Li Zeyu, Mao Yu, Wen Xiaoyong, Chen Guangji, Zhou Shiwei
Department of Thyroid Surgery, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, Hunan, China.
Department of Thyroid Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
Front Public Health. 2025 Jul 7;13:1499070. doi: 10.3389/fpubh.2025.1499070. eCollection 2025.
Subclinical hypothyroidism (SCH) is a prevalent endocrine disorder associated with metabolic and cardiovascular risks. While physical activity (PA) is well recognized for its benefits on metabolic and cardiovascular health, its relationship with SCH remains unclear. This study aimed to examine the associations between different types, intensities, and frequencies of PA and SCH prevalence using nationally representative data from the U. S. National Health and Nutrition Examination Survey (NHANES).
Data from the 2007-2012 NHANES cycles were analyzed. Weighted univariate and multivariate logistic regression models were employed to assess the associations between PA and SCH prevalence. Curve fitting and threshold effect analyses were conducted to explore potential non-linear relationships, while subgroup analyses examined effect modifications by demographic and clinical factors.
Among 6,133 participants included in the final analysis (approximately 20.15% of the total NHANES sample), the prevalence of SCH was 2.5%. Individuals without SCH exhibited significantly higher total PA duration, particularly in occupational physical activity (OPA), vigorous physical activity (VPA), moderate-to-vigorous physical activity (MVPA), MVPA intensity, and weekly frequency of vigorous occupational physical activity (VOPA). In the fully adjusted model, each 10-h/week increase in VPA and MVPA was associated with 33% (OR = 0.67, 95% CI: 0.49-0.91) and 11% (OR = 0.89, 95% CI: 0.81-0.98) lower odds of SCH, respectively. A 10% increase in MVPA intensity was linked to an 8% reduction (OR = 0.92, 95% CI: 0.87-0.97). Similar inverse associations were found for PA and OPA (PA: OR = 0.90, 95% CI: 0.82-0.98; OPA: OR = 0.90, 95% CI: 0.81-0.99). Among PA frequency measures, only VOPA frequency was significant, with each additional session per week associated with a 17% reduction in odds (OR = 0.83, 95% CI: 0.74-0.94). Curve fitting analysis revealed a non-linear relationship between MVPA intensity and SCH prevalence, with a threshold at 57.14%. Below this threshold, higher MVPA intensity was associated with lower SCH prevalence ( = 0.001), whereas above this threshold, the association became non-significant. Subgroup analyses identified a significant interaction with age, where the protective effects of PA and OPA were significant only in individuals aged <60 years.
This study suggests that higher PA levels, particularly at greater intensities and frequencies, are associated with a lower prevalence of SCH, especially in individuals aged <60 years. These findings highlight the potential role of regular, high-intensity PA in reducing SCH risk.
亚临床甲状腺功能减退症（SCH）是一种常见的内分泌疾病，与代谢和心血管风险相关。虽然体育活动（PA）对代谢和心血管健康的益处已得到充分认可，但其与SCH的关系仍不明确。本研究旨在利用美国国家健康与营养检查调查（NHANES）的全国代表性数据，探讨不同类型、强度和频率的PA与SCH患病率之间的关联。
分析了2007 - 2012年NHANES周期的数据。采用加权单变量和多变量逻辑回归模型评估PA与SCH患病率之间的关联。进行曲线拟合和阈值效应分析以探索潜在的非线性关系，同时进行亚组分析以检验人口统计学和临床因素的效应修正。
在最终分析纳入的6133名参与者中（约占NHANES总样本的20.15%），SCH的患病率为2.5%。未患SCH的个体总PA时长显著更长，尤其是在职业体力活动（OPA）、剧烈体力活动（VPA）、中等至剧烈体力活动（MVPA）、MVPA强度以及每周剧烈职业体力活动（VOPA）频率方面。在完全调整模型中，VPA和MVPA每周每增加10小时，患SCH的几率分别降低33%（OR = 0.67，95% CI：0.49 - 0.91）和11%（OR = 0.89，95% CI：0.81 - 0.98）。MVPA强度每增加10%，患SCH的几率降低8%（OR = 0.92，95% CI：0.87 - 0.97）。PA和OPA也发现了类似的负相关（PA：OR = 0.90，95% CI：0.82 - 0.98；OPA：OR = 0.90，95% CI：0.81 - 0.99）。在PA频率测量中，只有VOPA频率具有显著意义，每周每增加一次VOPA，患SCH的几率降低17%（OR = 0.83，95% CI：0.74 - 0.94）。曲线拟合分析揭示了MVPA强度与SCH患病率之间的非线性关系，阈值为57.14%。低于此阈值，较高的MVPA强度与较低的SCH患病率相关（P = 0.001），而高于此阈值，该关联变得不显著。亚组分析确定了与年龄的显著交互作用，其中PA和OPA的保护作用仅在年龄< = 60岁的个体中显著。
本研究表明，较高水平的PA，特别是在更高强度和频率下，与较低的SCH患病率相关，尤其是在年龄< = 60岁的个体中。这些发现突出了规律、高强度PA在降低SCH风险方面的潜在作用。
