Thyroid Function Tests in the Reference Range and Fracture: Individual Participant Analysis of Prospective Cohorts.

Détails

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Etat: Serval
Version: Author's accepted manuscript
ID Serval
serval:BIB_4308C6260F31
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Thyroid Function Tests in the Reference Range and Fracture: Individual Participant Analysis of Prospective Cohorts.
Périodique
The Journal of clinical endocrinology and metabolism
Auteur(s)
Aubert C.E., Floriani C., Bauer D.C., da Costa B.R., Segna D., Blum M.R., Collet T.H., Fink H.A., Cappola A.R., Syrogiannouli L., Peeters R.P., Åsvold B.O., den Elzen WPJ, Luben R.N., Bremner A.P., Gogakos A., Eastell R., Kearney P.M., Hoff M., Le Blanc E., Ceresini G., Rivadeneira F., Uitterlinden A.G., Khaw K.T., Langhammer A., Stott D.J., Westendorp RGJ, Ferrucci L., Williams G.R., Gussekloo J., Walsh J.P., Aujesky D., Rodondi N.
Collaborateur(s)
Thyroid Studies Collaboration
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
2719-2728
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
Hyperthyroidism is associated with increased fracture risk, but it is not clear if lower thyroid-stimulating hormone (TSH) and higher free thyroxine (FT4) in euthyroid individuals are associated with fracture risk.
To evaluate the association of TSH and FT4 with incident fractures in euthyroid individuals.
Individual participant data analysis.
Thirteen prospective cohort studies with baseline examinations between 1981 and 2002.
Adults with baseline TSH 0.45 to 4.49 mIU/L.
Primary outcome was incident hip fracture. Secondary outcomes were any, nonvertebral, and vertebral fractures. Results were presented as hazard ratios (HRs) with 95% confidence interval (CI) adjusted for age and sex. For clinical relevance, we studied TSH according to five categories: 0.45 to 0.99 mIU/L; 1.00 to 1.49 mIU/L; 1.50 to 2.49 mIU/L; 2.50 to 3.49 mIU/L; and 3.50 to 4.49 mIU/L (reference). FT4 was assessed as study-specific standard deviation increase, because assays varied between cohorts.
During 659,059 person-years, 2,565 out of 56,835 participants had hip fracture (4.5%; 12 studies with data on hip fracture). The pooled adjusted HR (95% CI) for hip fracture was 1.25 (1.05 to 1.49) for TSH 0.45 to 0.99 mIU/L, 1.19 (1.01 to 1.41) for TSH 1.00 to 1.49 mIU/L, 1.09 (0.93 to 1.28) for TSH 1.50 to 2.49 mIU/L, and 1.12 (0.94 to 1.33) for TSH 2.50 to 3.49 mIU/L (P for trend = 0.004). Hip fracture was also associated with FT4 [HR (95% CI) 1.22 (1.11 to 1.35) per one standard deviation increase in FT4]. FT4 only was associated with any and nonvertebral fractures. Results remained similar in sensitivity analyses.
Among euthyroid adults, lower TSH and higher FT4 are associated with an increased risk of hip fracture. These findings may help refine the definition of optimal ranges of thyroid function tests.

Pubmed
Web of science
Open Access
Oui
Création de la notice
16/05/2017 17:56
Dernière modification de la notice
08/05/2019 17:46
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