Thyroid function and risk of all-cause and cardiovascular mortality: a prospective population-based cohort studyGroothof, D., Flores-Guerrero, J. L., Nolte, I. M., Bouma, H. R., Gruppen, E. G., Bano, A., Post, A., Kootstra-Ros, J. E., Hak, E., Bos, J. H. J., de Borst, M. H., Gans, R. O. B., Links, T. P., Dullaart, R. P. F. & Bakker, S. J. L., 6-Jul-2020, In : Endocrine. 12 p.
Research output: Contribution to journal › Article › Academic › peer-review
- Life Course Epidemiology (LCE)
- Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE)
- Microbes in Health and Disease (MHD)
- PharmacoTherapy, Epidemiology and Economics
- Groningen Kidney Center (GKC)
- Lifestyle Medicine (LM)
- Lifelong Learning, Education & Assessment Research Network (LEARN)
- Damage and Repair in Cancer Development and Cancer Treatment (DARE)
- Guided Treatment in Optimal Selected Cancer Patients (GUTS)
- Groningen Institute for Organ Transplantation (GIOT)
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) (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). FT(3)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.
|Number of pages||12|
|Publication status||Published - 6-Jul-2020|
- Thyroid function, Euthyroid, Mortality risk, Cohort study, General population, Biomarker, CORONARY-HEART-DISEASE, FREE-THYROXINE, STIMULATING HORMONE, SERUM THYROTROPIN, OXIDATIVE STRESS, OLDER MEN, LIFE-SPAN, HYPERTHYROIDISM, HYPOTHYROIDISM, ASSOCIATION