Ozbakir O, Doğukan A, Kelestimur F
Department of Internal Medicine, Eriyes University School of Medicine, Kayseri, Turkey.
Endocr J. 1995 Oct;42(5):713-6. doi: 10.1507/endocrj.42.713.
The prevalence of thyroid dysfunction in the elderly is reported to be markedly high, at least in some Western countries in which iodine intake is sufficient or increased because of recent supplementation of iodine for public health. We therefore wished to investigate the prevalence of thyroid dysfunction among elderly people in an endemic goiter area. The study included 198 subjects over the age of 55 years. It was carried out in two towns 20-30 km, south of Kayseri, Central Anatolia. Questioning on medical history, physical examination and grading of thyroid gland size were performed. Serum TSH was measured by a sensitive immunoradiometric assay. Serum free thyroid hormones and thyroid autoantibodies were measured in the subjects with TSH concentrations below 0.4 mu IU/ml or above 4.5 mu IU/ml on the initial screen. Drinking water was also analysed for iodine content. Twenty-five (12.6%) subjects had either elevated (6.5%) or suppressed (6.1%) serum TSH levels. No patient had clinical hypothyroidism (high TSH and low free thyroxine and free triiodothyronine). Three (1.5%) subjects had clinical hyperthyroidism (low TSH and high free thyroxine and free triiodothyronine). Only one subject was positive for antimicrosomal and antithyroglobulin antibodies. The prevalence of goiter was 25.8%. The iodine level in drinking water was found to be 3 micrograms/L. In conclusion, we believe that the prevalence of thyroid dysfunction in the elderly may depend on the iodine status in the environment. We think that hyperthyroidism due to multinodular goiter is more important than hypothyroidism for elderly people living in an endemic goiter area, probably due to the low frequency of autoimmune thyroid disorders.
据报道，老年人甲状腺功能障碍的患病率显著较高，至少在一些西方国家是这样，在这些国家，由于近期为公共卫生目的补充碘，碘摄入量充足或有所增加。因此，我们希望调查地方性甲状腺肿地区老年人甲状腺功能障碍的患病率。该研究纳入了198名55岁以上的受试者。研究在安纳托利亚中部开塞利以南20 - 30公里的两个城镇进行。进行了病史询问、体格检查以及甲状腺大小分级。采用灵敏的免疫放射分析方法测定血清促甲状腺激素（TSH）。对初次筛查时TSH浓度低于0.4 μIU/ml或高于4.5 μIU/ml的受试者测定血清游离甲状腺激素和甲状腺自身抗体。还分析了饮用水中的碘含量。25名（12.6%）受试者的血清TSH水平升高（6.5%）或降低（6.1%）。没有患者出现临床甲状腺功能减退（TSH升高且游离甲状腺素和游离三碘甲状腺原氨酸降低）。3名（1.5%）受试者出现临床甲状腺功能亢进（TSH降低且游离甲状腺素和游离三碘甲状腺原氨酸升高）。只有一名受试者抗微粒体抗体和抗甲状腺球蛋白抗体呈阳性。甲状腺肿的患病率为25.8%。饮用水中的碘含量为3微克/升。总之，我们认为老年人甲状腺功能障碍的患病率可能取决于环境中的碘状况。我们认为，对于生活在地方性甲状腺肿地区的老年人来说，多结节性甲状腺肿所致的甲状腺功能亢进比甲状腺功能减退更为重要，这可能是由于自身免疫性甲状腺疾病的发生率较低。
