Pop V J, Maartens L H, Leusink G, van Son M J, Knottnerus A A, Ward A M, Metcalfe R, Weetman A P
Department of Social and Behavioral Sciences, University of Tilburg, The Netherlands.
J Clin Endocrinol Metab. 1998 Sep;83(9):3194-7. doi: 10.1210/jcem.83.9.5131.
The objective of this study was to examine the relationship between autoimmune thyroid disease and depression in perimenopausal women. Thyroid function [TSH, free T4, and thyroid peroxidase antibodies (TPO-Ab)] and depression (using the Edinburgh Depression Scale) were assessed cross-sectionally together with other determinants of depression. The subjects were 583 randomly selected perimenopausal women (aged 47-54 yr) from a community cohort of 6846 women. The main outcome measures were the occurrence of thyroid dysfunction (abnormal free T4 and/or TSH or elevated levels of TPO-Ab) and the concomitant presence of depression according to the Edinburgh Depression Scale. Neither biochemical thyroid dysfunction nor menopausal status was related to depression. Apart from several psycho-social determinants (the occurrence of a major life event, a previous episode of depression, or financial problems), an elevated level of TPO-Ab (> or = 100 U/mL) was significantly associated with depression (odds ratio, 3.0, 95% confidence interval, 1.3-6.8). We conclude that women with elevated TPO-Ab levels are especially vulnerable to depression, whereas postmenopausal status does not increase the risk of depression.
本研究的目的是探讨围绝经期女性自身免疫性甲状腺疾病与抑郁症之间的关系。对甲状腺功能[促甲状腺激素(TSH)、游离甲状腺素(free T4)和甲状腺过氧化物酶抗体(TPO-Ab)]以及抑郁症(采用爱丁堡抑郁量表)进行横断面评估,并同时评估其他抑郁症的决定因素。研究对象为从6846名女性的社区队列中随机选取的583名围绝经期女性(年龄47 - 54岁)。主要观察指标为甲状腺功能障碍的发生情况(游离T4和/或TSH异常或TPO-Ab水平升高)以及根据爱丁堡抑郁量表判断的抑郁症的并发情况。甲状腺生化功能障碍和绝经状态均与抑郁症无关。除了一些心理社会决定因素(重大生活事件的发生、既往抑郁症发作或经济问题)外,TPO-Ab水平升高(≥100 U/mL)与抑郁症显著相关(比值比为3.0,95%置信区间为1.3 - 6.8)。我们得出结论,TPO-Ab水平升高的女性尤其易患抑郁症,而绝经后状态并不会增加患抑郁症的风险。