A cross-sectional study of thyroid disease and dyslipidemia in elderly people in iodine excessive areas

Zhang Mengjie; Sun Yu; Wang Yan; Ni Wenjing; Wang Xiaowei; Wang Qifeng; Chen Guofang; Shen Tonggao; Liu Chao; Xu Shuhang

doi:10.13406/j.cnki.cyxb.003137

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A cross-sectional study of thyroid disease and dyslipidemia in elderly people in iodine excessive areas

Thyroiddiseasein the elderly | 更新时间：2025-10-21

- A cross-sectional study of thyroid disease and dyslipidemia in elderly people in iodine excessive areas
- Journal of Chongqing Medical University Vol. 47, Issue 11, Pages: 1305-1310(2022)
- 作者机构：
  
  1.南京中医药大学附属中西医结合医院内分泌科，南京 210028
  2.徐州医科大学附属宿迁医院内分泌科，宿迁 223800
  3.徐州医科大学附属宿迁医院老年医学科，宿迁 223800
  4.徐州睢宁县糖尿病内分泌医院，徐州 221200
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.003137
  CLC： R581
- Received：25 January 2022，
  
  Published：28 November 2022
- 稿件说明：
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张梦杰,孙宇,王艳,等.高碘地区老年人群甲状腺疾病与血脂紊乱的横断面调查研究[J].重庆医科大学学报,2022,47(11):1305-1310.

Zhang Mengjie,Sun Yu,Wang Yan,et al.A cross-sectional study of thyroid disease and dyslipidemia in elderly people in iodine excessive areas[J].Journal of Chongqing Medical University,2022,47(11):1305-1310.
张梦杰,孙宇,王艳,等.高碘地区老年人群甲状腺疾病与血脂紊乱的横断面调查研究[J].重庆医科大学学报,2022,47(11):1305-1310. DOI： 10.13406/j.cnki.cyxb.003137.

Zhang Mengjie,Sun Yu,Wang Yan,et al.A cross-sectional study of thyroid disease and dyslipidemia in elderly people in iodine excessive areas[J].Journal of Chongqing Medical University,2022,47(11):1305-1310. DOI： 10.13406/j.cnki.cyxb.003137.

摘要

目的

调查高碘地区老年人群甲状腺疾病的患病率，分析促甲状腺激素（thyroid stimulating hormone，TSH）水平与血脂紊乱患病率的相关性。

方法

筛选该地区65岁及以上老年人258人，根据年龄分为3组（65~69岁组、70~74岁组和≥75岁组）。每位受试者都完成问卷调查、体格检查、甲状腺超声检查和甲状腺功能检测。采用卡方检验比较各个年龄组老年人甲状腺功能异常及结节的患病率和不同TSH水平下血脂紊乱的患病率。使用斯皮尔曼相关分析年龄与TSH之间的相关性，采用简单线性回归建立回归方程。

结果

老年人群的中位尿碘浓度为397.60（225.58，647.73） μg/L，甲状腺疾病的总患病率为48.84%（126/258）。其中，甲状腺功能异常和甲状腺结节的患病率均为24.42%（63/258），亚临床甲状腺功能减退症为最常见的甲状腺功能异常

，患病率为22.48%（58/258），且随着年龄增加逐渐升高（

0.01）。年龄与TSH水平呈正相关（相关系数为0.31，

0.001）。随着TSH水平的逐渐升高，高总胆固醇（total cholesterol，TC）血症（

=0.020）、低高密度脂蛋白胆固醇血症（

=0.010）及高低密度脂蛋白胆固醇（low density lipoprotein cholesterin，LDL-C）血症（

0.01）的患病率逐渐升高，当TSH水平≥10 mU/L时，高TC血症和高LDL-C血症的患病率均高达66.67%（4/6）。

结论

高碘地区老年人群甲状腺疾病患病率较高，以亚临床甲状腺功能减退症和甲状腺结节为主。TSH水平随年龄增加呈逐渐升高趋势。随TSH水平逐渐升高，老年人血脂紊乱的患病率逐步攀升，以高TC血症和高LDL-C血症常见。

Abstract

Objective

To investigate the prevalence of thyroid diseases，and analyze the level of thyroid stimulating hormone（TSH） and the prevalence of dyslipidemia in elderly people in iodine excessive areas.

Methods

A total of 258 elderly people aged 65 and above were selected and divided into three groups according to age（65-69 years old，70-74 years old and ≥75 years old）. Each subject completed a questionnaire，physical examination，thyroid ultrasound and thyroid function test. Chi-square test was used to compare the prevalence of thyroid dysfunction and nodules and the prevalence of dyslipidemia under different TSH levels. Spearman correlation was used to analyze the correlation between age and TSH，and simple linear regression was used to establish the regression equation.

Results

The median urinary iodine concentration level of the elderly was 397.60（225.58，647.73） μg/L，and the total prevalence of thyroid diseases was 48.84%（126/258）. Among them， the prevalence of thyroid dysfunction and thyroid nodule were 24.42%（63/258），and subclinical hypothyroidism was the most common thyroid dysfunction， with the prevalence of 22.48%（58/258），and gradually increased with age（

0.01）. Age was positively correlated with TSH level（correlation coefficient=0.31，

0.001）. With the gradual increase of TSH level，the prevalence of high total cholesterol（T

C）（

0.020），low high density lipoprotein cholesterin（

=0.010） and low density lipoprotein cholesterin（LDL-C）（

0.01） gradually increased. When TSH level ≥10 mU/L，the prevalence of high TC and high LDL-C were up to 66.67%（4/6）.

Conclusion

Subclinical hypothyroidism and thyroid nodules are the main thyroid diseases in the elderly in iodine excessive areas. TSH level increases gradually with age. With the gradual increase of TSH level，the prevalence of dyslipidemia in the elderly gradually increase，with high TC and high LDL-C being the most common.

关键词

Keywords

references

国家统计局 . 第七次全国人口普查公报（第五号） [EB/OL ] .（ 2021-05-11 ）[ 2021-12-15 ] . http://www.stats.gov.cn/tjsj/tjgb/rkpcgb/qgrkpcgb http://www.stats.gov.cn/tjsj/tjgb/rkpcgb/qgrkpcgb .

National Bureau of Statistics . Bulletin of the seventh national census（No.5） [EB/OL ] . （ 2021-05-11 ）[ 2021-12-15 ] . http://www.stats.gov.cn/tjsj/tjgb/rkpcgb/qgrkpcgb http://www.stats.gov.cn/tjsj/tjgb/rkpcgb/qgrkpcgb .

中华医学会老年医学分会老年内分泌代谢疾病学组，中华医学会内分泌学分会甲状腺学组 . 中国老年人甲状腺疾病诊疗专家共识（2021） [J ] . 中华老年医学杂志， 2021 ， 40 （ 5 ）： 529 - 549 .

Expert consensus on diagnosis and treatment for elderly with thyroid diseases in China ( 2021 )[J ] . Chin J Geriatr， 2021 ， 40 （ 5 ）： 529 - 549 .

Li YZ ， Teng D ， Ba JM ， et al . Efficacy and safety of long-term universal salt iodization on thyroid disorders：epidemiological evidence from 31 provinces of mainland China [J ] . Thyroid ， 2020 ， 30 （ 4 ）： 568 - 579 .

Kwon H ， Kim WG ， Jeon MJ ， et al . Age-specific reference interval of serum TSH levels is high in adolescence in an iodine excess area：Korea national health and nutrition examination survey data [J ] . Endocrine ， 2017 ， 57 （ 3 ）： 445 - 454 .

Taylor PN ， Albrecht D ， Scholz A ， et al . Global epidemiology of hyperthyroidism and hypothyroidism [J ] . Nat Rev Endocrinol ， 2018 ， 14 （ 5 ）： 301 - 316 .

王　欣，任巧华，雷　琳，等 . 老年亚临床甲状腺功能减退症血脂水平及颈动脉内膜中层厚度的研究 [J ] . 中国临床保健杂志， 2019 ， 22 （ 2 ）： 212 - 215 .

Wang X ， Ren QH ， Lei L ， et al . Serum lipid level and carotid intima-media thickness in the elderly with subclinical hypothyroidism [J ] . Chin J Clin Healthc ， 2019 ， 22 （ 2 ）： 212 - 215 .

Manolis AA ， Manolis TA ， Melita H ， et al . Subclinical thyroid dysfunction and cardiovascular consequences：an alarming wake-up call? [J ] . Trends Cardiovasc Med ， 2020 ， 30 （ 2 ）： 57 - 69 .

江苏省卫健委 . 关于水源性高碘地区范围的通告（通告〔2018〕1号）[EB/OL ] . （ 2018-10-19 ）[ 2021-12-15 ] . http://wjw.jiangsu.gov.cn/art/2018/10/19/art_7312_7845100.html http://wjw.jiangsu.gov.cn/art/2018/10/19/art_7312_7845100.html .

Jiangsu Provincial Health Commission . Circular on the extent of areas with high iodine in water sources（Circular No.1 [2018 ] ）[EB/OL ] . （ 2018-10-19 ）[ 2021-12-15 ] . http://wjw.jiangsu.gov.cn/art/2018/10/19/art_7312_7845100.html http://wjw.jiangsu.gov.cn/art/2018/10/19/art_7312_7845100.html .

中华医学会内分泌学分会《中国甲状腺疾病诊治指南》编写组 . 中国甲状腺疾病诊治指南：甲状腺功能亢进症 [J ] . 中华内科杂志， 2007 ， 46 （ 10 ）： 876 - 882 .

Compilation group of Guidelines for Diagnosis and Treatment of Thyroid Diseases in China, Chinese Society of Endocrinology . Guidelines for the diagnosis and treatment of thyroid diseases in China-hyperthyroidism [J ] . Chin J Intern Med ， 2007 ， 46 （ 10 ）： 876 - 882 .

中华医学会内分泌学分会 . 成人甲状腺功能减退症诊治指南 [J ] . 中华内分泌代谢杂志， 2017 ， 33 （ 2 ）： 10 - 12 .

Chinese Society of Endocrinology . Guidelines for diagnosis and treatment of adult hypothyroidism [J ] . Chin J Endocrinol Metab ， 2017 ， 33 （ 2 ）： 10 - 12 .

诸骏仁，高润霖，赵水平，等 . 中国成人血脂异常防治指南（2016年修订版） [J ] . 中国循环杂志， 2016 ， 31 （ 10 ）： 937 - 953 .

Zhu JR ， Gao RL ， Zhao SP ， et al . Guidelines for prevention and treatment of dyslipidemia in adults in China （revised edition in 2016） [J ] . Chin Circ J ， 2016 ， 31 （ 10 ）： 937 - 953 .

中华医学会地方病学分会，中国营养学会，中华医学会内分泌学分会 . 中国居民补碘指南 [M ] . 北京：人民卫生出版社， 2018 .

Local Epidemiology Society of Chinese Medical Association , Chinese Nutrition Society Chinese Society of Endocrinology . Iodine supplementation guidelines for Chinese residents [M ] . Beijing ： People's Medical Publishing House ， 2018 .

WHO . Assessment of iodine deficiency disorders and monitoring their elimination: a guide for programme managers [M ] . 3rd ed . World Health Organization ， 2007 .

Cappola AR ， Fried LP ， Arnold AM ， et al . Thyroid status，cardiovascular risk，and mortality in older adults [J ] . JAMA ， 2006 ， 295 （ 9 ）： 1033 - 1041 .

Diaz-Olmos R ， Nogueira AC ， Penalva DQ ， et al . Frequency of subclinical thyroid dysfunction and risk factors for cardiovascular disease among women at a workplace [J ] . Revista Paulista De Med ， 2010 ， 128 （ 1 ）： 18 - 23 .

Zhai XD ， Zhang L ， Chen LL ， et al . An age-specific serum thyrotropin reference range for the diagnosis of thyroid diseases in older adults：a cross-sectional survey in China [J ] . Thyroid ， 2018 ， 28 （ 12 ）： 1571 - 1579 .

Goichot B ， Raverot V ， Klein M ， et al . Management of thyroid dysfunctions in the elderly. French Endocrine Society consensus 2019 guidelines. Short version [J ] . Ann Endocrinol（Paris）， 2020 ， 81 （ 5 ）： 511 - 515 .

Zhang YC ， Sun Y ， He ZW ， et al . Age-specific thyrotropin references decrease over-diagnosis of hypothyroidism in elderly patients in iodine-excessive areas [J ] . Clin Endocrinol （Oxf）， 2021 Sep 28.

Guan HX ， Shan ZY ， Teng XC ， et al . Influence of iodine on the reference interval of TSH and the optimal interval of TSH：results of a follow-up study in areas with different iodine intakes [J ] . Clin Endocrinol（Oxf）， 2008 ， 69 （ 1 ）： 136 - 141 .

Teng WP ， Shan ZY ， Teng XC ， et al . Effect of iodine intake on thyroid diseases in China [J ] . N Engl J Med ， 2006 ， 354 （ 26 ）： 2783 - 2793 .

Zhao M ， Yang T ， Chen L ， et al . Subclinical hypothyroidism might worsen the effects of aging on serum lipid profiles：a population-based case-control study [J ] . Thyroid ， 2015 ， 25 （ 5 ）： 485 - 493 .

Kanaya AM ， Harris F ， Volpato S ， et al . Association between thyroid dysfunction and total cholesterol level in an older biracial population：the health，aging and body composition study [J ] . Arch Intern Med ， 2002 ， 162 （ 7 ）： 773 - 779 .

Gu YQ ， Meng G ， Zhang Q ， et al . Thyroid function and lipid profile in euthyroid adults：the TCLSIH cohort study [J ] . Endocrine ， 2020 ， 70 （ 1 ）： 107 - 114 .

Razvi S ， Jabbar A ， Pingitore A ， et al . Thyroid hormones and cardiovascular function and diseases [J ] . J Am Coll Cardiol ， 2018 ， 71 （ 16 ）： 1781 - 1796 .

Chrysant SG . The current debate over treatment of subclinical hypothyroidism to prevent cardiovascular complications [J ] . Int J Clin Pract ， 2020 ， 74 （ 7 ）： e13499 .

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