Thyroid function and risk of all-cause and cardiovascular mortality: a prospective population-based cohort study.

Groothof, Dion; Flores-Guerrero, Jose L; Nolte, Ilja M; Bouma, Hjalmar R; Gruppen, Eke G; Bano, Arjola; Post, Adrian; Kootstra-Ros, Jenny E; Hak, Eelko; Bos, Jens H J; de Borst, Martin H; Gans, Reinold O B; Links, Thera P; Dullaart, Robin P F; Bakker, Stephan J L (2021). Thyroid function and risk of all-cause and cardiovascular mortality: a prospective population-based cohort study. Endocrine, 71(2), pp. 385-396. Springer (part of Springer Nature): Springer Open Choice Hybrid Journals 10.1007/s12020-020-02397-z

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PURPOSE

Although thyroid hormones are irrefutably implicated in cardiovascular physiology, the impact of within-reference range variations of thyroid function on cardiovascular disease (CVD) remains unclear. Elucidating this is important, since it could foster preventive treatment and reduce global CVD burden. We therefore investigated the impact of within-reference range variations of thyroid function on all-cause and cardiovascular mortality.

METHODS

We included community-dwelling individuals aged 28-75 years from a prospective cohort study, without known use of thyroid-affecting therapy and with thyrotropin within reference range. Associations of thyroid function with mortality were quantified using Cox models and adjusted for sociodemographic and cardiovascular risk factors.

RESULTS

Mean (SD) age of the 6,054 participants (52.0% male) was 53.3 (12.0) years. During 47,594 person-years of follow-up, we observed 380 deaths from all causes and 103 from CVDs. Although higher thyrotropin was not associated with all-cause mortality (adjusted HR 1.02, 95% CI 0.92-1.14), point estimates for cardiovascular mortality diverged toward increased risk in younger (<72 years) participants (1.31, 1.00-1.72) and decreased risk in elderly (≥72 years) (0.77, 0.56-1.06). Higher free thyroxine (FT4) was associated with all-cause mortality (1.18, 1.07-1.30) and with cardiovascular mortality only in elderly (1.61, 1.19-2.18), but not in younger participants (1.03, 0.78-1.34). Higher free triiodothyronine (FT3) was associated with all-cause mortality in females only (1.18, 1.02-1.35). FT3 was not associated with cardiovascular mortality (0.91, 0.70-1.18).

CONCLUSIONS

Community-dwelling elderly individuals with high-normal thyroid function are at increased risk of all-cause and cardiovascular mortality, reinforcing the need of redefining the current reference ranges of thyroid function.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

UniBE Contributor:

Bano, Arjola

Subjects:

300 Social sciences, sociology & anthropology > 360 Social problems & social services
600 Technology > 610 Medicine & health

ISSN:

1355-008X

Publisher:

Springer (part of Springer Nature): Springer Open Choice Hybrid Journals

Language:

English

Submitter:

Andrea Flükiger-Flückiger

Date Deposited:

22 Jul 2020 19:10

Last Modified:

21 Feb 2021 11:37

Publisher DOI:

10.1007/s12020-020-02397-z

PubMed ID:

32632723

Uncontrolled Keywords:

Biomarker Cohort study Euthyroid General population Mortality risk Thyroid function

BORIS DOI:

10.7892/boris.145143

URI:

https://boris.unibe.ch/id/eprint/145143

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