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[50至80岁患者甲状腺功能障碍的患病率。西南部某社区的一项流行病学横断面研究]

[Prevalence of thyroid gland dysfunctions in 50- to 80-year-old patients. An epidemiologic cross-sectional study in a southwestern community].

作者信息

Seck T, Scheidt-Nave C, Ziegler R, Pfeilschifter J

机构信息

Abteilung Innere Medizin I, Endokrinologie und Stoffwechsel, Medizinische, Universitätsklinik Heidelberg.

出版信息

Med Klin (Munich). 1997 Nov 15;92(11):642-6. doi: 10.1007/BF03044819.

Abstract

BACKGROUND

Thyroid dysfunctions in the elderly are common in iodine deficient Germany. However, the exact prevalence of hypo- and hyperthyroidism is unknown and differs according to the composition of the screened population. In this study we examined the prevalence of thyroid disorders in a population based sample of non-hospitalized elderly people living in a community in southwestern Germany.

PATIENTS AND METHODS

In the context of an epidemiological study on the prevalence of osteoporosis and associated factors, 288 men and 271 women between the age of 50 and 80 years were screened for plasma levels of thyreotropin, free T3 and free T4. Participants received an interview on medical conditions including a history on thyroid disorders.

RESULTS

6.7% of the women and 1.7% of the men had a history of thyroid surgery. Manifest or treated hyperthyroidism was observed in 3.5% of the women (n = 10) and 0.7% of the men (n = 2). In 2 of 12 patients with manifest hyperthyroidism the condition was previously unknown. 70- to 80-year old women tended to have a higher prevalence of hyperthyroidism (6.3%) than 50- to 59-year old women (2.9%), or 60- to 69-year old women (3.4%). Subclinical hyperthyroidism was observed in 7.3% of the men (n = 21) and 5.9% of the women (n = 16). We observed no cases of over hypothyroidism in men but in 1.8% of the women (n = 5). Four of 5 manifest states of hypothyroidism were previously unknown.

CONCLUSION

The prevalence of thyroid dysfunction in older women and men living in southwestern Germany is high. In view of the often nonspecific clinical symptoms of hypo- and hyperthyroidism in elderly individuals, thyroid disorders should be early included to the list of the differential diagnosis of clinical complaints in this age group.

摘要

背景

在缺碘的德国,老年人甲状腺功能障碍很常见。然而,甲状腺功能减退和亢进的确切患病率尚不清楚,且因筛查人群的构成不同而有所差异。在本研究中,我们调查了德国西南部一个社区非住院老年人的甲状腺疾病患病率。

患者与方法

在一项关于骨质疏松症患病率及相关因素的流行病学研究中,对288名年龄在50至80岁之间的男性和271名女性进行了促甲状腺激素、游离T3和游离T4血浆水平的筛查。参与者接受了包括甲状腺疾病史在内的医疗状况访谈。

结果

6.7%的女性和1.7%的男性有甲状腺手术史。3.5%的女性(n = 10)和0.7%的男性(n = 2)观察到显性或已治疗的甲状腺功能亢进。在12例显性甲状腺功能亢进患者中,有2例之前病情未知。70至80岁的女性甲状腺功能亢进患病率(6.3%)往往高于50至59岁的女性(2.9%)或60至69岁的女性(3.4%)。7.3%的男性(n = 21)和5.9%的女性(n = 16)观察到亚临床甲状腺功能亢进。男性未观察到甲状腺功能减退病例,但女性中有1.8%(n = 5)出现。5例显性甲状腺功能减退中有4例之前病情未知。

结论

生活在德国西南部的老年女性和男性中,甲状腺功能障碍的患病率较高。鉴于老年人甲状腺功能减退和亢进的临床症状通常不具有特异性,甲状腺疾病应尽早列入该年龄组临床主诉的鉴别诊断清单。

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