太原地区健康体检人群甲状腺功能紊乱患病情况调查

目的　调查太原地区人群中甲状腺功能紊乱的患病率。方法　测定太原地区 812 5名体检人群的TSH ,然后再测定FT3、FT4 和甲状腺抗体。结果　在此体检人群中 ,甲状腺功能亢进(甲亢 )患病率为 1.2 0 % ,亚临床甲亢患病率为 0 .87% ,甲状腺功能减退 (甲减 )患病率为 1.0 3 % ,亚临床甲减患病率为 0 .95 %。各种甲状腺功能紊乱的患病率女性均高于男性 (P <0 .0 5～ <0 .0 1)。结论　报道太原地区人群中甲状腺功能紊乱的患病率 ,无论是甲亢和亚临床甲亢或甲减和亚临床甲减 ,女性的患病率均高于男性     

高尿酸血症与甲状腺功能异常关系的相关性研究

目的 探讨高尿酸血症与甲状腺功能异常的关系.方法 调查10 405名21～89岁某石化企业员工人群,询问甲状腺疾病的手术、药物治疗史,检测血促甲状腺素(TSH)、游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FV3)和血尿酸(SUA).结果 ①该人群中高尿酸血症总患病率17.9%,男性22.6%,女性7.1%.②甲状腺疾病总体知晓率1.7%,男性0.9%,女性3.5%.③10 232名否认甲状腺疾病史者中,甲状腺功能异常总患病率4.2%,男性2.9%,其中TSH降低者0.4%,TSH升高者2.5%;女性7.2%,其中TSH降低者0.9%,TSH升高者6.3%.④与TSH正常组相比,不论性别,TSH升高组的血尿酸均显著升高(P<0.05),aSH降低组的血尿酸无显著变化.⑤TSH升高是高尿酸血症的独立影响因素(OR值男性为1.61、女性为1.72,P<0.01).结论 高尿酸血症患病率与TSH升高显著相关,临床或亚临床甲状腺功能减退症可能是高尿酸血症的危险因素.     

甲状腺功能异常与代谢综合征组分关系的流行病学研究

目的 探讨甲状腺功能异常与代谢综合征及其各组分的关系.方法 调查10 461名年龄20～90岁的宁波市某石化企业在职和退休员工人群,测定其体重指数、腰围、血压、空腹血糖、血脂谱和甲状腺功能.采用2005年国际糖尿病联盟(IDF)标准诊断代谢综合征.结果 (1)该企业员工甲状腺功能异常和代谢综合征的患病率分别为4.6％和10.2％;(2)有18.1％的员工存在腰围超标并含至少1项代谢异常;(3)TSH降低、正常和升高3组间代谢综合征的患病率差异无统计学意义;(4)代谢综合征5项组分中,经logistic回归分析显示降低的高密度脂蛋白胆固醇(HDL-C)与TSH降低有关(OR=0.313,95％ CI0.184 ～0.530),高甘油三酯与TSH升高有关(OR=0.767,95％CI0.595～0.991);(5)进一步分析TSH水平与血脂谱的关系,男性仅总胆固醇和HDL-C随TSH降低而降低;女性除载脂蛋白(Al)外,总胆固醇、低密度脂蛋白胆固醇、甘油三酯、载脂蛋白B随TSH升高而逐渐升高,HDL-C在TSH异常组均显著降低.结论 甲状腺功能异常与代谢综合征之间未见有显著相关性.甲状腺功能对于代谢综合征各组分的影响,主要表现为血脂谱改变.     

2型糖尿病合并甲状腺功能异常的临床分析

目的 探讨T2DM合并甲状腺疾病的患病情况及临床特点. 方法 回顾性分析420例住院T2DM患者甲状腺功能相关指标及临床资料. 结果 （1）T2DM患者甲状腺疾病患病率16.67％;甲状腺功能异常患病率15.71％.甲状腺功能异常患病率甲亢组3.57％,甲减组8.10％,低T3综合征组4.05％.甲减组中,亚临床甲减甲状腺功能异常患病率（4.52％）最高,女性甲状腺疾病及甲状腺功能异常的患病率均高于男性（P＜0.05）.（2）与T2DM组相比,T2DM合并甲状腺疾病组病程及胰岛素泵治疗时间增加,C-P120min水平降低;两组UAlb 30～299 mg/24 h差异有统计学意义（P＜0.01）.（3）甲亢组DPN患病率最高,低T3组年龄最大,且合并冠心病史发生率最高（P＜0.05）. 结论 T2DM合并甲状腺疾病患病率较高,甲状腺功能异常表现形式多样,对T2DM患者进行早期甲状腺功能的筛查具有临床意义.     

江苏地区甲状腺功能减退症流行现状调查

目的 研究江苏地区社区人群甲状腺功能减退症(甲减)的流行病学特点.方法 采用逐级分层整群抽样方法抽取江苏地区城乡6层样本,调查对象为≥20岁的常住(≥5年)居民,采集空腹静脉血标本7 122份,以固相化学发光酶免疫分析法(ICMA法)检测sTSH,对于sTSH在正常范围外的人群,检测FT33、FT4.结果 (1)江苏地区调查对象临床甲减粗患病率为0.66%,标化患病率为0.43%;亚临床甲减的粗患病率为7.53%,标化患病率为6.28%.(2)女性临床甲减和亚临床甲减的患病率均明显高于男性(均P<0.05).(3)随年龄增长,男性和女性亚临床甲减的患病率显著升高(P<0.05).结论 与临床甲减相比,江苏地区社区人群亚临床甲减的患病率明显升高,应加强对其随访和早期诊治.     

徐州矿区亚临床甲状腺疾病的流行特征及分析

目的了解徐州矿区人群亚临床甲状腺疾病的患病率及流行特征。方法采用分层随机整群抽样方法调查徐州矿区加岁及20岁以上的常住（〉5年）居民共468人（男127人,女341人）,进行问卷调查、体格检查、甲状腺B超检查和功能检测。结果徐州矿区成人总人群、男性及女性亚临床甲状腺疾病的粗患病率分别为52．14％、37．01％和57．77％,甲状腺结节、亚临床甲状腺功能亢进和亚临床甲状腺功能减退的患病率分别为25．00％、4．06％和23．08％,亚临床甲状腺疾病的患病率随年龄的增加呈现上升趋势。结论徐州矿区成年人群亚临床甲状腺疾病患病率较高,应重视对矿区人群亚临床甲状腺疾病的筛查、治疗和随访。     

马鞍山地区糖尿病患者合并甲状腺疾病的调查

调查2009年10月至2011年6月于十七冶医院就诊的423例糖尿病患者的甲状腺功能,其中299例患者作了甲状腺超声检查。结果 (1)糖尿病患者合并甲状腺疾病的患病率为43.27%,其中甲状腺功能减退者占26.36%(临床甲减8.55%,亚临床甲减18.11%),甲状腺功能亢进者16.91%(临床甲亢10.61%,亚临床甲亢6.30%),低T3综合征者6.11%。(2)糖尿病患者中甲状腺疾病患病率女性高于男性,差异有统计学意义(P<0.05)。结论糖尿病与甲状腺疾病均是常见的内分泌代谢性疾病,二者并存并非少见,有时症状叠加互相影响,甲状腺疾病可加速糖尿病的进程,促进某些慢性并发症的发生;对于糖尿病合并甲状腺疾病患者应两病兼治。     

2056例成人甲状腺功能及其自身抗体分析

目的　探讨亚临床甲状腺功能异常的早期诊断和确定筛查对象 ,分析一般人群中TSH、甲状腺自身抗体 (TAA)、年龄和性别间的关系。方法　对西安地区某单位全体职工 2 0 5 6人进行血清TSH、总甲状腺素 (TT4)、总三碘甲酰原氨酸 (TT3 )、甲状腺球蛋白抗体 (TGAb)和甲状腺微粒体抗体 (TMAb) 5项指标检测 ,排除甲状腺疾病家族史、怀孕、服用性激素及锂剂等影响因素后确定亚临床甲状腺功能异常的患病率。结果　未诊断组中 (即研究总体中去除有甲状腺疾病史和家族史、怀孕、服用性激素、锂剂等药物者 )甲减患病率为 8.0 % ,甲亢患病率为 6.0 % ,其中 95 %以上为亚临床甲状腺功能异常。TSH值随年龄增长而增高 ;60～ 69岁组TSH值达峰 ,女性和男性的TSH值中位数分别达 2 .47mU /L和 3 .3 1mU/L ;TSH值性别间差异不显著。TSH值明显异常时 (TSH≥ 10mU /L或≤ 0 .13mU/L) ,仅有 <2 0 %个体TT3和 (或 )TT4值超出正常值。TAA阳性存在明显的性别间差异 ,女性较高 (P <0 .0 5 ) ,但各年龄组间分布较一致。TAA阳性率与TSH值有相关性 ,当TSH值明显异常时TAA阳性率也显著增高。结论　一般成年人群中亚临床甲状腺功能异常的患病率较高 ,应重视亚临床甲状腺功能异常的早期诊断和防治。     

249名老年人中甲状腺疾病的发生及转归临床分析

目的研究老年人甲状腺疾病的患病率和发生发展特点。方法249例来自我国辽宁省、河北省的老年人(男102名,女147名;年龄60~88岁)参加了1999年的横断面调查,5年后进行了随访。初访和随访时均测定血清促甲状腺激素(TSH)、甲状腺过氧化物酶抗体(TPOAb)和甲状腺球蛋白抗体(TgAb),TSH异常者加测游离甲状腺激素(FT3、FT4)。结果该研究人群TSH正常范围为0.28~4.75mU/L。甲状腺功能异常(含临床和亚临床型)的总患病率10.84%,TPOAb和TgAb的阳性率分别为12.85%和11.65%。初访时确定为正常甲状腺功能的老年人(n=222,随访率79.7%),5年后新发临床甲状腺功能亢进(甲亢)1例、亚临床甲亢2例(均为男性),亚临床甲减3例(均为女性)。初访时甲状腺自身抗体阴性者,随访时有6例出现抗体的阳转,但未伴有甲状腺功能的异常。结论老年人甲状腺疾病患病率较高,应当开展甲状腺疾病筛查;老年人的亚临床甲状腺疾病多数可自行缓解,可采取以观察为主的处理方式。     

850例老年男性甲状腺结节与甲状腺功能调查

目的 调查男性老年人甲状腺结节的患病情况及甲状腺功能.方法 对850例参加2010年度本院干部体检老年男性进行甲状腺功能检查和甲状腺高频超声检查.按照有无甲状腺结节进行分组,进行结节与甲状腺功能的相关性分析.结果 850例体检对象中甲状腺结节患病率为71％,结节患病率随着年龄增加而明显升高(P＜0.05).甲状腺结节组除甲状腺前后径线较正常组增长外(P＜0.05),余各径线测定值和甲状腺功能与正常组相比差异无统计学意义.入选对象的血清TT3、FT3水平随年龄增长而降低(P＜0.05),TT4、FT4和促甲状腺激素水平无增龄性改变.结论 老年男性人群具有较高的甲状腺结节患病率.早期较小的结节对甲状腺功能无显著影响.老年男性的TT3、FT3水平随年龄增长而降低.     

Subclinical hypothyroidism and hyperthyroidism. I. Prevalence and clinical relevance

Subclinical hypothyroidism has a prevalence of approx. 6% in the general population; it is more common in females and in the elderly. The incidence of progression to overt hypothyroidism is 5–15% per year; women with positive thyroid antibodies are especially at risk. The biological significance appears to be small; there may be an association with depression. Subclinical hypothyroidism does not cause significant hypercholesterolaemia. Thyroxine treatment results in improvement of symptoms in 25–30%.Subclinical hyperthyroidism has a prevalence of approx. 1%; it is also more common in older age groups, but its female preponderance is less marked. The incidence of progression to overt thyrotoxicosis is approx. 5% per year; subjects with autonomous thyroid adenoma or nodular goiter are especially at risk. The biological significance appears to be small. Bone density is slightly reduced in cortical bone (radius and femoral neck) but not in trabecular bone (lumbar spine). There might be an association with atrial fibrillation, which is possibly more likely to convert to stable sinus rhythm after antithyroid treatment.In view of the high prevalence of subclinical hypothyroidism and hyperthyroidism one might consider screening programs in the general population, which are feasible by the availability of an appropriate screening test (the sensitive TSH assay) and effective treatment. Such screening programs, however, are not justified at the present time because (a) the associated burden of disease is small and (b) it has not been proven beyond doubt that early diagnosis and treatment in the asymptomatic phase improves clinical outcome. A high degree of suspicion of thyroid function disorders is, however, warranted, especially in females over 40 years presenting with non-specific complaints.     

Prevalence of subclinical thyroid dysfunction and its relation to socioeconomic deprivation in the elderly: a community-based cross-sectional survey

CONTEXT: Population-based screening has been advocated for subclinical thyroid dysfunction in the elderly because the disorder is perceived to be common, and health benefits may be accrued by detection and treatment. OBJECTIVE: The objective of the study was to determine the prevalence of subclinical thyroid dysfunction and unidentified overt thyroid dysfunction in an elderly population. DESIGN, SETTING, AND PARTICIPANTS: A cross-sectional survey of a community sample of participants aged 65 yr and older registered with 20 family practices in the United Kingdom. EXCLUSIONS: Exclusions included current therapy for thyroid disease, thyroid surgery, or treatment within 12 months. OUTCOME MEASURE: Tests of thyroid function (TSH concentration and free T4 concentration in all, with measurement of free T3 in those with low TSH) were conducted. EXPLANATORY VARIABLES: These included all current medical diagnoses and drug therapies, age, gender, and socioeconomic deprivation (Index of Multiple Deprivation, 2004). ANALYSIS: Standardized prevalence rates were analyzed. Logistic regression modeling was used to determine factors associated with the presence of subclinical thyroid dysfunction. RESULTS: A total of 5960 attended for screening. Using biochemical definitions, 94.2% [95% confidence interval (CI) 93.8-94.6%] were euthyroid. Unidentified overt hyper- and hypothyroidism were uncommon (0.3, 0.4%, respectively). Subclinical hyperthyroidism and hypothyroidism were identified with similar frequency (2.1%, 95% CI 1.8-2.3%; 2.9%, 95% CI 2.6-3.1%, respectively). Subclinical thyroid dysfunction was more common in females (P < 0.001) and with increasing age (P < 0.001). After allowing for comorbidities, concurrent drug therapies, age, and gender, an association between subclinical hyperthyroidism and a composite measure of socioeconomic deprivation remained. CONCLUSIONS: Undiagnosed overt thyroid dysfunction is uncommon. The prevalence of subclinical thyroid dysfunction is 5%. We have, for the first time, identified an independent association between the prevalence of subclinical thyroid dysfunction and deprivation that cannot be explained solely by the greater burden of chronic disease and/or consequent drug therapies in the deprived population.     

亚临床甲状腺功能减退症

亚临床甲状腺功能减退症（甲减）是一种亚临床甲状腺疾病。诊断标准是血清促甲状腺激素（TSH）水平高于正常上限而游离T4水平尚在正常范围。目前全世界亚临床甲减的平均患病率为4％-10％,主要发生在女性和老年人群。桥本甲状腺炎是最常见的病因。其主要的临床危害包括引起血脂异常、导致动脉粥样硬化和冠心病、影响认知功能,还可导致不孕和流产。治疗主要针对血清TSH〉10ml U／L的患者,应用左旋-T4替代治疗。对于血清TSH4～10ml U／L,特别是甲状腺自身抗体阳性者需密切监测。此外,对妊娠期亚临床甲减患者的治疗要求控制TSH〈2．5ml U／L。     

Subclinical hypothyroidism is an independent risk factor for atherosclerosis and myocardial infarction in elderly women: the Rotterdam Study

BACKGROUND: Overt hypothyroidism has been found to be associated with cardiovascular disease. Whether subclinical hypothyroidism and thyroid autoimmunity are also risk factors for cardiovascular disease is controversial. OBJECTIVE: To investigate whether subclinical hypothyroidism and thyroid autoimmunity are associated with aortic atherosclerosis and myocardial infarction in postmenopausal women. DESIGN: Population-based cross-sectional study. SETTING: A district of Rotterdam, The Netherlands. PARTICIPANTS: Random sample of 1149 women (mean age +/- SD, 69.0 +/- 7.5 years) participating in the Rotterdam Study. MEASUREMENTS: Data on thyroid status, aortic atherosclerosis, and history of myocardial infarction were obtained at baseline. Subclinical hypothyroidism was defined as an elevated thyroid-stimulating hormone level (>4.0 mU/L) and a normal serum free thyroxine level (11 to 25 pmol/L [0.9 to 1.9 ng/dL]). In tests for antibodies to thyroid peroxidase, a serum level greater than 10 IU/mL was considered a positive result. RESULTS: Subclinical hypothyroidism was present in 10.8% of participants and was associated with a greater age-adjusted prevalence of aortic atherosclerosis (odds ratio, 1.7 [95% CI, 1.1 to 2.6]) and myocardial infarction (odds ratio, 2.3 [CI, 1.3 to 4.0]). Additional adjustment for body mass index, total and high-density lipoprotein cholesterol level, blood pressure, and smoking status, as well as exclusion of women who took beta-blockers, did not affect these estimates. Associations were slightly stronger in women who had subclinical hypothyroidism and antibodies to thyroid peroxidase (odds ratio for aortic atherosclerosis, 1.9 [CI, 1.1 to 3.6]; odds ratio for myocardial infarction, 3.1 [CI, 1.5 to 6.3]). No association was found between thyroid autoimmunity itself and cardiovascular disease. The population attributable risk percentage for subclinical hypothyroidism associated with myocardial infarction was within the range of that for known major risk factors for cardiovascular disease. CONCLUSION: Subclinical hypothyroidism is a strong indicator of risk for atherosclerosis and myocardial infarction in elderly women.     

THE SPECTRUM OF THYROID DISEASE IN A COMMUNITY: THE WHICKHAM SURVEY

A survey has been conducted in Whickham, County Durham, to determine the prevalence of thyroid disorders in the community. Two thousand seven hundred and seventy-nine people (82.4% of the available sample) were seen in the survey. The prevalence of overt hyperthyroidism was 19/1000 females rising to 27/1000 females when possible cases were included, compared with 1.6–2.3/1000 males. The prevalence of overt hyothyroidism was 14/1000 females rising to 19/1000 females when possible cases were included, compared with less than 1/1000 males. The prevalence of spontaneous overt hypothyroidism (excluding iatrogenic cases) was 10/1000 females or 15/1000 females including unconfirmed cases. Minor degrees of hypothyroidism were defined on the basis of elevated serum thyrotrophin (TSH) levels in the absence of obvious clinical features of hypothyroidism. TSH levels did not vary with age in males but increased markedly in females after the age of 45 years. The rise of TSH with age in females was virtually abolished when persons with thyroid antibodies were excluded from the sample. TSH levels above 6 mu/1 were shown to reflect a significant lowering of circulating thyroxine levels and showed a strong association with thyroid antibodies in both sexes, independent of age. Elevated TSH levels (>6mu/l) were recorded in 7.5% of females and 2.8% of males of all ages. Thyroglobulin antibodies were present in 2% of the sample. Thyroid cytoplasmic antibodies were present in 6.8% of the sample (females 10.3%, males 2.7%) and their frequency did not vary significantly with age in males but increased markedly in females over 45 years of age. 3% of the sample (females 5.1%, males 1.1%) had thyroid antibodies and elevated TSH levels and the relative risk of a high TSH level in subjects with antibodies was 20:1 for males and 13:1 for females, independent of age. Small goitres (palpable but not visible) were found in 8.6% of the sample and obvious goitres (palpable and visible) in 6.9%. Goitres were four times more common in females than in males and were most commonly found in younger rather than older females. TSH levels were slightly but not significantly lower in those with goitre than in those without goitre. There was a weak association between goitre and antibodies in females but not males.     

Screening for thyroid diseases in an iodine sufficient area with sensitive thyrotrophin assays, and serum thyroid autoantibody and urinary iodide determinations

OBJECTIVE The present study was designed to investigate the prevalence of thyroid dysfunction and Its relation to thyroid autoantibodies and urine iodide concentration in apparently healthy people residing in Sapporo, a city of northern Japan, where the iodine intake is high. DESIGN AND SUBJECTS Serum TSH and thyroid autoantibodies, and urine iodide were measured in 4110 people (2931 men and 1179 women) (age 456 ± 103 years (mean ± SD)) who were recruited at the hospital for medical examinations. RESULTS The thyroid autoantibodies were positive in 6.4% of males and 13.8% of females with an age-related increase. Of the people with positive antibodies, 87.2% had normal TSH values (0.15–5.0 mU/l) as measured by a sensitive assay. The prevalence of unsuspected hyperthyroidism as defined by suppressed TSH values was 0.61%, of which 64% was diagnosed as Graves' disease based on positive thyrotrophin receptor antibody results. The prevalence of unsuspected hypothyroidism, as evidenced by supranormal TSH, was 0.68% for males and 3.13% for females with an age-related increase. Of those with hypothyroidism, 45.5% were autoantibody positive. The overall prevalence of Hashimoto's thyroiditis was 13.11% for females and 6.15% for males. The urine iodide levels of hypothyroidism with a positive autoantibody of 38.5 (17.7–83.9)μmol/l and a negative autoantibody of 34.9 (17.9–67.9) μmol/l were both significantly higher than that of normal subjects (26.9 (14.6–49.6) μmol/l) (P <0.01). When iodine intake was restricted for 6–8 weeks for hypothyroid subjects, the elevated TSH and thyroglobulin and low free T4 levels were reversed in the autoantibody negative but not in the positive group. CONCLUSIONS This study provides further information on the prevalence of thyroid dysfunction and autoimmune thyroid diseases in an iodine sufficient area. In addition, it suggests that more than half of the patients with unsuspected hypothyroidism were negative for autoantibodies and that the excessive iodine intake may be involved in causing latent hypothyroidism.     

Prevalence of subclinical hypothyroidism in a population living in the Milan metropolitan area

Subclinical hypothyroidism is a condition characterized by increased levels of thyroid-stimulating hormone (TSH) associated with normal levels of free triiodothyronine (FT3) and free thyroxine (FT4). The exact prevalence of this condition in Italy is not known. The aim of this study was to assess the presence of subclinical hypothyroidism in 1001 subjects living in the Milan area (age 17-89) and apparently free from thyroid pathology. This sample which had applied to a large laboratory centre (Centro Diagnostico Italiano, Milano) for a routine check-up was seen from April to July 1996. A serum TSH assay was performed using a highly sensitive immunoenzymatic method, while an FT3 and FT4 assay was performed by means of a radioimmunologic method using commercial kits. The prevalence of subclinical hypothyroidism in the total population proved to be 4.7% (95% CI-Confidence Interval: 3.4-6.0). Sex stratification showed a prevalence of 6.1% in females and 3.4% in males. Prevalence in patients up to 65 was 4.2%. This value increased up to 8.0% in subjects over 65. By combining these variables, in females >65 prevalence increased to 11.3%. Overall, symptoms typical of overt hypothyroidism were found in 58.3% of patients suffering from subclinical hypothyroidism and in 39.9% of healthy subjects (p<0.02). The results of this study show that there is a significant presence (about 5%) of subclinical hypothyroidism in this population and that its frequency is more than doubled in women over 65. Early treatment might reduce the progression to overt hypothyroidism. The benefits of such a procedure were recently suggested by a decision making modelling approach applied to the Italian environment.     

Circulating thyroid autoantibodies in a sample of Italian octo-nonagenarians: relationship to age, sex, disability, and lipid profile

Circulating thyroid autoantibodies were assessed in a sample of Italian octo-nonagenarians living in a restricted area (Val Vibrata, Abruzzo), and selected according to the absence or presence of chronic illness and disability. The study groups included: Group A ("Successful aging"), 98 free-living healthy, fully independent, octo-nonagenarians (57 males and 41 females, average age +/-SD 83.9+/-3 years); Group B ("Unsuccessful aging"), 62 highly disabled octo-nonagenarians (24 males and 38 females; average age 86.5+/-3.4 years), and Group C (Controls), 91 randomly selected healthy adult controls (42 males and 49 females; age 53.7+/-16.6 SD years, range 20-70). Serum autoantibodies to thyroglobulin (anti-Tg) and to thyroid peroxidase (anti-TPO) were measured by passive hemagglutination and radioimmunoassays (RIA); serum free thyroxine and thyrotropin by RIA. The prevalence of positive thyroid autoantibody tests was not significantly increased in the elderly groups compared to the controls, with the remarkable exception of anti-Tg detected by RIA which were increased in disabled elderly, compared to free-living elderly and controls. Two/62 disabled elderly had subclinical (1) or mild (1) primary hypothyroidism, and one free-living woman aged 90 years was hyperthyroid (toxic nodular goiter). No correlation was found between serum thyroid autoantibodies, thyroid hormones and TSH and serum lipoprotein fractions. The higher prevalence of thyroid autoantibodies found only in disabled, but not in free-living Italian octo-nonagenarians suggests that thyroid autoimmune phenomena in the elderly may be an expression of age-associated disease rather than related to the aging process in itself.     

Multi-center study on the prevalence of hypothyroidism in patients with hypercholesterolemia

Hypercholesterolemia is one of the most representative disorders of the common diseases. To evaluate the prevalence of hypothyroidism in the population of adult hypercholesterolemia, we prospectively examined the thyroid function in patients with untreated or treated hypercholesterolemia as a multi-center survey. Subjects were the patients who were treated with some antilipemic agents or the untreated patients whose total cholesterol (TC) was over 220 mg/dL and/or LDL-cholesterol (LDL-C) over 140 mg/dL. Among 737 cases recruited, 725 cases (300 males and 425 females) participated in the survey including the thyroid function test. The patient's backgrounds include hypertension (51%), diabetes mellitus (49%), fatty liver (17%), smoking (15%), and habitual drinking (10%). The 72% of the patients were treated with some antilipemic agents and the mean values of TC, LDL-C, triglyceride (TG), HDL-cholesterol (HDL-C), and LDL-C/HDL-C ratio (L/H) were 204.5 mg/dL, 119.6 mg/dL, 144.4 mg/dL, 60.7 mg/dL and 2.25, respectively. The primary hypothyroidism was seen in 27 cases (3.7%) (11 males, 16 females) with subclinical hypothyroidism in 17 cases (2.4%) and overt hypothyroidism in 10 cases (1.4%). The central hypothyroidism was seen in 4 cases (0.6%). The prevalence of hypothyroidism was 4.3% in patients with hypercholesterolemia. Taking account of the large number of patients with dyslipidemia and importance of avoiding unnecessary administration and associated adverse effects, evaluation of the thyroid function could be warranted in patients with dyslipidemia although cost-benefit issues waits further investigation.     

Subclinical hypothyroidism is associated with a low-grade inflammation, increased triglyceride levels and predicts cardiovascular disease in males below 50 years

OBJECTIVE: Mild thyroid failure is associated with an increased risk for development of atherosclerosis, but whether subclinical hypothyroidism is related to risk for cardiovascular disease is controversial. The purpose of the present study was to examine a possible association between subclinical hypothyroidism and cardiovascular disease. DESIGN: Cross-sectional study of a general population. PATIENTS: Twelve hundred and twelve subjects, men and women, between 20 and 69 years old without thyroid disease not treated with drugs interfering with thyroid function or analysis of TSH were included. MEASUREMENTS: Clinical signs of cardiovascular disease based on a questionnaire and medical records and laboratory analysis of lipids, atherothrombotic risk markers, C-reactive protein and TSH. RESULTS: The main findings were a high incidence of subclinical hypothyroidism (19.7%) in a general population. Subclinical hypothyroidism was associated with higher concentrations of triglycerides and C-reactive protein. Below 50 years of age cardiovascular disease was more frequent in males with subclinical hypothyroidism compared to euthyroid males. Subclinical hypothyroidism was a predictor of cardiovascular disease in males below 50 years with an odds ratio of 3.4 (95% confidence interval 1.6-6.8) for developing cardiovascular disease compared to euthyroid age-matched males. CONCLUSION: Our study demonstrates that patients with subclinical hypothyroidism have increased levels of triglycerides and signs of low-grade inflammation (raised C-reactive protein levels) and that subclinical hypothyroidism might be a risk factor for development of cardiovascular disease in younger males.