太原市社区人群与定期体检人群空腹血糖、血脂及血尿酸水平的调查分析

目的比较社区人群与定期体检人群之间血糖、血脂和血尿酸水平以及糖尿病、高血脂和高尿酸血症患病率的差异,为糖尿病、高脂血症、高尿酸血症的一级预防提供依据。方法对9960名太原市社区常住居民及我院体检中心定期体检的健康体检者的空腹血糖、血脂、尿酸水平及异常率进行调查,并比较其差异。结果太原市社区人群空腹血糖、血脂、血尿酸水平与定期体检人群比较差异无统计学意义;两人群高密度脂蛋白胆固醇、血尿酸水平有性别差异(P<0.05);同性别两人群各指标水平差异无统计学意义。社区人群糖尿病和高血脂患病率高于定期体检人群(P<0.05),高尿酸血症患病率未发现有差异;社区人群和定期体检人群糖尿病、高血脂(除高甘油三酯血症外)、高尿酸血症患病率有性别差异(P<0.05);两人群中男性低密度脂蛋白胆固醇异常率和高尿酸血症患病率差别有统计学意义,两人群中女性三种疾病患病率均有统计学差异(P<0.05)。社区男性人群糖尿病患病率、低密度脂蛋白胆固醇异常率随年龄增加有增高趋势,高密度脂蛋白胆固醇异常率、高尿酸血症随年龄增加有降低趋势,女性人群三种疾病患病率随年龄增加均有增高趋势;定期体检男性人群高密度脂蛋白胆固醇、低密度脂蛋白胆固醇患病率及...     

老年退休人员高尿酸血症的患病率及影响因素分析

目的调查老年退休人群高尿酸血症的患病情况,并对其相关危险因素进行分析。方法选择健康体检的5412例老年退休人员,分别进行高尿酸血症及相关危险因素的问卷调查、体格检查和血液检测,根据血尿酸水平分为高尿酸血症组1581例,血尿酸正常组3831例,采用非条件logistic回归分析高尿酸血症的影响因素。结果 5412例受检者中,高尿酸血症患病率为29.21%,男性和女性患病率分别为37.87%和24.98%(P=0.000),高尿酸血症组超重、血糖异常、肾功能下降、血尿素升高、天冬氨酸转氨酶升高、高TG血症、高TC血症、低HDL-C血症、高LDL-C血症的患病率较血尿酸正常组明显升高(P<0.05),多因素logistic回归分析显示,性别、超重、肾功能下降、高TG血症、高TC血症、血尿素升高为高尿酸血症的危险因素(P<0.01)。结论该地区老年退休人群的高尿酸血症患病率较高,提示对于老年高尿酸血症患者的治疗应采取综合防治的措施,以降低患病率。     

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。     

白银市健康体检人群高尿酸血症流行特征分析

目的了解甘肃省白银市健康人群高尿酸血症流行特征,为预防高尿酸血症提供参考依据。方法分析5 362名白银市机关事业单位和退休人员2013年健康体检资料,并将调查对象分为高尿酸血症和正常血尿酸组,分析高尿酸血症与高血压、高血脂、高血糖发生的关系。结果 5 362名体检人群中检出高尿酸血症患者486例,患病率9.06%,其中,男性为12.97%,女性为4.82%,男性高于女性(χ2=107.773,P0.05);男性高尿酸血症患病率以49岁~和50岁~两个年龄组患病率最高(χ2=34.376,P0.05),女性高尿酸血症患病率随年龄增长呈递增趋势,高尿酸血症组合并高血压(χ2=96.676)、高血脂(χ2=91.955)、高血糖(χ2=112.714)的发生率明显高于正常血尿酸组(χ2=12.555,均P0.05)。结论高尿酸血症是严重危害人群健康的潜在性疾病,并与多种代谢性疾病密切相关,应高度重视和积极预防。     

不同性别高尿酸血症与慢性肾脏病的相关研究

目的评价不同性别中老年健康体检人群高尿酸血症和慢性肾脏病(CKD)的关系。方法本横断面研究中共纳入24095名观察对象,常规测量血压、身高、体质量,同时检测血脂、血糖及肾功能指标,观察男女血尿酸水平和慢性肾脏病之间的关系。CKD定义为eGFR60 mL/min/1.73 m~2。结果高尿酸血症患病率为16.0%,其中男性(21.6%)高于女性(7.3%),并随着年龄的增长,高尿酸血症患病率增加,其中女性在绝经后血尿酸水平显著增长。CKD患病率随着血尿酸水平的增长而增加,多因素校正回归分析显示,与血尿酸1分位水平比较,男女血尿酸4分位水平CKD风险分别增加6.30倍(95%CI为4.84~8.19)和9.08倍(95%CI为6.27~13.14)。结论高尿酸血症患病率呈年龄依赖性增长,同时高尿酸血症是CKD的独立危险因素,并随血尿酸水平增高CKD风险增加,女性高尿酸血症人群CKD风险高于男性。     

甲状腺素对老年亚临床甲状腺功能减退患者血脂、血糖、血尿酸水平的影响

目的探讨甲状腺素对老年亚临床甲状腺功能减退患者体内血脂、血糖、血尿酸水平的影响。方法选择老年亚临床甲状腺功能减退患者100例,根据治疗方法不同分为两组,观察组50例采用左旋甲状腺素25μg/d治疗,并根据临床症状和实验室检查结果使用剂量逐渐增大待促甲状腺素(TSH)恢复正常后,改维持剂量,最大剂量150μg/d。对照组予中成药六味地黄丸治疗8粒,3次/d。两组患者均连续治疗6个月。比较治疗前后2组患者血脂、血糖和血尿酸水平。结果两组患者治疗后促甲状腺素(TSH)、游离T3(FT3)、游离T4(FT4)水平均有所变化,观察组治疗前后比较差异有统计学意义(P<0.05);观察组治疗后TSH、FT3、FT4水平与对照组治疗后比较差异有统计学意义(P<0.05);观察组治疗前后总胆固醇(TC)、甘油三酯(TG)、载脂蛋白B(ApoB)水平比较差异有统计学意义(P<0.05);观察组治疗后TC、TG、ApoB水平与对照组治疗后比较差异有统计学意义(P<0.05);两组患者治疗后尿酸(UA)水平与治疗前比较差异有统计学意义(P<0.05);观察组患者治疗后UA水平与对照组治疗后比较差异有统计学意义(P<0.05)。结论亚临床甲状腺机能减退易导致体内血脂、血尿酸升高,引发脂代谢紊乱和高尿酸血症,甲状腺素可改善患者临床症状,降低血脂、血UA。     

2型糖尿病患者甲状腺功能及血尿酸与高同型半胱氨酸血症相关性的研究

目的 探讨甲状腺功能正常T2DM患者甲状腺功能指标、甲状腺激素敏感指数及血尿酸（SUA）与高同型半胱氨酸血症（HHcy）的相关性。方法 选取2020年1月至2022年10月于我院内分泌科收治的甲状腺功能正常的T2DM患者281例，同期选取我院体检健康者85名为正常对照（NC）组。比较各组一般资料、生化指标、甲状腺反馈分位数指数（TFQI）及游离三碘甲腺原氨酸/游离甲状腺素。结果 T2DM组血清同型半胱氨酸（Hcy）高于NC组（P<0.01）。Spearman相关分析显示，血清Hcy与BMI、SUA、促甲状腺激素（TSH）、TFQI呈正相关（P<0.05），与HbA1c、eGFR呈负相关（P<0.05）。Logistic回归分析显示，男性、高尿酸血症（HUA）、正常高值的TSH是HHcy的影响因素。结论 甲状腺功能正常的T2DM患者中，男性、HUA及正常高值的TSH与HHcy风险升高相关。     

原发性老年高血压患者高尿酸血症患病率的调查研究

目的了解原发性老年高血压患者高尿酸血症的患病率情况。方法选取资料完整的原发性老年高血压患者2057例,男性780例,女性1277例,60~70岁871例;71~80岁674例和>80岁512例,并分别按年龄、性别对高尿酸血症的患病率进行统计分析,并比较各年龄段间男性与女性患病率差异。结果所有患者血尿酸为(385.42±106.34)μmol/L,高尿酸血症患病率为46.1%,其中男性高尿酸血症患病率为48.6%,女性高尿酸血症患病率为44.6%,男性高尿酸血症患病率虽高于女性,但差异无统计学意义(P=0.083);60~70岁、71~80岁和>80岁高尿酸血症患病率分别为46.5%,44.5%,47.7%,其中男性分别为52.0%,45.8%,46.7%,女性分别为43.1%,43.6%,48.2%。60~70岁患者中,男性高尿酸血症患病率明显高于女性(P<0.01)。结论原发性老年高血压患者高尿酸血症患病率高,而且男性与女性的患病率相当。     

2012—2016年南京市区体检人群血尿酸的职业、年龄、性别分布特点和相关因素分析

目的:分析南京市来自6个行业体检人群血尿酸的年龄、性别分布特点,和高尿酸血症(HUA)的患病情况及其影响因素。方法:纳入2012年至2016年南京市4家医院参加健康体检的107478例体检者,比较不同性别、不同年份的HUA发病率;按照血尿酸值分为正常组和HUA组,比较两组代谢指标、年龄,计算不同行业体检人群的血尿酸水平,并采用多因素logistic回归方法计算HUA发病危险OR值。结果:HUA总体患病率为14.9%,男性HUA的患病率明显高于女性(20.5%比2.5%,χ2=5850.1,P<0.01),女性HUA的患病率随着年龄的增加呈上升趋势(20~29、30~39、40~49、50~59、60~69和≥70岁组的HUA患病率分别为1.0%、0.7%、0.9%、2.7%、3.8%和9.6%;趋势P<0.01)。HUA组的高血压、高血脂、糖尿病患病率及体重指数均高于血尿酸正常组(P≤0.01)。卫生行业人群血尿酸水平[(298±91)μmol/L]和HUA患病率(10.4%)最低,公安行业的血尿酸水平[(342±82)μmol/L]和HUA患病率最高(16.5%)。血尿酸水平与血脂、血糖、血压等代谢指标相关(P≤0.01),多因素logistic回归分析显示,男性、高血压、高甘油三酯、高胆固醇、肥胖、职业类别和高尿酸血症的发生相关。结论:南京地区体检人群中男性HUA患病率明显高于女性,女性HUA的患病率随着年龄的增加而增加。卫生行业体检人群的血尿酸水平和HUA患病率最低,而公安职业类别人群最高。男性、高血压、高脂血症、肥胖、职业类别与HUA的发生相关。     

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.     

The Colorado thyroid disease prevalence study

CONTEXT: The prevalence of abnormal thyroid function in the United States and the significance of thyroid dysfunction remain controversial. Systemic effects of abnormal thyroid function have not been fully delineated, particularly in cases of mild thyroid failure. Also, the relationship between traditional hypothyroid symptoms and biochemical thyroid function is unclear. OBJECTIVE: To determine the prevalence of abnormal thyroid function and the relationship between (1) abnormal thyroid function and lipid levels and (2) abnormal thyroid function and symptoms using modern and sensitive thyroid tests. DESIGN: Cross-sectional study. PARTICIPANTS: Participants in a statewide health fair in Colorado, 1995 (N = 25 862). MAIN OUTCOME MEASURES: Serum thyrotropin (thyroid-stimulating hormone [TSH]) and total thyroxine (T4) concentrations, serum lipid levels, and responses to a hypothyroid symptoms questionnaire. RESULTS: The prevalence of elevated TSH levels (normal range, 0.3-5.1 mIU/L) in this population was 9.5%, and the prevalence of decreased TSH levels was 2.2%. Forty percent of patients taking thyroid medications had abnormal TSH levels. Lipid levels increased in a graded fashion as thyroid function declined. Also, the mean total cholesterol and low-density lipoprotein cholesterol levels of subjects with TSH values between 5.1 and 10 mIU/L were significantly greater than the corresponding mean lipid levels in euthyroid subjects. Symptoms were reported more often in hypothyroid vs euthyroid individuals, but individual symptom sensitivities were low. CONCLUSIONS: The prevalence of abnormal biochemical thyroid function reported here is substantial and confirms previous reports in smaller populations. Among patients taking thyroid medication, only 60% were within the normal range of TSH. Modest elevations of TSH corresponded to changes in lipid levels that may affect cardiovascular health. Individual symptoms were not very sensitive, but patients who report multiple thyroid symptoms warrant serum thyroid testing. These results confirm that thyroid dysfunction is common, may often go undetected, and may be associated with adverse health outcomes that can be avoided by serum TSH measurement.     

Prevalence of thyroid disease, thyroid dysfunction and thyroid peroxidase antibodies in a large, unselected population. The Health Study of Nord-Trondelag (HUNT)

OBJECTIVE: To examine the prevalence of thyroid disease and dysfunction including thyroid autoimmunity in Norway. MATERIALS AND METHODS: All inhabitants 20 years and older (94009) in Nord-Trondelag were invited to participate in a health survey with a questionnaire and blood samples. RESULTS: The prevalence of former diagnosed hyperthyroidism was 2.5% in females and 0.6% in males, hypothyroidism 4.8% and 0.9%, and goitre 2.9% and 0.4% respectively. In both sexes the prevalence increased with age. In individuals without a history of thyroid disease the median, 2.5 and 97.5 percentiles for TSH (mU/l) were 1.80 and 0.49-5.70 for females and 1. 50 and 0.56-4.60 for males. The TSH values increased with age. When excluding individuals with positive thyroid peroxidase antibodies (TPOAb) (>200U/ml), the 97.5 percentiles dropped to 3.60 mU/l and 3. 40 mU/l respectively. The prevalence of pathological TSH values in females and males were TSH >/=10mU/l 0.90% and 0.37%; TSH 4.1-9. 9mU/l 5.1% and 3.7%; and TSH200U/ml) was 13.9% in females and 2.8% in males. In females the lowest percentage (7.9%) of positive TPOAb was seen with TSH 0.2-1.9mU/l and increased both with lower and higher levels of TSH. The percentage of males with positive TPOAb was lower than in females in all TSH groups except for those with TSH>10mU/l (85% TPOAb positive). CONCLUSIONS: In spite of a high prevalence of recognised thyroid disease in the population a considerable number of inhabitants have undiagnosed thyroid dysfunction and also positive TPOAb.     

Gender and Age Impacts on the Association Between Thyroid Function and Metabolic Syndrome in Chinese

The relationship between thyroid dysfunction and metabolic syndrome (MS) is complex. We aimed to explore the impact of gender and age on their association in a large Chinese cohort.This cross-sectional study enrolled 13,855 participants (8532 male, 5323 female), who self-reported as healthy without any known previous diseases. Clinical data including anthropometric measurements, thyroid function, and serum metabolic parameters were collected. The associations between thyroid function and MS of both genders were analyzed separately after dividing thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and age into subgroups. MS risks were calculated by binary logistic regression models.Young males had significantly higher MS prevalence than females, yet after menopause, females had higher prevalence than males. Females had higher incidence of thyroid dysfunction than males. By using TSH quartiles as the categorical variables and the lowest quartile as reference, significantly increased MS risk was demonstrated in quartile 4 for males, yet quartiles 3 and 4 for females. By using FT3 quartiles as the categorical variables, significantly increased MS risk was demonstrated in quartile 2 to 4 for females only. By using age subgroups as the categorical variables, significantly increased MS risk was shown in both genders, with females (4.408–58.455) higher than males (2.588–4.943).Gender and age had substantial influence on thyroid function and MS. Females with high TSH and high FT3 had higher MS risks than males. Aging was a risk for MS, especially for females. Urgent need is necessary to initiate interventional programs.     

Post-partum thyroiditis in South Brazil presenting as thyrotoxicosis: prevalence and risk factors

The prevalence of post-partum thyroiditis (PPT) has been reported in several countries (1.9 to 16.7%) but is not known in Brazil. Several factors have been associated to its development, such as a female sex of the newborn, PPT in a previous pregnancy, a family history of thyroid disease and cigarette smoking. To investigate the prevalence of PPT and its risk factors in a southern Brazilian city, a three-cross-sectional observation study was performed. PPT was diagnosed in 14/284 subjects (5.3%) and all cases had thyrotoxicosis (13 sub-clinical and one clinical). Serum total T4 and free T4 were higher and serum TSH was lower in PPT subjects. Anti-thyroid antibodies were positive in 16.7% of PPT subjects and in 4.5% of those with no thyroid dysfunction. Goiter was identified in 14.3% of PPT subjects and in 15% of no PPT subjects. Thyroid was hardened more frequently in PPT subjects (21.4%) than in others (5.2%). Male sex of the newborn was associated to PPT, increasing 11 times the risk of PPT. Cigarette smoking was associated to PPT in group II subjects. There was no clinical sign or symptom able to contribute to this diagnosis, except the presence of hardened thyroid. Based on these findings, PPT, manifesting itself as mild thyrotoxicosis, is a common problem in southern Brazil and is associated to male sex of the newborn.     

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 folic Acid and vitamin B12 deficiencies in patients with thyroid disorders

Although macrocytosis might occur with frequency in patients with thyroid disorders, there is controversial information on the metabolic relationship between thyroid stimulating hormone (TSH), folic acid and B12 in the general population. We performed a retrospective analysis to retrieve results of serum folic acid, B12, and TSH performed on consecutive outpatients referred by general practitioners for routine blood testing over the last 2 years. A positive, significant trend towards increased values of folic acid, but not of B12, could be observed across the spectrum of TSH values suggestive for hypo- and hyperthyroidism. However, the prevalence of subjects with folic acid or B12 deficiency did not differ significantly among the subgroups of subjects. In multivariable linear regression analysis folic acid, but not B12, was associated with TSH levels. These results do not support the routine screening for either B12 or folic acid deficiency in subjects with subclinical disturbances of thyroid function, though we can not rule out that it might still be useful in patients with overt thyroid dysfunction.     

Association between serum free thyroxine concentration and atrial fibrillation

BACKGROUND: Previous studies have suggested that minor changes in thyroid function are associated with risk of atrial fibrillation (AF). Our objective was to determine the relationship between thyroid function and presence of atrial fibrillation (AF) in older subjects. METHODS: A population-based study of 5860 subjects 65 years and older, which excluded those being treated for thyroid dysfunction and those with previous hyperthyroidism. Main outcome measures included tests of thyroid function (serum free thyroxine [T(4)] and thyrotropin [TSH]) and the presence of AF on resting electrocardiogram. RESULTS: Fourteen subjects (0.2%) had previously undiagnosed overt hyperthyroidism and 126 (2.2%), subclinical hyperthyroidism; 5519 (94.4%) were euthyroid; and 167 (2.9%) had subclinical hypothyroidism and 23 (0.4%), overt hypothyroidism. The prevalence of AF in the whole cohort was 6.6% in men and 3.1% in women (odds ratio, 2.23; P<.001). After adjusting for sex, logistic regression showed a higher prevalence of AF in those with subclinical hyperthyroidism compared with euthyroid subjects (9.5% vs 4.7%; adjusted odds ratio, 2.27; P=.01). Median serum free T(4) concentration was higher in those with AF than in those without (1.14 ng/dL; interquartile range [IQR], 1.05-1.27 ng/dL [14.7 pmol/L; IQR, 13.5-16.4 pmol/L] vs 1.10 ng/dL; IQR, 1.00-1.22 ng/dL [14.2 pmol/L; IQR, 12.9-15.7 pmol/L]; P<.001), and higher in those with AF when analysis was limited to euthyroid subjects (1.13 ng/dL; IQR, 1.05-1.26 ng/dL [14.6 pmol/L; IQR, 13.5-16.2 pmol/L] vs 1.10 ng/dL; IQR, 1.01-1.21 ng/dL [14.2 pmol/L; IQR, 13.0-15.6 pmol/L]; P=.001). Logistic regression showed serum free T(4) concentration, increasing category of age, and male sex all to be independently associated with AF. Similar independent associations were observed when analysis was confined to euthyroid subjects with normal TSH values. CONCLUSIONS: The biochemical finding of subclinical hyperthyroidism is associated with AF on resting electrocardiogram. Even in euthyroid subjects with normal serum TSH levels, serum free T(4) concentration is independently associated with AF.     

The association of thyroid function and heart valve sclerosis. Results from a population-based study

Objectives: Thyroid dysfunction is associated with detrimental cardiovascular effects. We analyzed whether thyroid status is associated with aortic valve sclerosis (AVS) and mitral annular calcification (MAC) as markers of generalized atherosclerosis. Design: Data of 2065 subjects (923 women and 1142 men) aged > or =45 years from the Study of Health in Pomerania (SHIP) were analyzed with respect to low, medium and high TSH levels. Logistic regression models were adjusted for major confounders of atherosclerosis. Main outcome: In women, the prevalence of AVS was the highest in those with low TSH (35.1% vs. 26.7% in medium TSH; p<0.05), while there was a higher prevalence of MAC in men with high TSH levels (9.2% vs. 5.2% in medium TSH; p<0.05). Compared with euthyroid men there was an increased adjusted odds ratio for MAC (OR 2.07; 95% CI 1.12-3.89, p<0.05), for the combination of AVS and MAC (OR 2.13; 95% CI 1.08-4.21, p<0.05) or for one of both (OR 1.47; 95% CI 1.02-2.13, p<0.05) among men with high TSH. No such association was found in women. Conclusions: There was an association between thyroid function and valvular sclerosis. Men with high TSH values had increased odds for AVS or MAC, and the combination of both. These findings may reflect an increased atherosclerotic state in affected subjects.     

江苏社区人群甲状腺结节的流行病学研究

采用逐级分层整群抽样抽取江苏地区城乡6层样本,调查对象为20岁以上的常住(≥5年)居民6 128人进行甲状腺超声检查及甲状腺功能检测,应用7.5 MHz/50 mm探头B超诊断仪进行甲状腺超声检查,记录甲状腺结节部位、直径、数量、回声、边界、钙化等.采用固相化学发光酶免疫分析法(ICMA法)检测促甲状腺素(TSH),对于TSH在正常范围外的人群,检测游离三碘甲状腺原氨酸(FT3)和游离甲状腺激素(FT4).调查对象甲状腺结节的粗患病率为21.12%、标化患病率为15.69%;男性和女性的粗患病率为14.55%和25.24%,标化患病率为11.20%和20.40%(P＜0.05).以单发结节和直径＜1.0 cm的结节为主,不同年龄段甲状腺结节直径＜1.0 cm和≥1.0 cm构成比之间的差异无统计学意义(P＞0.05),而不同年龄段单发结节和多发结节构成比之间的差异有统计学意义(P＜0.05).江苏地区社区人群的甲状腺结节的患病率较高,加强对其随访和早期诊治有重要意义.

Abstract：

The residents who had lived for at least 5 years and aged over 20 years old were sampled from urban to rural districts of Jiangsu Province with a stratified cluster sampling technique. B mode ultrasonography and thyroid function determination were carried out in 6 128 persons. The location, diameter, number, boundary, and calcification in thyroid nodules were described by using 7.5 MHz/50 mm transducer of thyroid ultrasonography. TSH was measured by chemiluminescence immunoassay. Free triiodothyronine(FT3)and free thyroxin(FT4)were measured when TSH was abnormal. The crude prevalence of thyroid nodules was 21.12% in total population, 14.55% in male, and 25.24% in female. The standardized prevalence was 15.69%, 11.20%, and 20.40%, respectively. The prevalence was lower in male than in female, and increased with age(P＜0.05). Thyroid nodules in Jiangsu Province were highly prevalent and more attention should be paid to the follow-up, early diagnosis, and treatment.     

Thyroid hormone levels and thyroid dysfunction of French adults participating in the SU.VI.MAX study

Abnormal thyroid function has important public health consequences. However, the various degrees of thyroid dysfunction remain unsettled. The SU.VI.MAX cohort provided a unique opportunity to conduct a cross-sectional study of abnormal thyroid function in a large representative population of 11256 men and women representing the geographic distribution of the French continental adult population. Thyroid status was measured, in fasting blood samples, at baseline in 1994-1995. Serum thyrotropin (TSH) levels (abnormal < 0.4 mU/l or > or =4.0 mU/l) and free thyroxine (fT4) were both performed in duplicate on the same sample. Subjects with previous or present thyroid diseases or who were taking thyroid hormones or antithyroid drugs (n=920) were excluded (8.1%). Thus, the final study group consisted of 10346 subjects, 4121 men aged 45-60 years (mean +/-SD) (51.8+/-4.7 yrs), 2641 women aged 35-44 years (40.6+/-2.8 yrs), and 3584 women aged 45-60 years (51.4+/-4.4 yrs). Median (2.5th and 97.5th percentiles) for TSH (mU/l) were 1.52 (0.20-4.54) for men, 1.78 (0.22-5.54) for women aged 35-44 years, and 1.96 (0.22-6.80) for women aged 45-60 years. The TSH distribution of women was shifted to the right compared with men. Arithmetic mean fT4 (+/-SD) was 10.7+/-1.7 ng/l (13.8 +/-2.2 pmol/l) for men and 10.9+/-1.8 ng/l (14.0+/-2.3 pmol/l) for women. The prevalence of abnormal TSH values in men, and in women (35-44 yrs and 45-60 yrs) were TSH<0.4 mU/l 7.0%, 5.3% and 4.4%; TSH 4.0-9.9 mU/l 4.0%, 7.2% and 11.1% and TSH > or =10.0 mU/l 0.2%, 0.4% and 0.7%, respectively. Geometric mean serum TSH and arithmetic mean serum fT4 concentrations showed significant overall inter-regional differences for men and women (p<0.0001). There was also an inter-regional difference in the prevalence of thyroid dysfunction for men (p=0.003), and for the older group of women (i.e. > or =45 yrs) (p=0.04) exclusively. Over the age of 45 years, the women: men ratio for unrecognized elevated TSH levels (> or =4.0 mU/l) was 2.82, whereas it was 0.64 for low TSH levels (<0.4 mU/l). In summary, abnormal TSH values and thyroid dysfunction were more prevalent in women than men, increased with age and were significantly associated with environmental factors. A high prevalence of identified thyroid diseases in the French population was confirmed by the high number of subjects in this study with laboratory evidence of abnormal biochemical thyroid function. Further studies are needed to determine the geographical determinants of thyroid dysfunctions, especially regional differences in iodine intakes, and to assess the long-term adverse effects of biochemical thyroid dysfunction on all-cause morbidity.