中国全科医学2017，Vol.20Issue(31)：3893-3897,5.DOI:10.3969/j.issn.1007-9572.2017.31.012
基于心血管事件的促甲状腺激素参考范围上限值研究
TSH Upper Reference Limit and Cardiovascular Events
摘要
Abstract
Objective To investigate the prevalence of cardiovascular events in population with different thyroid stimulating hormone (TSH) levels and explore the association between TSH upper reference limit and prevalence of cardiovascular events.Methods This was an ancillary study of the " Risk Evaluation of cAncers in Chinese diabeTic Individuals:A lONgitudinal (REACTION study)".7 711 residents aged 40 or over and had TSH levels within the reference range in Yunyan District,Guiyang were selected as the subjects from May to August in 2011.Divided them into four groups based on their TSH levels,group 1 (n =1 297,TSH levels ranged from 0.550 ～ 1.499 mU/L);group 2 (n =2 623,TSH levels ranged from 1.500～2.499 mU/L),group 3 (n =2 188,TSH levels ranged from 2.500 ～3.499 mU/L) and group 4 (n =1 603,TSH levels ranged from 3.500 ～ 4.780 mU/L).The prevalence of cardiovascular events was compared in the four groups of subjects.And the association between serum TSH levels within the reference range and prevalence of cardiovascular events was investigated by Logistic regression analysis.Results The average TSH levels of groups 1,2,3 and 4 were (1.148 ± 0.251),(2.004 ± 0.284),(2.977 ± 0.286) and (4.078 ± 0.363) mU/L,respectively.The four groups had significant differences in male to female ratio,levels of total cholesterol (TC),triacylglycerol (TG) and low-density lipoprotein cholesterol (LDL-C) (P ＜ 0.05),but not in mean age,BMI,waist circumference,systolic blood pressure,diastolic blood pressure,fasting plasma glucose (FPG) and high-density lipoprotein cholesterol (HDL-C) (P ＞ 0.05).The prevalence of cardiovascular events did not differ significantly between the four groups (P ＞ O.05).Logistic regression analysis showed that the level of TSH in the reference range was not associated with the prevalence of cardiovascular events (P ＞ 0.05).After adjusting for sex and age,the level of TSH in the reference range was not associated with the prevalence of cardiovascular events (P ＞ 0.05).Furthermore,after adjusting for sex,age,FPG,TC,TG,LDL-C and HDL-C,the level of TSH in the reference range was still not associated with the prevalence of cardiovascular events (P ＞ 0.05).Conclusion The prevalences of cardiovascular events for population with different TSH levels within the reference range are similar.Therefore,this cross-sectional study does not provide an evidence in support of lowering the TSH upper reference limit is associated with decreased prevalence of cardiovascular events.关键词
促甲状腺素/参考值/心血管疾病/脑血管疾病Key words
Thyrotropin/Reference values/Cardiovascular diseases/Cerebrovascular disease分类
医药卫生引用本文复制引用
袁丽莉,彭年春,时立新,张巧,胡颖,张淼,庄惠君..基于心血管事件的促甲状腺激素参考范围上限值研究[J].中国全科医学,2017,20(31):3893-3897,5.基金项目
贵州省省长资金临床应用课题专项研究(黔省专合字2012-100号) （黔省专合字2012-100号）
