CAJ | 학술논문

背景：目前相关研究认为，亚临床甲状腺功能减退与颈动脉内膜中层厚度存在相关性，但此观点仍存在许多争议。目的：评价分析亚临床甲状腺功能减退患者的颈动脉内膜中层厚度与甲状腺功能正常者的颈动脉内膜中层厚度是否存在差异。方法：收集已公开发表的有关亚临床甲状腺功能减退患者颈动脉内膜中层厚度与甲状腺功能正常者比较的相关研究，按照Meta分析的要求对检索到的原始文献的研究方法及研究数据进行评价。结果与结论：符合纳入标准的文献8篇，总样本量3602例。合并结果提示，亚临床甲状腺功能减退组与甲状腺功能正常的对照组的颈动脉内膜中层厚度的差异有显著性意义[加权平均差WMD=0.056，95%CI(0.020，0.092)]。敏感性分析的合并结果采用7项质量更高的研究，进一步证明了亚临床甲状腺功能减退患者的颈动脉内膜中层厚度高于对照组[加权平均差 WMD=0.064，95%CI(0.024，0.105)]。亚组分析中，在促甲状腺激素≥10 mU/L的患者，亚临床甲状腺功能减退与颈动脉内膜中层厚度更有显著性关联[加权平均差WMD=0.082，95%CI(0.049，0.116)]。同时，亚临床甲状腺功能减退也与收缩压增高、三酰甘油、总胆固醇、低密度脂蛋白及空腹血糖水平等存在相关性。结果提示，亚临床甲状腺功能减退与颈动脉内膜中层厚度存在相关性，这可能与促甲状腺激素水平的提高、血脂异常、高血压有关。尽管存在明显的个体差异，去进一步评估此观察的结论，大样本量的前瞻性研究是有必要的。
배경：목전상관연구인위，아림상갑상선공능감퇴여경동맥내막중층후도존재상관성，단차관점잉존재허다쟁의。목적：평개분석아림상갑상선공능감퇴환자적경동맥내막중층후도여갑상선공능정상자적경동맥내막중층후도시부존재차이。방법：수집이공개발표적유관아림상갑상선공능감퇴환자경동맥내막중층후도여갑상선공능정상자비교적상관연구，안조Meta분석적요구대검색도적원시문헌적연구방법급연구수거진행평개。결과여결론：부합납입표준적문헌8편，총양본량3602례。합병결과제시，아림상갑상선공능감퇴조여갑상선공능정상적대조조적경동맥내막중층후도적차이유현저성의의[가권평균차WMD=0.056，95%CI(0.020，0.092)]。민감성분석적합병결과채용7항질량경고적연구，진일보증명료아림상갑상선공능감퇴환자적경동맥내막중층후도고우대조조[가권평균차 WMD=0.064，95%CI(0.024，0.105)]。아조분석중，재촉갑상선격소≥10 mU/L적환자，아림상갑상선공능감퇴여경동맥내막중층후도경유현저성관련[가권평균차WMD=0.082，95%CI(0.049，0.116)]。동시，아림상갑상선공능감퇴야여수축압증고、삼선감유、총담고순、저밀도지단백급공복혈당수평등존재상관성。결과제시，아림상갑상선공능감퇴여경동맥내막중층후도존재상관성，저가능여촉갑상선격소수평적제고、혈지이상、고혈압유관。진관존재명현적개체차이，거진일보평고차관찰적결론，대양본량적전첨성연구시유필요적。
BACKGROUND:Recently, subclinical hypothyroidism has been associated with increased carotid intima-media thickness, but it is controversial. OBJECTIVE:To assess whether carotid intima-media thickness in patients with subclinical hypothyroidism differs from that in euthyroid subjects. METHODS:We searched published studies concerning the carotid intima-media thickness of patients with subclinical hypothyroidism in comparison with euthyroid subjects. Then, we evaluated each potential study for eligibility, assessed the methodological quality, and extracted the data for a Meta-analysis. RESULTS:Eight observational studies with 3 602 cases met the eligibility criteria. In patients with subclinical hypothyroidism, the pooled estimate of the weighted mean difference (WMD) of increased carotid intima-media thickness was 0.056 [95%CI (0.020, 0.092)]. Sensitivity analysis using a pooled result of the seven higher-quality studies demonstrated higher carotid intima-media thickness level in patients with subclinical hypothyroidism than in euthyroid subjects [WMD=0.064, 95%CI(0.024, 0.105)]. In a subgroup analysis, subclinical hypothyroidism was even more significantly associated with the carotid intima-media thickness in patients with a mean thyrotropin level > 10.0 mU/L [WMD=0.082, 95%CI (0.049, 0.116)]. Subclinical hypothyroidism was also associated with a significant increase in systolic blood pressure, triglyceride levels, total cholesterol levels, low-density lipoprotein levels and with a decrease in fasting plasma glucose. This meta-analysis indicates that subclinical hypothyroidism is associated with an increased carotid carotid intima-media thickness, which may be due to elevated thyrotropin, dyslipidemia and hypertension. Despite the obvious individual differences, a prospective large-sample study is necessary to further assess the conclusions of this observation.