甲状腺の状態,障害,認知機能,そして高齢における生存率
Jacobijn Gussekloo1, Eric van Exel, Anton J M de Craen
1Section of Gerontology and Geriatrics, Department of General Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands. jgussekloo@lumc.nl
JAMA
|December 2, 2004
まとめ
最も高齢の高齢者では,高いチロトロピンのレベルは有害な結果と関連付けられず,寿命を延ばす可能性があります. しかし,準臨床的な甲状腺機能不全の治療が高齢者に有益かどうかを確認するために,ランダム化試験が必要である.
科学分野:
- ゲロントロジーはゲロントロジーの学科です.
- エンドクリノロジー エンドクリノロジー
- エピデミオロジー エピデミオロジー
背景:
- 臨床的見解は,多くの場合,混合試験結果にもかかわらず,高齢者のサブ臨床的甲状腺疾患の治療を好みます.
- 高齢期における未治療の甲状腺機能障害の長期的な影響は不明である.
研究 の 目的:
- 甲状腺のサブクリニック機能障害が,最も高齢の高齢者のパフォーマンスと生存に与える影響を調査する.
- 高齢者におけるサブクリニック性甲状腺機能障害の治療が正当化されるかどうかを判断する.
主な方法:
- 85歳以上の599人の個人を対象とした前向きな,人口ベースのフォローアップ研究.
- 甲状腺の状態,日常生活障害,うつ症状,認知機能,および死亡率は,平均3.7年の追跡期間で評価されました.
主要な成果:
- タイロトロピンとフリーチロキシンレベルは,障害,うつ病,または認知障害と関連しませんでした.
- 高いチロトロピンのレベルは,より低い死亡率 (HR,SD増加あたり0.77) と相関しています.
- 自由チロキシン濃度の上昇は死亡率の増加と相関する (HR,SD増加あたり1.16).
結論:
- 最も高齢の高齢者では,チロトロピン濃度の上昇は有害な影響を及ぼさないようで,寿命の延長と関連している可能性があります.
- 高齢者のサブ臨床的な甲状腺機能不全の治療決定を導くために,ランダム化比較試験からのさらなる証拠が必要です.
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