the importance of monitoring thyroid function as a preventative measure against dementia.

摘要

背景

甲状腺功能对各种类型痴呆症(包括阿尔茨海默病[AD]和血管性痴呆[VD])风险的影响尚不清楚。本荟萃分析旨在探讨甲状腺功能障碍与这些痴呆类型风险之间的关联,为痴呆症预防策略提供信息。

方法

系统检索了PubMed、Embase 和 Cochrane Library 中截至 2023 年 2 月发表的关于甲状腺功能障碍与痴呆风险的研究,排除重复文献、无法获取全文的文献、数据不完整的文献、动物研究、病例报告和综述。采用 STATA 15.1 软件进行数据分析。

结果

分析表明,显性甲状腺功能亢进显著增加所有研究的痴呆类型的风险(OR=1.18,95%CI:1.04-1.35)。相反,显性甲状腺功能减退与 AD(OR=0.73,95%CI:0.55-0.98)和 VD(OR=0.71,95%CI:0.62-0.82)的风险降低相关。亚临床甲状腺功能亢进也与任何痴呆症(OR=1.26,95%CI:1.09-1.46)和特定的 VD(OR=6.70;95%CI:1.38-32.58)风险增加显著相关。

结论

本研究表明,显性甲状腺功能减退可能降低痴呆症(包括 AD 和 VD)的风险,而显性和亚临床甲状腺功能亢进与风险增加相关。这些发现强调了监测甲状腺功能作为预防痴呆症的重要措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99e4/11346895/644b0550084f/medi-103-e39394-g001.jpg

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