Mariotti S, Barbesino G, Caturegli P, Bartalena L, Sansoni P, Fagnoni F, Monti D, Fagiolo U, Franceschi C, Pinchera A
Istituto di Endocrinologia, University of Pisa, Italy.
J Clin Endocrinol Metab. 1993 Nov;77(5):1130-4. doi: 10.1210/jcem.77.5.8077303.
Several changes in thyroid function have been described in the elderly and largely attributed to concomitant nonthyroidal illness. The extent to which aging per se contributes to these changes remains to be elucidated, and scanty data are available in extremely old subjects. The present study was designed to focus on thyroid function during physiological aging, taking advantage of two groups of selected aged individuals: group A of healthy centenarians (n = 41; age range, 100-110 yr) and group B including healthy elderly subjects selected by the criteria of the EURAGE SENIEUR protocol (n = 33; age range, 65-80 yr). Control groups included 98 healthy normal adult subjects (group C; age range, 20-64 yr) and 52 patients with miscellaneous nonthyroidal illness (group D; age range, 28-82 yr). Our previous report of a low prevalence of thyroid autoantibodies in centenarians was confirmed and extended by the finding of a similar low autoantibody prevalence in the highly selected healthy elderly population of group B. Subclinical primary hypothyroidism was found in 3 (7.3%) centenarians, and their data were excluded from further statistical evaluation. No significant difference was found in the median serum free T4 levels of groups A-C. Median (and range) serum free T3 (FT3) was lower in centenarians [3.67 pmol/L (2.3-5.5)] than in group B [5.22 pmol/L (3.4-6.1)] and group C [5.38 pmol/L (2.9-8.4); P < 0.0001 vs. both groups]. Similarly, the median serum TSH level of centenarians [0.97 mU/L (< 0.09 to 2.28)] was lower than those in groups B [1.17 mU/L (0.53-2.74)] and C [1.7 mU/L (0.4-4.8); P < 0.0001 vs. both groups]; moreover, serum TSH was also significantly (P < 0.01) lower in group B than in group C. Both serum FT3 and TSH concentrations showed a significant inverse correlation (r = -0.634; P < 0.0001 and r = -0.377; P < 0.0001, respectively) with age. Median serum FT3 in centenarians was lower than that in group D patients [4.61 pmol/L (2.15-6.6); P < 0.0001]. In contrast, median serum rT3 in centenarians [0.40 nmol/L (0.20-0.77)], although higher than those in groups B [0.24 nmol/L (0.15-0.37); P < 0.0001] and C [0.22 nmol/L (0.05-0.46); P < 0.0001], was significantly lower than that in group D [0.60 nmol/L (0.13-2.08); P < 0.0001]. In conclusion, thyroid function appears to be well preserved until the eighth decade of life if healthy subjects are studied, whereas a reduction of serum FT3 is observed in extreme aging.(ABSTRACT TRUNCATED AT 400 WORDS)
老年人甲状腺功能出现了一些变化，这些变化大多归因于同时存在的非甲状腺疾病。衰老本身对这些变化的影响程度尚待阐明，而且关于极年老人的数据很少。本研究旨在关注生理衰老过程中的甲状腺功能，利用两组选定的老年个体：A组为健康的百岁老人（n = 41；年龄范围100 - 110岁），B组包括根据EURAGE SENIEUR方案标准选定的健康老年受试者（n = 33；年龄范围65 - 80岁）。对照组包括98名健康正常成年人（C组；年龄范围20 - 64岁）和52名患有各种非甲状腺疾病的患者（D组；年龄范围28 - 82岁）。我们之前关于百岁老人甲状腺自身抗体低患病率的报告得到了证实，并通过在高度选定的B组健康老年人群中发现类似的低自身抗体患病率得以扩展。在3名（7.3%）百岁老人中发现了亚临床原发性甲状腺功能减退，他们的数据被排除在进一步的统计评估之外。A - C组血清游离T4水平中位数无显著差异。百岁老人血清游离T3（FT3）中位数[3.67 pmol/L（2.3 - 5.5）]低于B组[5.22 pmol/L（3.4 - 6.1）]和C组[5.38 pmol/L（2.9 - 8.4）；与两组相比P < 0.0001]。同样，百岁老人血清TSH水平中位数[0.97 mU/L（< 0.09至2.28）]低于B组[1.17 mU/L（0.53 - 2.74）]和C组[1.7 mU/L（0.4 - 4.8）；与两组相比P < 0.0001]；此外，B组血清TSH也显著低于C组（P < 0.01）。血清FT3和TSH浓度均与年龄呈显著负相关（分别为r = -0.634；P < 0.0001和r = -0.377；P < 0.0001）。百岁老人血清FT3中位数低于D组患者[4.61 pmol/L（2.15 - 6.6）；P < 0.0001]。相比之下，百岁老人血清反T3中位数[0.40 nmol/L（0.20 - 0.77）]虽然高于B组[0.24 nmol/L（0.15 - 0.37）；P < 0.0001]和C组[0.22 nmol/L（0.05 - 0.46）；P < 0.0001]，但显著低于D组[0.60 nmol/L（0.13 - 2.08）；P < 0.0001]。总之，如果研究的是健康受试者，甲状腺功能在生命的第八个十年之前似乎保存良好，而在极老龄时会观察到血清FT3降低。（摘要截断于400字）
