| ObjectTo investigate the effects of thyroid hormone stimulating hormone(TSH)suppressive therapy on the cognition of subclinical hyperthyroidism(SHyper)in middle-aged and young women with differentiated thyroid carcinoma(DTC),and to grope for the impact factors of cognitive dysfunction in middle-aged and young women with DTC.MethodsThe clinical data of young and middle-aged female patients with DTC were analyzed,selected 401 cases of patients which all meeting inclusion and exclusion criteria and agreeing on the assessment of cognitive function.Recent plasma levels of Free triiodothyroid hormone(FT3),Free tetraiodothyroid hormone(FT4)and TSH in patients were detected,on the basis of thyroid function,these patients were grouped into the SHyper group and the Thyroxine replacement therapy(TR)group,and neuropsychological assessment was performed using Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS)and Mini-Mental State Examination(MMSE).The differences in cognitive function,anxiety and depression between the two groups were analyzed.The risk factors of cognitive dysfunction in young and middle-aged women with DTC were analyzed by analysis of univariate and multivariate Logistic regression.ResultsThe mean age of 219 patients in the SHyper group was 51.06±8.35 years old,and the mean hospitalization time was 11.20±4.93 days;The mean age of 182 patients in TR group was 50.34±7.97 years old,and the mean hospitalization time was 9.04±3.73 days.There was no significant difference in FT3(4.69±0.69 pmol/L vs4.83±0.82 pmol/L)and FT4(15.65±3.99pmol/L vs 15.85±3.58pmol/L)between the SHyper group and the TR group(P>0.05).The level of TSH in TR group was significantly higher(1.36±1.00 pmol/L vs 0.08±0.06pmol/L,P<0.001).The oral dose of Levothyroxine(L-T4)in SHyper group was higher than that in TR group(88.53±37.29μg vs 80.98±34.56μg,P<0.05);There was statistically significant difference in the course of oral L-T4 between the two groups(P<0.001).The anxiety of SHyper group was significantly worse than that of TR group(P<0.001);There was no significant difference in depression mood and overall cognitive function between these two groups(P>0.05).For middle-aged and young women with DTC,age(P=0.022,OR=1.06,95%CI=1.01～1.12)may be a risk factor leading to cognitive decline.Conclusions1.For middle-aged and young female DTC patients,exogenous SHyper caused by TSH suppressive therapy after surgery can not increase the risk of cognitive dysfunction compared with patients receiving thyroid hormone replacement therapy,but it is more likely to lead to anxiety in patients.2.Age is closely related to the outcome of cognitive dysfunction in young and middle-aged female DTC patients,and it is a risk factor for cognitive impairment in young and middle-aged female DTC patients. |
