慢性阻塞性肺疾病中甲状腺功能障碍的患病率及临床特征：一项系统评价和荟萃分析。
Prevalence and clinical characterisation of thyroid dysfunction in COPD: a systematic review and meta-analysis.
作者信息
Wu Ling, He Li, Hu Xiaorong, Zhang Hanqiong, He Zeming, Huang Xiaotao, Li Caihong, Zhang Yong
机构信息
Department of Respiratory and Critical Care Medicine, The First People's Hospital of Shuangliu District, Chengdu, Sichuan, China.
Department of Thoracic Surgery, The First People's Hospital of Shuangliu District, Chengdu, Sichuan, China.
出版信息
Front Med (Lausanne). 2025 Apr 30;12:1571165. doi: 10.3389/fmed.2025.1571165. eCollection 2025.
BACKGROUND
The prevalence of COPD is increasing annually, accompanied by a growing number of complications and organ function abnormalities. Thyroid dysfunction is prevalent among patients with chronic obstructive pulmonary disease (COPD). Updated evidence is needed to complement previous systematic reviews on this topic to provide best practice.
METHODS
The EMBASE, Web of Science, Cochrane and PubMed databases were searched for articles containing the keywords "COPD" and "thyroid dysfunction" (PROSPERO CRD42024592606). Eligibility screening, data extraction and quality assessment of retrieved articles were performed independently by two reviewers. Meta-analyses were performed to determine the prevalence of thyroid dysfunction in patients with COPD. Regression analyses were used to explore sources of heterogeneity. The clinical features of COPD combined with thyroid dysfunction were clarified by comparing the age, sex (percentage of males), BMI, smoking index, Forced Vital Capacity (FVC%), Forced Expiratory Volume in One Second (FEV1%), partial pressure of oxygen (PaO2), partial pressure of carbon dioxide (PaCO2), and albumin in patients with and without thyroid dysfunction. The differences in the prevalence of thyroid dysfunction between stable and acute exacerbations in COPD were also compared.
RESULTS
Twelve studies were included, with an overall prevalence of 42.1% (95% CI, 31.8-52.9). The most common type of thyroid dysfunction in COPD was non-thyroidal illness syndrome (NTIS) in 45.3% (95% CI, 22.3-68.3). There was no difference in the prevalence of dysfunctions between stable and acute exacerbations of COPD. Patients in the thyroid dysfunction group in COPD had lower PCO2 and albumin and higher FEV1%.
CONCLUSION
Thyroid dysfunction has a high prevalence among patients with COPD, with NTIS being the most common. Thyroid dysfunction in COPD may affect lung function and lead to decreased albumin. Patients with COPD should be screened for thyroid function, and attention should be paid to the clinical features of this group of patients with thyroid dysfunction to facilitate better identification and management.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/PROSPERO/myprospero, PROSPERO ID (CRD42024592606).
背景
慢性阻塞性肺疾病（COPD）的患病率逐年上升，并发症和器官功能异常的数量也在增加。甲状腺功能障碍在慢性阻塞性肺疾病（COPD）患者中很常见。需要更新证据以补充之前关于该主题的系统评价，从而提供最佳实践。
方法
在EMBASE、Web of Science、Cochrane和PubMed数据库中检索包含关键词“COPD”和“甲状腺功能障碍”的文章（PROSPERO注册号：CRD42024592606）。由两名评审员独立进行检索文章的资格筛选、数据提取和质量评估。进行荟萃分析以确定COPD患者甲状腺功能障碍的患病率。采用回归分析探索异质性来源。通过比较有无甲状腺功能障碍患者的年龄、性别（男性百分比）、体重指数、吸烟指数、用力肺活量（FVC%）、一秒用力呼气量（FEV1%）、氧分压（PaO2）、二氧化碳分压（PaCO2）和白蛋白，明确COPD合并甲状腺功能障碍的临床特征。还比较了COPD稳定期和急性加重期甲状腺功能障碍患病率的差异。
结果
纳入12项研究，总体患病率为42.1%（95%CI，31.8 - 52.9）。COPD中最常见的甲状腺功能障碍类型是非甲状腺疾病综合征（NTIS），占45.3%（95%CI，22.3 - 68.3）。COPD稳定期和急性加重期功能障碍的患病率无差异。COPD甲状腺功能障碍组患者的PCO2和白蛋白较低，FEV1%较高。
结论
甲状腺功能障碍在COPD患者中患病率较高，NTIS最为常见。COPD中的甲状腺功能障碍可能影响肺功能并导致白蛋白降低。应对COPD患者进行甲状腺功能筛查，并关注这组甲状腺功能障碍患者的临床特征，以便更好地识别和管理。
系统评价注册
https://www.crd.york.ac.uk/PROSPERO/myprospero，PROSPERO编号（CRD42024592606）
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