健康老年人促甲状腺激素参考区间影响因素的荟萃分析

Meta-Analysis of Factors Influencing Thyroid Stimulating Hormone Reference Intervals in Healthy Older Adults

目的促甲状腺激素(TSH)参考区间容易受年龄、性别、种族、地区和碘营养状况等因素影响,但目前未见全面分析老年人TSH参考区间建立影响因素的研究。方法应用计算机检索PubMed、Embase、Cochrane、Scopus、Medline英文数据库和CNKI、万方、CQVIP中文数据库的文献,检索期限为1960年1月~2021年11月,最终纳入11篇论文。所有数据统计及TSH浓度曲线绘制采用Review Manager 5.3、GraphPad Prism 8.0和Microsoft Excel 2010进行。结果老年人TSH参考区间受年龄影响较小,80岁以后老年人TSH中位数随年龄下降。老年女性TSH中位数普遍高于男性。除70~79岁老年人亚组的样本量存在组间差异外(P<0.05),地区、仪器等亚组差异均未见统计学意义(P>0.05)。结论老年人TSH参考区间主要受性别、样本量因素的影响,本研究为今后老年人TSH参考区间分层的研究提供了依据。

Objective The reference intervals of thyroid stimulating hormone(TSH)are affected by many factors such as age,gender,race,region and iodine nutritional status.So far,however,there are few comprehensive studies on the influential factors of TSH reference intervals in older people.Methods The following databases were searched:PubMed,Embase,Cochrane,Scopus,Medline,CNKI,Wanfang,CQVIP.The retrieval period was from January 1960 to November 2021.A total of 11 papers were finally included.Review Manager 5.3,GraphPad Prism 8.0 and Microsoft Excel 2010 were performed for data analysis and TSH concentration curve plots.Results TSH reference intervals in older adults were rarely affected by age,and the median value of TSH decreased with age after 80.Median value of TSH was generally higher in older women than in men.There were inter-group differences in the sample size of the subgroup aged 70-79(P<0.05),but there were no statistical differences in the subgroups of regions and instruments(P>0.05).Conclusion TSH reference intervals in older people are mainly influenced by gender and sample size.This study provides a basis for further investigation on the stratification of TSH reference intervals in the elderly.