摘要
目的探讨老年人群亚临床甲状腺功能减退（简称甲减）对非酒精性脂肪性肝病（NAFLD）患病的影响。方法整群抽样兰州市某社区60—75岁居民共1329名，对其进行问卷调查、人体学测量、甲状腺激素、血脂、血糖等指标检测及上腹部超声检查，根据性别及甲状腺功能（简称甲功）对受试者分组并分别进行数据分析。结果资料完整者共1265名，其中甲功正常组847例，亚临床甲减组364例，亚临床甲减患病率为28．77％，女性患病率明显高于男性（33．09％比21．54％，P〈0．01）。女性亚临床甲减组甘油三酯（TG）、ALT、AST、γ-谷氨酰基转移酶（γ-GT）水平均明显高于甲功正常组（P均〈0．01）。女性亚临床甲减组的NAFLD检出率（38．4％）明显高于甲功正常组（30．2％，P〈0．05），而男性中两组比较差异无统计学意义（P〉0．05）。Logistic回归分析结果显示，模型一校正年龄及BMI后，亚临床甲减明显增加女性NAFLD的患病风险（OR=1．426，95％CI 1．017～1．998，P=0．040）；模型二进一步校正糖化血红蛋白、收缩压、舒张压后结果显示，亚临床甲减仍增加女性NAFLD的患病风险（OR=1．428，95％CI 1．014—2．012，P=0．041）；模型三再进一步校正TG后结果显示，女性亚临床甲减与NAFLD患病风险无明显相关性（OR=1．301，95％CI 0．913～1．854，P=0．145）。结论老年人群亚临床甲减患病率高，女性亚临床甲减患者NAFLD患病率明显高于甲功正常者，但亚临床甲减不是NAFLD患病的独立危险因素。
Objective To investigate the impact of subclinical hypothyroidism （SCH） on non-alcoholic fatty liver disease（NAFLD） among the elderly. Methods A total of 1 329 residents aged 60-75 years old in a community in Lanzhou were included by cluster sampling. Each of them underwent detailed questionnaire survey, anthropometric measurement, thyroid hormones testing, biochemical testing including blood lipids and glucose and upper abdominal uhrasonography. Subjects were divided into different groups and analyzed according to gender and thyroid function. Results Data of 1265 cases were complete, of which 847 cases were in euthyroid group and 364 cases were in SCH group. The prevalence of SCH was 28.77% in the total population and was higher in females compared to males （33.09% vs 21.54% , P 〈 0.05 ）. In female subjects, triglyceride （ TG）, ALT, AST and gamma-glutamyl transferase （ γ-GT ） were significantly higher in SCH group compared with euthyroid group（P 〈0.01 ）. The incidence of NAFLD in SCH group（38.4% ） was higher than that in euthyroid group（ 30.2% ） in females （P 〈 0.05 ）, whereas no difference was found in males （ P 〉0. 05 ）. Logistic regression analyses showed, after adjusting age and BMI in model 1, SCH significantly increased the occurrence of NAFLD in females （ OR = 1. 426,95 % CI 1. 017-1. 998, P = 0. 040）. After further adjustment for systolic blood pressure, diastolic blood pressure and glycosylated hemoglobin Alc in model 2, SCH still increased the occurrence of NAFLD in females （ OR = 1. 428,95% CI 1. 014-2. 012, P = 0. 041 ）. However, after additional adjustment for TG in model 3, there was no significant correlation between SCH and the risk of NAFLD in females （OR = 1. 301, 95% CI 0. 913-1. 854 ,P = 0. 145 ）. Conclusion The prevalence of SCH is high among the elderly. The incidence of NAFLD in SCH patients is higher than that in euthyroid subjects in females among the elderly. However, SCH is not an independent risk factor for NAFLD.
作者
刘丽娟
汤旭磊
甄东户
孙蔚明
韩婕
杨晓梅
Liu Lijuan;Tang Xulei;Zhen Donghu(Department of Endocrinology,the First Hospital of Lanzhou University,Lanzhou 730000,Chin)
出处
《临床内科杂志》
CAS
2018年第7期452-455,共4页
Journal of Clinical Internal Medicine
基金
甘肃省卫生行业科研计划项目（GSWSKY-2014-27）
