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目的:探讨不同性别甲状腺功能正常人群促甲状腺素(TSH)与代谢综合征(MS)的关系,为防治提供临床依据。方法 :采用横断面研究,选取甲状腺功能正常者10 842例,男7 250例,女3 592例,测量身高、体重、血糖、收缩压(SBP)、舒张压(DBP)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、尿酸(UA)、尿素氮(BUN)、肌酐(SCr)及甲状腺功能,计算体重指数(BMI)及预估肾小球滤过率(eGFR),分析TSH与MS的关系。结果:男、女MS患病率分别为20.1%、9.4%,MS组TSH水平均显著高于非MS组(男P=0.049,女P=0.009)。不同性别人群的TSH按四分位数分组,随着TSH的增加,MS的患病率升高,且符合MS诊断标准的项目数也显著增加(男P=0.05,女P<0.01)。在男性TSH,与年龄、SBP、UA、TG、SCr呈正相关,与HDL-C、eGFR呈负相关;在女性,TSH与年龄、SBP、DBP、UA、TG、LDL-C、TC、SCr、BMI呈正相关,与HDL-C、eGFR呈负相关。Logistic回归分析,校正年龄、尿酸、血糖、血脂后,男性TSH是MS的独立危险因素(P=0.043)。结论:在甲状腺功能正常的人群,尤其是男性人群中,TSH水平升高可能增加MS的患病风险,进而增加心血管疾病的发生风险。
Objective: To investigate the relationship between thyroid-stimulating hormone (TSH) and metabolic syndrome (MS) in different genders of thyroid function normal population and to provide a clinical basis for prevention and treatment. Methods: A total of 10 842 patients with normal thyroid function, 7 250 men and 3 592 women were enrolled in this study. Height, weight, blood glucose, systolic blood pressure (SBP), diastolic blood pressure (DBP) and total cholesterol (TC) (TG), LDL-C, HDL-C, UA, BUN, SCr and thyroid function were calculated. Body mass index (BMI) and estimated glomerular filtration rate (eGFR), analyze the relationship between TSH and MS. Results: The prevalence rates of MS in males and females were 20.1% and 9.4%, respectively. TSH levels in MS group were significantly higher than those in non-MS group (P = 0.049, P = 0.009). The TSH of different sex groups were divided into quartiles. With the increase of TSH, the prevalence of MS increased, and the number of items meeting the MS diagnostic criteria also increased significantly (P = 0.05 for males and P <0.01 for females). In women, TSH was positively correlated with age, SBP, UA, TG and SCr, and negatively correlated with HDL-C and eGFR. In women, TSH was positively correlated with age, SBP, DBP, UA, TG, LDL- BMI was positively correlated with HDL-C, eGFR was negatively correlated. Logistic regression analysis showed that male TSH was an independent risk factor for MS after adjusting for age, uric acid, blood glucose, and lipids (P = 0.043). CONCLUSIONS: TSH levels may increase the prevalence of MS in patients with normal thyroid function, especially in the male population, thus increasing the risk of cardiovascular disease.