甲状腺功能正常及亚临床甲状腺功能减退的老年人血清促甲状腺激素水平与认知障碍的相关性

doi:10.3969/j.issn.1003-9198.2024.05.013

Abstract

Abstract: Objective To investigate the association between serum thyroid-stimulating hormone (TSH) level and cognitive impairment (CI) in the elderly with normal thyroid function or subclinical hypothyroidism (SCH). Methods A total of 292 elderly patients with normal thyroid function or SCH in Department of Geriatrics, Jiangsu Province Hospital from Jul 2016 to Dec 2018 were retrospectively enrolled in this study. Montreal Cognitive Assessment(MoCA)was used to measure the cognitive function. The demographic and clinical data were collected.The restricted cubic spline model and multivariate Logistic regression model were used to explore the correlation between serum TSH concentration and the risk of CI and the dose-response relationship, and subgroup analyses were performed to evaluate the influence of multiple factors on CI. Results The CI group (MoCA < 26, n=230) included 30 cases of SCH, while the non-CI group (MoCA ≥ 26, n=62) had no SCH case, showing a significant difference in SCH prevalence (P<0.001). No significant difference in TSH level were observed between the two groups (P>0.05).Restricted cubic spline showed that the dose-response relationship between TSH and the risk of CI was U-shaped (P=0.047).The SCH patients were set as the SCH group, and those with normal TSH level were divided into normal low group (0.41-1.48 mIU/L), normal middle group (1.49-2.51 mIU/L) and normal high group (2.52-4.50 mIU/L) according to tertile of TSH levels. After adjustment for all confounders, the odds ratios for CI were 0.37(95%CI: 0.16-0.80) and 7.72(95%CI: 2.15-51.02) for the normal high group and SCH group, respectively, compared with the normal low group.Subgroup analysis showed that the serum TSH level was significantly negatively associated with the risk of CI in male subjects and subjects aged 75 years and over (P<0.05). Conclusions Increased serum TSH levels within the normal range may reduce the risk of cognitive impairment. SCH is an independent risk factor for cognitive impairment in the elderly.

Key words: subclinical hypothyroidism, cognitive impairment, aged, thyroid-stimulating hormone

CLC Number:

WEI qian, CAI Yingyuan, WANG Shan,TAN Fuyun, LU Xiaowei. Relationship between serum thyrotropin and risk of cognitive impairment in elderly with normalthyroid function and subclinical hypothyroidism[J]. Practical Geriatrics, 2024, 38(5): 486-437.

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Relationship between serum thyrotropin and risk of cognitive impairment in elderly with normalthyroid function and subclinical hypothyroidism

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