Defining Optimal Health Range for Thyroid Function Based on the Risk of Cardiovascular Disease.
Détails
Etat: Public
Version: Author's accepted manuscript
ID Serval
serval:BIB_BBB2A73DA224
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Defining Optimal Health Range for Thyroid Function Based on the Risk of Cardiovascular Disease.
Périodique
The Journal of clinical endocrinology and metabolism
ISSN
1945-7197 (Electronic)
ISSN-L
0021-972X
Statut éditorial
Publié
Date de publication
01/08/2017
Peer-reviewed
Oui
Volume
102
Numéro
8
Pages
2853-2861
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Résumé
Reference ranges of thyroid-stimulating hormone (TSH) and free thyroxine (FT4) are defined by their distribution in apparently healthy populations (2.5th and 97.5th percentiles), irrespective of disease risk, and are used as cutoffs for defining and clinically managing thyroid dysfunction.
To provide proof of concept in defining optimal health ranges of thyroid function based on cardiovascular disease (CVD) mortality risk.
In all, 9233 participants from the Rotterdam Study (mean age, 65.0 years) were followed up (median, 8.8 years) from baseline to date of death or end of follow-up period (2012), whichever came first (689 cases of CVD mortality).
We calculated 10-year absolute risks of CVD mortality (defined according to the SCORE project) using a Fine and Gray competing risk model per percentiles of TSH and FT4, modeled nonlinearly and with sex and age adjustments.
Overall, FT4 level >90th percentile was associated with a predicted 10-year CVD mortality risk >7.5% (P = 0.005). In men, FT4 level >97th percentile was associated with a risk of 10.8% (P < 0.001). In participants aged ≥65 years, absolute risk estimates were <10.0% below the 30th percentile (∼14.5 pmol/L or 1.10 ng/dL) and ≥15.0% above the 97th percentile of FT4 (∼22 pmol/L or 1.70 ng/dL).
We describe absolute 10-year CVD mortality risks according to thyroid function (TSH and FT4) and suggest that optimal health ranges for thyroid function can be defined according to disease risk and are possibly sex and age dependent. These results need to be replicated with sufficient samples and representative populations.
To provide proof of concept in defining optimal health ranges of thyroid function based on cardiovascular disease (CVD) mortality risk.
In all, 9233 participants from the Rotterdam Study (mean age, 65.0 years) were followed up (median, 8.8 years) from baseline to date of death or end of follow-up period (2012), whichever came first (689 cases of CVD mortality).
We calculated 10-year absolute risks of CVD mortality (defined according to the SCORE project) using a Fine and Gray competing risk model per percentiles of TSH and FT4, modeled nonlinearly and with sex and age adjustments.
Overall, FT4 level >90th percentile was associated with a predicted 10-year CVD mortality risk >7.5% (P = 0.005). In men, FT4 level >97th percentile was associated with a risk of 10.8% (P < 0.001). In participants aged ≥65 years, absolute risk estimates were <10.0% below the 30th percentile (∼14.5 pmol/L or 1.10 ng/dL) and ≥15.0% above the 97th percentile of FT4 (∼22 pmol/L or 1.70 ng/dL).
We describe absolute 10-year CVD mortality risks according to thyroid function (TSH and FT4) and suggest that optimal health ranges for thyroid function can be defined according to disease risk and are possibly sex and age dependent. These results need to be replicated with sufficient samples and representative populations.
Pubmed
Web of science
Open Access
Oui
Création de la notice
30/05/2017 17:51
Dernière modification de la notice
20/08/2019 16:29