Objective: To analyze the thyroid stimulating hormone (TSH) levels in different genders and ages, and the association between TSH level and the risk of coronary heart disease. Methods: The baseline survey was conducted using a multi-stage cluster random sampling method from September to December 2015, in Jurong City, Jiangsu Province. A total of 10 703 participants were included in the analysis. The proportion of participants with abnormally elevated TSH defined by three cut-off values (4.5, 7.0, and 10.0 mU/L) were calculated. The cohort was followed up until August 2023 to collect and verify new cases of coronary heart disease. The population was divided into age-and gender-specific quintile subgroups based on TSH. Multivariate Cox regression analysis was used to examine the relationship between TSH and the risk of coronary heart disease. Results: The median age was [M (Q1, Q3)] 61.1(51.8, 67.9) years-old, and there were 4 168 males (38.94%) in the study. The proportions of participants with abnormally increased TSH rose with aging in different genders, and was higher in females than in males (all Ptrend0.05). A total of 206 participants with coronary heart disease at baseline were excluded, and the other 10 497 were followed up for an average of (7.33±1.49) years, during which 350 new cases of coronary heart disease occurred, and the cumulative incidence rate was 3.34%. The cumulative incidence rates among TSH quintile Q1-Q5 groups were 3.62%, 3.32%, 3.56%, 3.28% and 2.57% respectively. Multivariate Cox regression analysis indicated that compared with TSH Q1 group, participants in Q5 group had a lowest risk of coronary heart disease (HR=0.704, 95%CI: 0.498-0.994). The TSH Q5 group was associated with a reduced risk of coronary heart disease in individuals60 years old (HR=0.484, 95%CI: 0.243-0.965), and the risk of coronary heart disease decreased as TSH levels increased (Ptrend=0.008). Conclusions: TSH level increases with aging, and is higher in females than in males. In individuals 60 years old, higher levels of TSH may assaciate with a lower incidence rate of coronary heart disease.
目的： 分析不同性别、年龄居民促甲状腺激素（TSH）水平及其与冠心病发病风险的关联。 方法： 采用多阶段整群随机抽样法于2015年9—12月在江苏省句容市进行基线调查，共10 703人纳入分析；计算3种切点值（4.5、7.0、10.0 mU/L）定义下TSH异常升高的比例。随访至2023年8月，收集并核实新发冠心病情况。将TSH水平按年龄和性别进行五分位数分组，采用多因素Cox回归模型分析TSH水平与冠心病发病风险的关系。 结果： 研究对象年龄［M（Q1，Q3）］为61.1（51.8，67.9）岁，其中男性4 168名（38.94%）。在3种切点值定义下，不同性别TSH异常升高比例均随着年龄增长而增加（均P趋势0.05），且女性中TSH异常升高比例高于男性。排除基线患冠心病者206例，对其余10 497名研究对象进行随访。随访（7.33±1.49）年，新发冠心病350例，冠心病累积发病率为3.34%，TSH水平五分位数Q1~Q5组累积发病率分别为3.62%、3.32%、3.56%、3.28%、2.57%。多因素Cox回归模型结果显示，与TSH Q1组相比，Q5组冠心病发病风险最低（HR=0.704，95%CI：0.498~0.994）；60岁人群中TSH Q5组与冠心病发病风险降低存在关联（HR=0.484，95%CI：0.243~0.965），且冠心病发病风险随TSH升高呈降低趋势（P趋势=0.008）。 结论： TSH水平随着年龄增长而升高，且女性高于男性。在60岁人群中，TSH水平较高者冠心病发病风险较低。.