轻度亚临床甲状腺功能减退症是否需要干预:基于循证医学的思考

摘要

亚临床甲状腺功能减退症(SCH)是较为常见的临床疾病,女性发病率大于男性,并随着年龄和促甲状腺激素水平的升高进一步增加.既往的研究发现,即使轻度SCH亦会增加心血管疾病、代谢性疾病和不良妊娠结局等的风险,并且替代治疗可使整体健康获益.但轻度SCH与骨骼肌系统、认知功能异常、情绪障碍、血脂紊乱和糖尿病等之间的联系及其治疗的临床获益仍存在争议.%Subclinical hypothyroidism(SCH) is a common problem (prevalence is greater in women than men),which increases further with increasing age and thyroid stimulating hormone level.Previous studies suggested that even though mild-SCH had a detrimental effect on cardiovascular risk factors and metabolic diseases,and increased risk of adverse pregnancy outcomes,and that its effective treatment might have a beneficial impact on overall health.However,evidence on the association of mild-SCH and musculoskeletal system,cognitive dysfunction,mood disorders,dyslipidaemia,and diabetes,and the clinical benefits of treatment are controversial.