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老年人甲状腺功能和自身免疫的变化:对Whickham队列的纵向分析

Salman S Razvi^1,2, Helen Wild², Lorna Ingoe²

¹Translational and Clinical Research Institute, Newcastle University Centre for Life, Central Parkway, Newcastle upon Tyne, NE1 3BZ, UK.

The Journal of clinical endocrinology and metabolism

|December 14, 2024

概括

甲状腺功能随着年龄的增长而发生变化,可能导致甲状腺功能低下的过度诊断. 使用甲状腺刺激激素 (TSH) 的特定年龄参考范围可以防止老年人不必要的治疗.

科学领域:

内分泌学在内分泌学.
老年医学老年医学
临床诊断临床诊断临床诊断

背景情况:

纵向的甲状腺功能研究产生不一致的结果.
衰老对甲状腺功能和亚临床甲状腺功能低下症诊断的影响尚不清楚.

研究的目的:

在老化队列中研究甲状腺功能参数的纵向变化.
评估标准与适龄基准范围对亚临床甲状腺功能低下症的诊断影响.

主要方法:

对204名老年人进行了跟踪 (2008-2012年和2016-2019年).
测量了血清甲状腺激素 (TSH),自由甲状腺素 (FT4),自由三甲状腺素 (FT3) 和甲状腺过氧化酶抗体 (TPOAb).
不包括甲状腺疾病或服用影响甲状腺的药物的人.

主要成果:

血清TSH增加,而FT3和TPOAb下降;FT4保持稳定.
在随访期间,正常TSH的上限增加.
标准范围导致亚临床甲状腺功能障碍患病率上升 (3.5%至9.0%),而特定年龄范围保持在2.0%.

结论:

甲状腺功能表现出与年龄相关的变化.
标准TSH参考范围可能会在老年人中过度诊断亚临床甲状腺功能低下症.
适合年龄的TSH范围可以减少不必要的诊断和治疗.

关键词:

在 TSH 中,您可以使用衰老的衰老衰老的衰老甲状腺功能甲状腺功能

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