Analysis Of The Characteristics And Related Factors Of Thyroid Function In The Elderly

1 Background and purposeThyroid hormone(TH)is an amino acid hormone,mainly in two forms,thyroxin(3,5,3,5,-tetraiodothyronine,T4)and triiodothyronine.Acids(3,5,3,-thiiodothyronine,T3),in which T4 is also called thyroxin.After T3 or T4 was released into the blood,they entered the target tissue in the form of free thyroid hormone.The results are to accelerate the metabolism of fat,protein,glucose,calciumor phosphorus or to increase the oxygen consumption and heat production of most tissues of the body,and also to promote the growth and development.T4 can also be transformed into a small amount of non-bioactive reverse triiodothyronine by internal ring 5-deiodization(reverse T3,rT3).Hyperthyroidism or hypothyroidism in blood can cause diseases.According to the degree of hyperthyroidism or hypothyroidism,it can be divided into clinical hyperthyroidism or hypothyroidism,subclinical hyperthyroidism or hypothyroidism.In addition,in recent years,scholars in the industry have proposed abnormal thyroid parameters caused by non-thyroid diseases,which are called non-thyroid sick syndrome.(Euthyroid sick syndrome,ESS).With the development of society,most countries in the world have entered an aging society.In the elderly,the number of thyroid diseases is increasing,and people pay more attention to it.The purpose of this study was to investigate the relationship between thyroid hormone level with age,sex,ALB,TC,LDL or CRP in the elderly to provide evidence for longevity,health and integrated management of chronic diseases in elderly patients.2 Data and methodsDuring the period of January 2015 to December 2017,118 cases of geriatric patients from our hospital were collected.According to the age of the elderly in China,they were all over 60 years old,and denied that there are haven thyroid diseases.(Including hyperthyroidism,hypothyroidism,subclinical hyperthyroidism,hypothyroidism and the history of thyroid surgery)including 66 Males and 52 females.Fasting blood was collected at 6 o'clock on the morning of 2nd,and free triiodothyronine(FT3),Free thyroxine(FT4),Thyroid stimulating hormone(TSH),Serum albumin(ALB),Serum cholesterol(TC),Serum low density lipoprotein(LDL),or C-reactive protein level(CRP)was detected to analyze the correlation between the above indexes with thyroid hormone level.3 Results3.1 Comparison of thyroid hormone levels in different age groups.Among 118 patients,the aged of 60-70 years old were 24,the aged of 71-80 years old were 34,and the 64 patients'age were over 80 yeas old.In the different age groups,there was no statistically significant difference in the levels of FT4 and the levels of TSH(p>0.05).There were significant differences in the levels of FT3 among the patients in different age groups(p<0.05).There were significant differences in the levels of FT3 between 60-70 and 71-80 years old groups,and between 60-70and 80 over years old age groups(p<0.05).There was no statistical difference between the other two groups.(p>0.05).The levels of FT3 was negatively correlated with age.There were no significantly correlated between the age and the levels of FT4 or TSH.3.2 Comparison of the levels of thyroid hormones in patients with different sex groupsIn 118 patients,there 66 cases were the male,52 cases were the female.In the two groups,the levels of FT3 or TSH were not statistically significant(p>0.05).The levels of FT4 in women is lower than that of men.The levels of FT4 was statistically significant between the two groups(p<0.05).3.3 Comparison of thyroid hormone levels in patients with different serum albumin groupsIn 118 patients,there were 16 patients in the group that the levels of serum albumin were<30 g/L,24 patients in the group that the levels of serum albumin were 30-35 g/L,and 78 patients in the group that the levels of serum albumin were>35 g/L.There was no significant difference in the levels of TSH between different serum albumin groups(p>0.05).There were significant differences in the levels of FT3 or FT4 between the different serum albumin groups(p<0.05).The levels of FT3 in the group(ALB>35 g/L)was higher than the other goups(ALB<30 g/L or 30-35 g/L).There was statistically significant in the different levels of FT3(p<0.05).There was positively correlated between with FT3 andALB,FT3 levels increased with elevated ALB,.The levels of FT4 in the group(ALB<30g/L)was higher than the other groups(ALB>35g/L or 30-35g/L).There was a statistically significant of the difference groups in the levels of FT4(P<0.05).There was not correlated between the levels of TSH or FT4 with ALB.3.4Comparison of the levels of thyroid hormones in patients with different serum total cholesterol groupIn 118 patients,there were 35 cases in the group that the levels of serum cholesterol was lower than 3.35mmol/L,76 cases in the group that the levels of serum cholesterol was in 3.35-5.7mmol/L,7 cases in the group that the levels of serum cholesterol was higher than 5.7 mmol/L.There was no statistically significant difference in the levels of FT3,FT4 or TSH in patients with different cholesterol groups(p>0.05).3.5Comparison of the levels of thyroid hormones in patients with different serum low-density lipoprotein groupIn 118 patients,there was 60 cases who serum low-density lipoprotein less than 2.06mmol/L,and 58 cases who serum LDL was higher than 2.06mmol/L.There was no satistically significant difference in the levels of FT3,FT4 or TSH in different groups(p>0.05).3.6Compared of the levels of Thyroid hormone in patients with different C-reactive protein groupsAmong 118 patients,there were 37 cases who the levels of C reactive protein higher than or equal to 5 mg/L,and 81 cases who the levels of CRP less than 5 mg/L.There was no significant difference in the levels of TSH between the two groups(p>0.05).There were significant difference in the levels of FT3 between the two groups(p<0.05).The levels of FT4 was positively correlated with CRP.The levels of FT3 was weak negatively correlated with CRP.The levels of TSH was no significant correlation with CRP.4 Conclusions4.1 The level of FT3 in the elderly population was negatively correlated with age,and there was no significant correlation between FT4,TSH and age.FT3 is affected by age and decreases with age,while FT4 and TSH levels are not affected by age,suggesting that this is an important feature of thyroid hormones in the elderly.4.2 The level of FT4 is affected by gender,women are lower than men,and FT3 and TSH are not affected by gender.4.3 FT3 and FT4 were affected by serum albumin,FT3 levels increased with elevated ALB,FT4 levels decreased with elevated ALB,and TSH was not affected by ALB.4 4 FT3 was affected by CRP and decreased with the increase of CRP.FT4 and TSH were not affected by CRP.5 SignificanceThe incidence of thyroid dysfunction in the elderly population increases with age,and most of them are co-existent with multiple chronic diseases.This article provides ideas and basis for the comprehensive diagnosis,treatment and management of elderly patients'diseases.