| 张娟娟,何悦荣,唐志远,孙向东,沈家乐,巩建萍,刘超,夏阳.生命九要素与甲状腺功能障碍风险关联的队列研究[J].中华流行病学杂志,2025,46(8):1400-1408 |
| 生命九要素与甲状腺功能障碍风险关联的队列研究 |
| Associations of Life's Crucial 9 and the risk of thyroid dysfunction: a cohort study |
| 收稿日期:2024-12-17 出版日期:2025-08-21 |
| DOI：10.3760/cma.j.cn112338-20241217-00807 |
| 中文关键词: 甲状腺功能障碍 甲状腺功能亢进症 甲状腺功能减退症 生命九要素 队列研究 |
| 英文关键词: Thyroid dysfunction Hyperthyroidism Hypothyroidism Life's Crucial 9 Cohort study |
| 基金项目:河北省高等学校科学研究项目（QN2025221） |
| 作者 | 单位 | E-mail | | 张娟娟 | 河北大学公共卫生学院, 保定 071000
河北省公共卫生安全重点实验室, 保定 071000 | | | 何悦荣 | 河北大学公共卫生学院, 保定 071000 | | | 唐志远 | 河北大学教务处, 保定 071000 | | | 孙向东 | 河北大学公共卫生学院, 保定 071000 | | | 沈家乐 | 河北大学公共卫生学院, 保定 071000 | | | 巩建萍 | 河北大学附属医院体检中心, 保定 071000 | | | 刘超 | 河北大学经济学院, 保定 071000 | | | 夏阳 | 沈阳医学院公共卫生学院, 沈阳 110004
中国医科大学附属盛京医院临床流行病学科, 沈阳 110004 | xytmu507@126.com |
|
| 摘要点击次数: 2878 |
| 全文下载次数: 803 |
| 中文摘要: |
| 目的 探究生命九要素（LC9）与甲状腺功能障碍（TD）风险之间的关联，及其潜在的预测效能。方法 选取来自英国生物银行的247 600名未患TD者为研究对象。将LC9评分划分为低（0~）、中（50~）和高（80~100）3个心血管健康（CVH）组。采用Cox比例风险回归模型计算HR值及其95%CI。通过计算Harrell一致性指数（C指数）、净重新分类指数（NRI）以及综合判别改善指数（IDI），对比评估生命八要素（LE8）评分和LC9评分对TD风险的预测效能。结果 在中位随访的12.3年间，本研究分别记录了5 515、911和4 869名新发TD、甲状腺功能亢进症和甲状腺功能减退症患者。相较于LC9低CVH组，高CVH组发生TD、甲状腺功能亢进症和甲状腺功能减退症风险分别降低57.00%（HR=0.43，95%CI：0.38~0.49）、55.00%（HR=0.45，95%CI：0.34~0.60）和58.00%（HR=0.42，95%CI：0.37~0.47）。此外，与LE8评分相比，LC9评分预测TD风险的C指数为0.004（95%CI：0.001~0.007）、NRI为0.101（95%CI：0.021~0.103）、IDI为0.001（95%CI：0.000~0.001）。结论 由LC9定义的较好CVH状态与较低TD风险相关。相较于LE8评分，LC9评分对TD风险的判别以及重新分类能力均有明显改善。 |
| 英文摘要: |
| Objective Exploring the association between Life's Crucial 9 (LC9) and the risk of thyroid dysfunction (TD), as well as its potential predictive capacity. Methods A total of 247 600 TD-free participants from the UK Biobank were enrolled in the study. The LC9 score was divided into three CVH groups: low (0-), medium (50-), and high (80-100). Cox proportional hazards regression models were used to calculate the HRs and 95%CIs of the risk of TD with LC9 CVH status. Calculate Harrell's concordance index (C-index), net reclassification improvement (NRI), and integrated discrimination improvement (IDI) to evaluate the predictive ability of the LC9 score and Life's Essential 8 (LE8) score. Results During a median follow-up of 12.3 years, 5 515, 911, and 4 869 new cases of TD, hyperthyroidism, and hypothyroidism were documented, respectively. Participants with a high LE8 CVH group had 57.00% (HR=0.43, 95%CI: 0.38-0.49), 55.00% (HR=0.45, 95%CI: 0.34-0.60), and 58.00% (HR=0.42, 95%CI: 0.37-0.47) lower risk of TD, hyperthyroidism, and hypothyroidism, respectively, than those with low CVH group. Compared with the LE8 score, the improvement in C-index for the LC9 score predicted TD risk was 0.004 (95%CI: 0.001-0.007), the NRI was 0.101 (95%CI: 0.021-0.103), and the IDI was 0.001 (95%CI: 0.000-0.001). Conclusions The better CVH status, defined by LC9, was associated with a lower risk of TD. Compared to the LE8 score, the LC9 score demonstrated a significant enhancement in both risk discrimination and reclassification capability for TD risk. |
|
查看全文
Html全文
查看/发表评论 下载PDF阅读器 |
|
| 关闭 |
|
|
|
