甲状腺功能正常人群中甲状腺激素水平与高尿酸血症的关联研究

Associations between thyroid hormone levels and hyperuricemia in population with normal thyroid function

目的:本文旨在研究甲状腺功能正常人群中甲状腺激素水平与高尿酸血症之间的关联。方法:这是一项横断面研究,共纳入12 445名参与者(6 649名男性和5 796名女性),他们是2018年1月至2018年12月在天津医院接受健康检查的人群。采用化学发光免疫分析法测定血清中促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)和游离甲状腺素(FT4)水平。高尿酸血症的诊断标准:血清尿酸>420μmol/L。使用二元逻辑回归计算甲状腺激素水平与高尿酸血症风险的优势比和95%置信区间(95%CI)。结果:共计2 247例参与者(18.1%)存在高尿酸血症。在多因素模型中,高水平TSH(≥2.5μIU/mL)发生高尿酸血症风险是低水平TSH(<2.5μIU/mL)的0.825(95%CI0.716~0.950)倍。此外,FT3/FT4比值与高尿酸血症风险呈负相关,每增加一个标准差,高尿酸血症风险降低0.060(95%CI 0.891~0.992)。进一步以TSH水平进行分层,发现低水平TSH人群中,FT3/FT4比值与高尿酸血症的发病风险的关联无统计学意义,而在高水平TSH人群中,FT3/FT4比值与高尿酸血症的发病风险呈显著负相关(0.865,0.759~0.985)。结论:本研究发现在甲状腺功能正常人群中,TSH和FT3/FT4比值与高尿酸血症的发病风险显著相关,且高水平TSH显著地增加FT3/FT4比值对高尿酸血症发病风险的影响。

Objective:To investigate the associations between thyroid hormone levels and the risk of hyperuricemia in population with normal thyroid function.Materials and methods:It was a cross-sectional study including 12445 participants(6649 men and 5796 women)who underwent a health check-up at the Tianjin Medical University General Hospital(Tianjin,China)between January,2018 and December,2018.Chemiluminescence immunoassay method was used to estimate the levels of thyroid stimulating hormone(TSH),free triiodothyronine(FT3)and free thyroxine(FT4)in the serum samples.Hyperuricemia was defined as serum uric acid>420μmol/L.Binary logistic regression was used to calculate the odds ratio(OR)and 95%confidence intervals(95%CI)of thyroid hormone levels with the risk of hyperuricemia.Results:A total of 2247 participants(18.1%)were found to have hyperuricemia.In the multivariable models,the OR of high TSH(≥2.5μIU/mL)for the risk of hyperuricemia was 0.825(95%CI 0.716~0.950)that of low TSH(<2.5μIU/mL).In addition,FT3/FT4 was negatively associated with the risk of hyperuricemia,and the risk of hyperuricemia was reduced by 0.060(95%CI 0.891~0.992)for increases per standard deviation.In subgroup analyses,there was no statistically significant association between FT3/FT4 and the risk of hyperuricemia in poplution with low TSH,while FT3/FT4 was significantly negatively associated with the risk of hyperuricemia(0.865,0.759~0.985)in poplution with high TSH.Conclusions:This study found that TSH and FT3/FT4 were significantly associated with the risk of hyperuricemia in population with normal thyroid function,and high TSHsignificantly increased the effect of FT3/FT4 on the risk of hyperuricemia.