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老年男性甲状腺功能变化和亚临床甲状腺疾病的演变
Stephanie Y Tan1, S A Paul Chubb1,2, Leon Flicker1,3
1Medical School, University of Western Australia, Perth, WA, Australia.
Clinical endocrinology
|December 7, 2023
概括
在年长的男性中,甲状腺刺激激素 (TSH) 水平随着年龄的增长而增加,导致最初五分之一的甲状腺功能低下症患者出现亚临床甲状腺功能低下症. 较高的基线TSH和年龄预测了这种进展,这表明在这个人口群体中增加了对甲状腺功能障碍的监测.
科学领域:
- 老年学是一门学科.
- 内分泌学 在内分泌学.
- 内部医学 内部医学
背景情况:
- 亚临床甲状腺疾病的患病率随着年龄的增长而上升,但对老年男性的最佳检测和监测策略尚未明确.
- 了解甲状腺刺激激素 (TSH) 和自由甲状腺素 (FT4) 的纵向变化对于管理老年人群中的甲状腺功能障碍至关重要.
研究的目的:
- 评估老年男性的TSH和FT4度及其纵向变化.
- 为了确定70岁及以上男性的亚临床甲状腺功能障碍的患病率和发病率.
主要方法:
- 一项纵向研究涉及994名社区居民,年龄≥70岁,没有先前甲状腺疾病的男性.
- 在基线和平均8.7年后测量了TSH和FT4水平,使用后勤回归和ROC分析来确定事件功能障碍的预测因素.
主要成果:
- 在基线时,8.6%患有亚临床甲状腺功能低下症,1.0%患有亚临床甲状腺功能过强症.
- 在最初的甲状腺功能良好的男性中,有20.0%的人在随访期间发展出亚临床/明显的甲状腺功能低下症.
- 较高的年龄和基线TSH (≥2.34mIU/L) 是发展甲状腺功能低下症的显著预测因素,具有高灵敏度和特异性.
结论:
- 老年男性的TSH度随着时间的推移而增加,而FT4保持相对稳定.
- 五分之一的初始无甲状腺老年男性患有亚临床或明显的甲状腺功能低下症,年龄和较高的TSH基线是关键预测因素.
- 在老年男性,特别是那些高正常TSH水平的男性中,需要加强对甲状腺功能障碍的监测.
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