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老年人中阳性发炎毒素症风险的性别差异:对现实世界临床数据的分析
Roy Adams1,2, Jennifer Sophie Mammen3
1Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
概括
年龄较大的女性面临甲状腺激素过度治疗的更高风险,原因是身体组成的差异. 根据瘦体质量调整勒沃西的剂量可能会降低女性的这种风险.
科学领域:
- 内分泌学 在内分泌学.
- 老年病的医生 老年病的医生
- 药理学 药理学是指药理学的学科.
背景情况:
- 用甲状腺激素过度治疗是一个普遍的问题,特别是在老年人中.
- 在女性中观察到更高的过度治疗率,需要了解基于性别的差异.
- 在甲状腺激素治疗中发现导致性别差异的因素,可以改善临床实践和患者的治疗结果.
研究的目的:
- 调查50岁及以上的成年人中阳性发炎毒素与患者的性别之间的关系.
- 探索身体组成和levothyroxine剂量的作用,以性别为基础的差异在iatrogenic发炎毒性病.
- 要确定根据理想或瘦体质量调整甲状腺激素剂量是否可以减轻与性别有关的风险.
主要方法:
- 一项回顾性队列研究使用来自美国大型社区卫生系统的电子健康记录进行.
- 分析了20724名成年患者 (年龄≥50岁) 的数据,重点关注人口统计学,并发病症,身体组成和levothyroxine剂量.
- 调解分析被用来评估身体质量指标 (实际,理想,瘦) 对女性性别和阳性发育性甲状腺毒性之间的关联的影响.
主要成果:
- 妇女占研究人口的77%,比男性更有可能出现低甲状腺激素 (TSH) 水平 (36.7%对23.9%).
- 虽然初步分析显示女性患有较高的阳性铁毒性病的风险,但当基于瘦体质量计算Levothyroxine剂量时,这种关联是完全介导的.
- 与男性相比,女性每实际体重接受的levothyroxine剂量略高 (1.2μg/kg对1.1μg/kg).
结论:
- 身体组成的差异,特别是瘦体质量,似乎解释了与男性相比,在老年女性中观察到的阳性发育性铁毒性病的风险增加.
- 使用基于理想或瘦身体重的剂量计算器,而不是实际体重,可能会降低老年妇女过度治疗的风险.
- 这一发现表明,需要在甲状腺激素剂量策略中考虑性别特异性因素,以提高老年人群的治疗安全性.
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