1999 - 2000年美国国家健康与营养检查调查中感染、血清促甲状腺激素和甲状腺素之间的关联。
Association between infection, serum thyroid-stimulating hormone, and thyroxine in the National Health and Nutrition Examination Survey 1999-2000.
作者信息
Lu Ting, Lu Shunshun, Lin Jieqiong, Shao Xiaona, Chen Dahua, Shen Jianwei
机构信息
Department of Gastroenterology, Ningbo Medical Center Lihuili Hospital, Ningbo, ZheJiang, China.
Department of Hospital-Acquired Infection Control, Ningbo Medical Center Lihuili Hospital, Ningbo, ZheJiang, China.
出版信息
Front Endocrinol (Lausanne). 2025 Feb 3;16:1482073. doi: 10.3389/fendo.2025.1482073. eCollection 2025.
BACKGROUND
has been increasingly implicated in extra-gastric diseases. Current evidence regarding the association between serum thyroid-stimulating hormone (TSH), thyroxine (T4), and infection remains inconclusive. Consequently, this study aimed to explore the correlation between TSH and T4 levels and infection in a US-based population sample.
METHODS
Data from the US National Health and Nutrition Examination Survey (NHANES), comprising 971 participants aged 30-85 years from 1999 to 2000, were analyzed. Binary logistic regression was employed to analyze the correlation between and TSH and T4 levels. The impact of TSH and T4 on infection was further assessed using restricted cubic spline (RCS) analysis. In addition, subgroup analyses stratified by sex and age were conducted.
RESULTS
Subjects with seropositivity demonstrated lower serum TSH levels and higher serum T4 levels compared to those with seronegativity. A significant positive correlation was identified between seropositivity and T4 levels with increasing quartiles of hormonal levels in both univariate regression models (Q4 vs. Q1: OR = 1.483; 95% CI, 1.033-2.129) and multivariate regression models (Q4 vs. Q1: OR = 1.004; 95% CI, 0.981-1.026). Conversely, a negative correlation was observed between seropositivity and TSH levels with increasing quartiles of hormonal levels in univariate regression models (Q4 vs. Q1: OR = 0.579; 95% CI, 0.403-0.831) and in multivariate regression models (Q4 vs. Q1: OR = 0.580; 95% CI, 0.389-0.866). In stratified analyses, the adjusted association of serum T4 levels with seropositivity was statistically significant among men (T4: Q4 vs. Q1: OR = 2.253; 95% CI, 1.311-3.873), age over 68 years in TSH levels (Q4 vs. Q1: OR = 0.434; 95% CI, 0.206-0.911), and age 41-54 years in T4 levels (Q4 vs. Q1: OR = 4.965; 95% CI, 2.071-11.903). RCS analysis revealed a non-linear relationship between TSH levels and infection. Notably, when TSH < 0.98 IU/ml, the likelihood of infection significantly increased.
CONCLUSIONS
Lower TSH and higher T4 levels were associated with infection, particularly among men and elderly individuals.
背景
[疾病名称]越来越多地与胃外疾病相关。目前关于血清促甲状腺激素（TSH）、甲状腺素（T4）与[疾病名称]感染之间关联的证据尚无定论。因此，本研究旨在探讨美国人群样本中TSH和T4水平与[疾病名称]感染之间的相关性。
方法
分析了美国国家健康与营养检查调查（NHANES）1999年至2000年期间971名年龄在30 - 85岁参与者的数据。采用二元逻辑回归分析[疾病名称]与TSH和T4水平之间的相关性。使用受限立方样条（RCS）分析进一步评估TSH和T4对[疾病名称]感染的影响。此外，还进行了按性别和年龄分层的亚组分析。
结果
与[疾病名称]血清学阴性者相比，[疾病名称]血清学阳性者的血清TSH水平较低，血清T4水平较高。在单变量回归模型（四分位数4 vs. 四分位数1：OR = 1.483；95% CI，1.033 - 2.129）和多变量回归模型（四分位数4 vs. 四分位数1：OR = 1.004；95% CI，0.981 - 1.026）中，随着激素水平四分位数的增加，[疾病名称]血清学阳性与T4水平之间均存在显著正相关。相反，在单变量回归模型（四分位数4 vs. 四分位数1：OR = 0.579；95% CI，0.403 - 0.831）和多变量回归模型（四分位数4 vs. 四分位数1：OR = 0.580；95% CI，0.389 - 0.866）中，随着激素水平四分位数的增加，[疾病名称]血清学阳性与TSH水平之间呈负相关。在分层分析中，血清T4水平与[疾病名称]血清学阳性的校正关联在男性中具有统计学意义（T4：四分位数4 vs. 四分位数1：OR = 2.253；95% CI，1.311 - 3.873），在TSH水平方面，68岁以上年龄组（四分位数4 vs. 四分位数1：OR = 0.434；95% CI，0.206 - 0.911），以及在T4水平方面，41 - 54岁年龄组（四分位数4 vs. 四分位数1：OR = 4.965；95% CI，2.071 - 11.903）。RCS分析显示TSH水平与[疾病名称]感染之间存在非线性关系。值得注意的是，当TSH < 0.98 IU/ml时，[疾病名称]感染可能性显著增加。
结论
较低的TSH和较高的T4水平与[疾病名称]感染相关，尤其是在男性和老年人中。
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