亚高原地区成人亚临床甲状腺功能减退症患病率调查

The Prevalence of Subclinical Hypothyroidism inAdults from Subhighland Area

目的研究亚高原地区成人亚临床甲减患病率特点以及与性别、年龄的关系。方法纳入2018年4月至2019年5月昆明地区在云南省阜外心血病医院2283例体检者,采集空腹静脉血清,测定受检者血清促甲状腺素(TSH)、游离甲状腺素(FT_(4))、总四碘甲状腺原氨酸(TT_(4))水平以及亚甲减患病率与年龄和性别的关系;比较不同年龄组亚甲减患病率。结果2283例受试者中亚临床甲减患病率为14.7%,其中13.6%为轻度亚临床甲减和1.1%为重度亚临床甲减,轻度亚甲减患病率高于重度亚甲减(P<0.01),且轻度亚甲减TSH低于重度亚甲减、FT_(4)高于重度亚甲减,差异均有统计学意义(P<0.01),女性轻度亚甲减患病率为16.1%明显高于男性患病率11%(P<0.01),在184例女性轻度亚甲减受试者中,不同年龄组间差异存在统计学意义(P<0.01),其中50-60岁组,61-70岁组及≥71岁组患病率均高于18-30岁组及31-40岁组(P<0.05),61-70岁组患病率高于41-50岁组(P<0.05)。在126例男性轻度亚甲减受试者中,≥71岁组高于其他年龄组(P<0.05);女性41-50岁组,51-60岁组,61-70岁组患病率高于同年龄段男性(P<0.05)。结论亚高原地区亚甲减患病率处于较高的水平,轻度亚甲减患病率中老年女性显著升高。

Objective To study the prevalence of adult subclinical hypothyroidism and its relationship with sex and age.Methods From April,2018 to May,2019,2283 patients who underwent physical examination in Fuwai Hospital for Cardiovascular Disease in Yunnan Province in Kunming were included in the study.Fasting venous serum was collected to determine the relationship between serum thyrotropin(TSH),free thyroxine(FT_(4)),total tetraiodinothyroxine(TT_(4))levels and the prevalence of hypothyroidism with age and gender.The prevalence of hypothyroidism in different age groups was compared.Results The prevalence of central Asian clinical hypothyroidism in 2,283 subjects was 14.7%,of which 13.6%were mild subclinical hypothyroidism and 1.1%were severe subclinical hypothyroidism.The prevalence of mild subclinical hypothyroidism was higher than that of severe subclinical hypothyroidism(P<0.01),and TSH of mild subclinical hypothyroidism was lower than that of severe hypothyroidism,while the TSH of mild subclinical hypothyroidism was FT_(4) and higher than that of severe hypothyroidism.The prevalence of mild hypothyroidism in females was 16.1%,which was significantly higher than that in males(11%,P<0.01).In 184 female patients with mild hypothyroidism,there were differences among groups(P<0.01),in which the prevalence of 50 to 60 years old,61 to 70 years old and≥71 years old were higher than those of 18 to 30 years old and 31 to 40 years old(P<0.05),and the prevalence of 61 to 70 years old was higher than that of 41 to 50 years old(P<0.05).Among 126 male patients with mild hypothyroidism,≥71 years old group was higher than other age groups(P<0.05).The prevalence rate in female 41-50 years old group,51-60 years old group and 61-70 years old group was higher than that in male(P<0.05).Conclusion The prevalence of subhypothyroidism is at a high level in subplateau area,and the prevalence of mild subhypothyroidism is significantly higher in middle-aged and elderly women.