广泛性焦虑障碍与甲状腺激素水平的相关性研究

Study on correlation between generalized anxiety disorder and thyroid hormone level

目的探讨广泛性焦虑障碍(GAD)与甲状腺激素水平的相关性。方法采用横断面研究方法,纳入2019年6月—2020年1月就诊于北京中医药大学第三附属医院(以下简称“我院”)脑病科门诊的62例广泛性焦虑障碍患者作为研究组,纳入同期于我院体检中心进行体检的60名健康成人作为对照组。所有受试者均测定血清甲状腺激素水平,包括促甲状腺激素(TSH)、三碘甲状腺原氨酸(T3)、游离三碘甲状腺原氨酸(FT3)、甲状腺素(T4)、游离甲状腺素(FT4)。研究组采用汉密尔顿焦虑量表(HAMA)进行焦虑程度测评,其中轻度焦虑组20例、中度焦虑组32例、重度焦虑组10例。比较研究组与对照组、不同程度广泛性焦虑障碍组间甲状腺激素水平的差异,分析广泛性焦虑障碍与甲状腺激素水平的关系,并探讨不同程度广泛性焦虑障碍与甲状腺激素水平的相关性。结果研究组T3、T4水平高于对照组,差异有统计学意义(P<0.05);两组FT3、TSH、FT4水平比较,差异无统计学意义(P>0.05)。不同焦虑程度组间T4水平差异有统计学意义(P<0.05),其中重度焦虑组患者T4水平分别高于轻度焦虑组及中度焦虑组,差异有统计学意义(P>0.05);三组TSH、T3、FT3、FT4水平比较,差异无统计学意义(P>0.05)。GAD患者的焦虑程度与T4水平呈正相关(r=0.332,P<0.01),与FT3、TSH、T3、FT4均无相关性(P>0.05)。结论广泛性焦虑障碍患者存在甲状腺激素水平的异常,即甲状腺激素水平异常与广泛性焦虑障碍的发生具有一定相关性,合理调控甲状腺激素水平,可一定程度上降低GAD发生的风险。

Objective To investigate the relationship and correlation between generalized anxiety disorder(GAD)and thyroid hormone level.Methods With the cross-sectional study method,a total of 62 patients with generalized anxiety disorder who visited the Department of Encephalopathy of the Third Affiliated Hospital of Beijing University of Chinese Medicine(“our hospital”for short)from June 2019 to January 2020 were selected as study group,a total of 60 healthy adults who take a physical examination in the physical examination center of our hospital during the same period were selected as the control group.Serum thyroid hormone levels were measured in all subjects,including thyroid stimulating hormone(TSH),triiodothyronine(T3),free triiodothyronine(FT3),thyroxine(T4)and free thyroxine(FT4).Hamilton anxiety scale(HAMA)was used to evaluate the anxiety level of all members of the study group,there were 20 cases in the mild anxiety group,32 cases in the moderate anxiety group and 10 cases in the severe anxiety group.The differences of thyroid hormone levels between the study group and the control group and among the groups with different degrees of generalized anxiety disorder were compared.The relationship between generalized anxiety disorder and thyroid hormone levels was analyzed,the correlation between the groups with different degrees of generalized anxiety disorder and thyroid hormone levels was explored.Results The levels of T3 and T4 in the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).There were no significant differences in FT3,TSH and FT4 levels between the two groups(P>0.05).There were significant differences in T4 level among groups with different anxiety levels(P<0.05),and T4 level in severe anxiety group was higher than that in mild anxiety group and moderate anxiety group,respectively,with statistical significance(P>0.05).There were no significant differences in TSH,T3,FT3 and FT4 levels among the three groups(P>0.05).The anxiety level of GAD patients was positively correlated with T4 level(r=0.332,P<0.01),and had no significant correlation with FT3,TSH,T3 and FT4.Conclusion Patients with GAD have abnormal thyroid hormone level,that is abnormal thyroid hormone level is correlated with the occurrence of GAD to a certain extent.Reasonable regulation of thyroid hormone level can reduce the risk of GAD to a certain extent.