老年亚临床甲状腺功能减退症患者血清25-(OH)D_(3)与甲状腺功能的关系

Correlation between serum 25-(OH)D_(3) and thyroid function in elderly patients with subclinical hypothyroidism

目的研究血清25羟基维生素D_(3)[25-(OH)D_(3)]与老年亚临床甲状腺功能减退症患者甲状腺功能的关系。方法选取2020—2021年每年3—5月到山东省慢性病医院就诊的60岁以上诊断为亚临床甲状腺功能减退症(SCH)的患者50例(以下简称SCH组)及正常对照50例(对照组),采集两组临床资料、生化指标、甲功五项、25-(OH)D_(3)。结果SCH组高密度脂蛋白胆固醇(HDL-C)、游离甲状腺素(FT4)、血清钙(Ca^(2+))、25-(OH)D_(3)低于对照组;三酰甘油(TG)、促甲状腺激素(TSH)、抗甲状腺球蛋白抗体(TGAb)、甲状腺过氧化物酶抗体(TPOAb)高于对照组,差异均有统计学意义(P均<0.05);老年人群维生素D(VitD)缺乏、不足的患病率分别为42%、41%。男性、女性VitD营养状况分布比较,差异无统计学意义(P=0.585);不同VitD营养状况组间比较,游离三碘甲状腺原氨酸(FT3)水平差异无统计学意义(P>0.05)。VitD缺乏组分别与正常组和不足组的FT4、TSH、TPOAb、TGAb比较,差异均有统计学意义(P均<0.05)。结论VitD不足可以作为老年人甲状腺功能衰退的危险预警指标,为补充VitD作为预防及治疗亚临床甲状腺功能减退症提供相关依据。

Objective To identify the correlation between serum 25-(OH)D_(3) and thyroid function in elderly patients with subclinical hypothyroidism.Methods A total of 50 elderly patients over 60 years old with subclinical hypothyroidism(SCH group)and 50 age-matched normal controls(normal group)in Shandong Provincial Chronic Disease Hospital from March to May in 2020 and 2021 were selected.Clinical data,biochemical indicators,five thyroid function indicators,and 25-(OH)D_(3) levels were collected.Results High-density lipoprotein cholesterol(HDL-C),free thyroxine(FT4),serum calcium(Ca^(2+))and 25-(OH)D_(3) levels in SCH group were significantly lower than those of control group,while triglyceride(TG),thyroid stimulating hormone(TSH),thyroglobulin antibody(TGAb),thyroid peroxidase antibody(TPOAb)were significantly higher(P<0.05).The prevalence of vitamin D(VitD)deficiency and insufficiency in the elderly was 42%and 41%,respectively.There was no significant difference in the distribution of VitD nutritional status between male and female elderly(P=0.585).There was no significant difference in FT3 among elderly with varied VitD nutritional status(P>0.05).There were statistically significant differences in FT4,TSH,TPOAb,and TGAb between the VitD deficiency group and the normal group and the insufficiency group(P<0.05).Conclusion Insufficient VitD can serve as a risk warning indicator for thyroid function decline in the elderly,providing relevant evidence for supplementing VitD as a preventive and therapeutic measure for subclinical hypothyroidism.