高碘地区老年人群甲状腺疾病与血脂紊乱的横断面调查研究

A cross-sectional study of thyroid disease and dyslipidemia in elderly people in iodine excessive areas

摘要:

目的： 调查高碘地区老年人群甲状腺疾病的患病率，分析促甲状腺激素（thyroid stimulating hormone，TSH）水平与血脂紊乱患病率的相关性。方法： 筛选该地区65岁及以上老年人258人，根据年龄分为3组（65~69岁组、70~74岁组和≥75岁组）。每位受试者都完成问卷调查、体格检查、甲状腺超声检查和甲状腺功能检测。采用卡方检验比较各个年龄组老年人甲状腺功能异常及结节的患病率和不同TSH水平下血脂紊乱的患病率。使用斯皮尔曼相关分析年龄与TSH之间的相关性，采用简单线性回归建立回归方程。结果： 老年人群的中位尿碘浓度为397.60（225.58，647.73）μg/L，甲状腺疾病的总患病率为48.84%（126/258）。其中，甲状腺功能异常和甲状腺结节的患病率均为24.42%（63/258），亚临床甲状腺功能减退症为最常见的甲状腺功能异常，患病率为22.48%（58/258），且随着年龄增加逐渐升高（P<0.01）。年龄与TSH水平呈正相关（相关系数为0.31，P<0.001）。随着TSH水平的逐渐升高，高总胆固醇（total cholesterol，TC）血症（P=0.020）、低高密度脂蛋白胆固醇血症（P=0.010）及高低密度脂蛋白胆固醇（low density lipoprotein cholesterin，LDL-C）血症（P<0.01）的患病率逐渐升高，当TSH水平≥10 mU/L时，高TC血症和高LDL-C血症的患病率均高达66.67%（4/6）。结论： 高碘地区老年人群甲状腺疾病患病率较高，以亚临床甲状腺功能减退症和甲状腺结节为主。TSH水平随年龄增加呈逐渐升高趋势。随TSH水平逐渐升高，老年人血脂紊乱的患病率逐步攀升，以高TC血症和高LDL-C血症常见。

Abstract:

Objective: To investigate the prevalence of thyroid diseases, and analyze the level of thyroid stimulating hormone (TSH) and the prevalence of dyslipidemia in elderly people in iodine excessive areas. Methods: A total of 258 elderly people aged 65 and above were selected and divided into three groups according to age (65-69 years old, 70-74 years old and≥75 years old) . Each subject completed a questionnaire, physical examination, thyroid ultrasound and thyroid function test. Chi-square test was used to compare the prevalence of thyroid dysfunction and nodules and the prevalence of dyslipidemia under different TSH levels. Spearman correlation was used to analyze the correlation between age and TSH, and simple linear regression was used to establish the regression equation. Results: The median urinary iodine concentration level of the elderly was 397.60 (225.58, 647.73) μg/L, and the total prevalence of thyroid diseases was 48.84% (126/258) . Among them, the prevalence of thyroid dysfunction and thyroid nodule were 24.42% (63/258) , and subclinical hypothyroidism was the most common thyroid dysfunction, with the prevalence of 22.48% (58/258) , and gradually increased with age (P<0.01) . Age was positively correlated with TSH level (correlation coefficient=0.31, P<0.001) . With the gradual increase of TSH level, the prevalence of high total cholesterol (TC) (P=0.020) , low high density lipoprotein cholesterin (P=0.010) and low density lipoprotein cholesterin (LDL-C) (P<0.01) gradually increased. When TSH level≥10 mU/L, the prevalence of high TC and high LDL-C were up to 66.67% (4/6) . Conclusion: Subclinical hypothyroidism and thyroid nodules are the main thyroid diseases in the elderly in iodine excessive areas. TSH level increases gradually with age. With the gradual increase of TSH level, the prevalence of dyslipidemia in the elderly gradually increase, with high TC and high LDL-C being the most common.