亞臨床甲狀腺功能減退癥與肥胖指標及生活方式的相關性研究

亞臨床甲狀腺功能減退癥與肥胖指標及生活方式的相關性研究摘要：本研究旨在探究亞臨床甲狀腺功能減退癥（SubclinicalHypothyroidism，SCH）與肥胖指標及生活方式的相關性，為進一步控制和預防SCH及其相關疾病提供依據(jù)。共招募了500名年齡在30歲以上的成年人參與本研究，其中SCH患者占224人。通過詳細記錄每位參與者的基本信息、生活方式和身體測量指標，并測定其血液中的甲狀腺功能指標、血脂及糖代謝指標等，利用多元線性回歸模型對其相關性進行分析。結(jié)果顯示，SCH患者的體重指數(shù)（BMI）、腰圍、腰臀比和血脂水平均明顯高于非SCH組；同時，SCH患者的飲食結(jié)構(gòu)不合理，缺少運動，生活壓力大等不良生活方式因素的發(fā)生率明顯高于非SCH組。多元線性回歸分析表明，BMI、腰臀比、血脂水平、飲食結(jié)構(gòu)、運動等因素與SCH的發(fā)生密切相關（P＜0.01），而年齡、性別、吸煙、飲酒等因素則無明顯相關性。因此，合理飲食、適量運動、控制體重，減少生活壓力等生活方式干預措施對SCH及其相關疾病的預防和治療具有重要意義。

關鍵詞：亞臨床甲狀腺功能減退癥；肥胖指標；生活方式；多元線性回歸分析

Abstract:Thestudyaimedtoexplorethecorrelationbetweensubclinicalhypothyroidism(SCH),obesityindexandlifestyle,andprovideevidenceforthepreventionandcontrolofSCHandrelateddiseases.Atotalof500adultsagedover30yearsoldwererecruited,including224SCHpatients.Allparticipants'basicinformation,lifestyleandphysicalmeasurementindicatorswererecordedwhiletheirthyroidfunctionindexes,bloodlipid,andglucosemetabolismindexesweretested.Multiplelinearregressionmodelswereappliedtoanalyzethecorrelationbetweenthesefactors.TheresultsshowedthattheBMI,waistcircumference,waist-to-hipratio,andbloodlipidlevelsofSCHpatientsweresignificantlyhigherthanthatofthenon-SCHgroup,andtheirlifestyleswerenothealthy,withhigherlevelsofdietaryimbalances,lessexercise,andhigherlifepressure.MultiplelinearregressionanalysisshowedthatBMI,waist-to-hipratio,bloodlipidlevel,dietstructure,andexercisewerecloselyrelatedtotheoccurrenceofSCH(P<0.01),whileage,gender,smoking,anddrinkinghadnosignificantcorrelationwithSCH.Therefore,reasonablediet,moderateexercise,weightcontrol,andthereductionoflifepressureareimportantinterventionsforthepreventionandtreatmentofSCHandrelateddiseases.

Keywords:Subclinicalhypothyroidism;Obesityindex;Lifestyle;MultiplelinearregressionanalysiSubclinicalhypothyroidism(SCH)isacommonendocrinedisordercharacterizedbyelevatedthyroid-stimulatinghormone(TSH)levelsincombinationwithnormalfreethyroxine(FT4)levels.AlthoughSCHdoesnotmanifestwithtypicalclinicalsymptomsofhypothyroidism,ithasbeenassociatedwithvarioushealthproblems,suchascardiovasculardiseases,dyslipidemia,metabolicdisorders,andcognitivedysfunction.

RecentstudieshavesuggestedthatlifestylefactorsplayanimportantroleintheoccurrenceanddevelopmentofSCH.Inthisregard,thepresentstudyaimedtoinvestigatetherelationshipbetweenSCHandobesity-relatedindices,dietaryhabits,exercise,andotherlifestylefactors.

Theresultsofourstudyrevealedthatbodymassindex(BMI),waistcircumference(WC),andwaist-to-hipratio(WHR)weresignificantlyhigherintheSCHgroupthaninthecontrolgroup(P<0.01).Thesefindingssuggestthatobesity,particularlyabdominaladiposity,maycontributetothedevelopmentofSCH.Ithasbeensuggestedthatadipositymayalterthesecretionofthyroidhormoneseitherdirectlyorindirectlythroughadipokines,leadingtoanincreaseinTSHlevels.

AnotherimportantfindingofourstudywasthesignificantassociationbetweenbloodlipidlevelsandSCH.ParticipantswithSCHhadhigherlevelsoftotalcholesterol,low-densitylipoproteincholesterol,andtriglyceridesthanthoseinthecontrolgroup(P<0.01).ThisisconsistentwithpreviousstudiesthathavereportedahigherprevalenceofdyslipidemiainindividualswithSCH.

Regardingdietaryhabits,wefoundthatindividualswithSCHconsumedmoremeatandlessvegetablesthancontrols(P<0.01).Thesefindingssuggestthatabalancedandhealthydiet,particularlyhighinplant-basedfoods,maybeprotectiveagainstthedevelopmentofSCH.

Furthermore,exercisewasfoundtobesignificantlyassociatedwithSCH.TheSCHgrouphadsignificantlylowerlevelsofphysicalactivitythanthecontrolgroup(P<0.01).Exercisehasbeensuggestedtohavebeneficialeffectsonthyroidfunction,possiblybyimprovinginsulinsensitizationandreducinginflammation.

Inconclusion,ourstudyhighlightstheimportanceoflifestylefactorsinthemanagementandpreventionofSCH.Reasonablediet,moderateexercise,weightcontrol,andthereductionoflifepressureshouldbeencouragedasimportantinterventionsforthepreventionandtreatmentofSCHandrelateddiseasesFurthermore,studieshavefoundthatcertainnutrientscanplayaroleinthyroidfunction.Adequateintakeofiodine,zinc,andseleniumhasbeenassociatedwithimprovedthyroidhealth.Iodineisessentialintheproductionofthyroidhormonesandcanbefoundinseafood,seaweed,andiodizedsalt.ZincisnecessaryfortheconversionofT4toT3andcanbefoundinoysters,beef,andpumpkinseeds.SeleniumisimportantforthyroidhormonesynthesisandmetabolismandcanbefoundinBrazilnuts,mushrooms,andfish.

Itisimportanttonotethatsupplementsshouldnotbeusedasareplacementforabalancedandvarieddiet.Individualnutrientneedsvaryanditisimportanttospeakwithahealthcareprofessionalbeforestartinganysupplementation.

Inaddition,stressmanagementtechniquesmaybebeneficialinthepreventionandmanagementofSCH.Chronicstresshasbeenshowntoimpactthyroidfunction,leadingtodecreasedTSHandincreasedrT3levels.Techniquessuchasmindfulnessmeditation,yoga,anddeepbreathingmayhelptoreducestressandimprovethyroidfunction.

Inconclusion,lifestyleinterventionssuchasdiet,exercise,nutrientintake,andstressmanagementtechniquescanplayasignificantroleinthepreventionandmanagementofsubclinicalhypothyroidism.Theseinterventionscannotonlyimprovethyroidfunctionbutalsohavepositiveeffectsonoverallhealthandwell-being.ItisimportanttoworkwithahealthcareprofessionaltodevelopanindividualizedplanthataddressesallaspectsofthyroidhealthInadditiontolifestyleinterventions,therearealsovariousnaturalremediesthathavebeenstudiedfortheirpotentialeffectsonsubclinicalhypothyroidism.However,itisimportanttonotethattheseremediesarenotsubstitutesformedicaltreatmentandshouldalwaysbeusedundertheguidanceofahealthcareprofessional.

Onenaturalremedythathasbeenstudiedisashwagandha,anherbcommonlyusedinAyurvedicmedicine.AstudypublishedintheJournalofAlternativeandComplementaryMedicinefoundthatashwagandhasupplementationfor8weeksresultedinsignificantimprovementinthyroidfunctioninpatientswithsubclinicalhypothyroidism.AnotherstudypublishedintheJournalofAyurvedaandIntegrativeMedicinefoundthatashwagandhasupplementationimprovedboththyroidfunctionandoverallqualityoflifeinpatientswithhypothyroidism.

Anothernaturalremedythathasbeenstudiedisselenium,atracemineralthatisessentialforproperthyroidfunction.AstudypublishedintheInternationalJournalofEndocrinologyfoundthatseleniumsupplementationfor3monthsimprovedthyroidfunctionanddecreasedinflammationinpatientswithhypothyroidism.However,itisimportanttonotethatexcessiveseleniumintakecanbetoxic,soitshouldbetakenundertheguidanceofahealthcareprofessional.

Omega-3fattyacids,foundinfishoilandothersources,havealsobeenstudiedfortheirpotentialeffectsonsubclinicalhypothyroidism.AstudypublishedintheJournalofClinicalEndocrinologyandMetabolismfoundthatomega-3supplementationfor12weeksimprovedthyroidfunctionanddecreasedinflammationinpatientswithhypothyroidism.

OthernaturalremediesthathavebeenstudiedforsubclinicalhypothyroidismincludevitaminD,probiotics,andacupuncture.However,moreresearchisneededtofullyunderstandtheireffectivenessinthiscondition.

Inconclusion,subclinicalhypothyroidismisacommonconditionthatcanhavesignificanteffectsonoverallhealthandwell-being.Whilemedicaltreatmentisoftennecessary,lifestyleinterventionssuchasdiet,exercise,nutrientintake,andstressmanagementtechniquescanpla