Thyroid function within the normal range and risk of coronary heart disease: an individual participant data analysis of 14 cohorts.
| Title: | Thyroid function within the normal range and risk of coronary heart disease: an individual participant data analysis of 14 cohorts. |
|---|---|
| Authors: | Åsvold BO; Department of Public Health, Norwegian University of Science and Technology, Trondheim2Department of Endocrinology, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.; Vatten LJ; Department of Public Health, Norwegian University of Science and Technology, Trondheim3Department of Epidemiology, Harvard School of Public Health, Harvard University, Boston, Massachusetts.; Bjøro T; Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway5Faculty of Medicine, University of Oslo, Oslo, Norway.; Bauer DC; Department of Medicine, University of California, San Francisco7Department of Epidemiology and Biostatistics, University of California, San Francisco.; Bremner A; School of Population Health, The University of Western Australia, Crawley.; Cappola AR; Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, School of Medicine, University of Pennsylvania, Philadelphia.; Ceresini G; Department of Clinical and Experimental Medicine, Geriatric Endocrine Unit, University Hospital of Parma, Parma, Italy.; den Elzen WP; Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands.; Ferrucci L; National Institute on Aging, Baltimore, Maryland.; Franco OH; Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.; Franklyn JA; School of Clinical and Experimental Medicine, College of Medical and Dental Sciences, University of Birmingham, Birmingham, England.; Gussekloo J; Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands.; Iervasi G; National Council Research Institute of Clinical Physiology/Tuscany Region G. Monasterio Foundation, Pisa, Italy.; Imaizumi M; Department of Clinical Studies, Radiation Effects Research Foundation, Nagasaki, Japan.; Kearney PM; Department of Epidemiology and Public Health, University College Cork, Cork, Ireland.; Khaw KT; Department of Public Health and Primary Care, University of Cambridge, Cambridge, England.; Maciel RM; Division of Endocrinology, Department of Medicine, Federal University of São Paulo, São Paulo, Brazil.; Newman AB; Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.; Peeters RP; Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands21Rotterdam Thyroid Center, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands.; Psaty BM; Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology, and Health Services, University of Washington, Seattle23Group Health Research Institute, Group Health Cooperative, Seattle, Washington.; Razvi S; Department of Endocrinology, Gateshead Health Foundation National Health Service Trust, Gateshead, England.; Sgarbi JA; Division of Endocrinology, Department of Medicine, Federal University of São Paulo, São Paulo, Brazil25Division of Endocrinology, Faculdade de Medicina de Marília, Marília, Brazil.; Stott DJ; Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, Scotland.; Trompet S; Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands28Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.; Vanderpump MP; Department of Endocrinology, Royal Free Hospital, London, England.; Völzke H; Institute for Community Medicine, Study of Health in Pomerania/Clinical-Epidemiological Research and German Centre of Cardiovascular Research, University of Greifswald, Greifswald, Germany.; Walsh JP; Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia32School of Medicine and Pharmacology, The University of Western Australia, Crawley.; Westendorp RG; Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands33Netherlands Consortium for Healthy Aging, Leiden, the Netherlands34Department of Public Health, University of Copenhagen, Copenhagen, Denmark.; Rodondi N; Department of General Internal Medicine, Inselspital, University of Bern, Bern, Switzerland. |
| Corporate Authors: | Thyroid Studies Collaboration |
| Source: | JAMA internal medicine [JAMA Intern Med] 2015 Jun; Vol. 175 (6), pp. 1037-47. |
| Publication Type: | Journal Article; Meta-Analysis; Research Support, N.I.H., Extramural; Research Support, N.I.H., Intramural; Research Support, Non-U.S. Gov't |
| Language: | English |
| Journal Info: | Publisher: American Medical Association Country of Publication: United States NLM ID: 101589534 Publication Model: Print Cited Medium: Internet ISSN: 2168-6114 (Electronic) Linking ISSN: 21686106 NLM ISO Abbreviation: JAMA Intern Med Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Chicago, IL : American Medical Association, [2013]- |
| MeSH Terms: | Coronary Disease/*etiology ; Hypothyroidism/*complications ; Thyrotropin/*blood; Coronary Disease/blood ; Hypothyroidism/blood ; Hypothyroidism/diagnosis ; Cohort Studies ; Humans |
| Abstract: | Importance: Some experts suggest that serum thyrotropin levels in the upper part of the current reference range should be considered abnormal, an approach that would reclassify many individuals as having mild hypothyroidism. Health hazards associated with such thyrotropin levels are poorly documented, but conflicting evidence suggests that thyrotropin levels in the upper part of the reference range may be associated with an increased risk of coronary heart disease (CHD).; Objective: To assess the association between differences in thyroid function within the reference range and CHD risk.; Design, Setting, and Participants: Individual participant data analysis of 14 cohorts with baseline examinations between July 1972 and April 2002 and with median follow-up ranging from 3.3 to 20.0 years. Participants included 55,412 individuals with serum thyrotropin levels of 0.45 to 4.49 mIU/L and no previously known thyroid or cardiovascular disease at baseline.; Exposures: Thyroid function as expressed by serum thyrotropin levels at baseline.; Main Outcomes and Measures: Hazard ratios (HRs) of CHD mortality and CHD events according to thyrotropin levels after adjustment for age, sex, and smoking status.; Results: Among 55,412 individuals, 1813 people (3.3%) died of CHD during 643,183 person-years of follow-up. In 10 cohorts with information on both nonfatal and fatal CHD events, 4666 of 48,875 individuals (9.5%) experienced a first-time CHD event during 533,408 person-years of follow-up. For each 1-mIU/L higher thyrotropin level, the HR was 0.97 (95% CI, 0.90-1.04) for CHD mortality and 1.00 (95% CI, 0.97-1.03) for a first-time CHD event. Similarly, in analyses by categories of thyrotropin, the HRs of CHD mortality (0.94 [95% CI, 0.74-1.20]) and CHD events (0.97 [95% CI, 0.83-1.13]) were similar among participants with the highest (3.50-4.49 mIU/L) compared with the lowest (0.45-1.49 mIU/L) thyrotropin levels. Subgroup analyses by sex and age group yielded similar results.; Conclusions and Relevance: Thyrotropin levels within the reference range are not associated with risk of CHD events or CHD mortality. This finding suggests that differences in thyroid function within the population reference range do not influence the risk of CHD. Increased CHD risk does not appear to be a reason for lowering the upper thyrotropin reference limit. |
| References: | Int J Epidemiol. 2014 Oct;43(5):1624-32. (PMID: 25011453); Arch Intern Med. 2005 Nov 28;165(21):2467-72. (PMID: 16314542); J Am Geriatr Soc. 2013 Jun;61(6):868-74. (PMID: 23647402); J Clin Endocrinol Metab. 2005 Sep;90(9):5489-96. (PMID: 16148346); J Clin Endocrinol Metab. 2009 Dec;94(12):5023-7. (PMID: 19846737); Diabetes Metab Res Rev. 2007 Mar;23(3):227-33. (PMID: 16906626); Stat Med. 2010 May 30;29(12):1282-97. (PMID: 19408255); Diabetes Care. 2002 Aug;25(8):1346-50. (PMID: 12145233); J Clin Endocrinol Metab. 2005 Aug;90(8):4946-54. (PMID: 15928247); J Clin Endocrinol Metab. 2010 Apr;95(4):1734-40. (PMID: 20150579); Circulation. 2002 Dec 3;106(23):2919-24. (PMID: 12460872); Control Clin Trials. 1986 Sep;7(3):177-88. (PMID: 3802833); J Clin Endocrinol Metab. 2012 Dec;97(12):E2230-7. (PMID: 22977271); JAMA Intern Med. 2014 Jan;174(1):32-9. (PMID: 24100714); Lancet. 2001 Sep 15;358(9285):861-5. (PMID: 11567699); J Clin Endocrinol Metab. 2010 Mar;95(3):1095-104. (PMID: 20097710); Best Pract Res Clin Endocrinol Metab. 2009 Dec;23(6):753-67. (PMID: 19942151); J Clin Endocrinol Metab. 2015 Mar;100(3):1088-96. (PMID: 25514105); Eur J Epidemiol. 2013 Nov;28(11):889-926. (PMID: 24258680); Eur J Endocrinol. 2013 Jul;169(1):73-82. (PMID: 23641017); Ann Intern Med. 2000 Feb 15;132(4):270-8. (PMID: 10681281); JAMA. 2010 Sep 22;304(12):1365-74. (PMID: 20858880); J Clin Endocrinol Metab. 2012 Mar;97(3):852-61. (PMID: 22238391); J Bone Miner Res. 2013 Mar;28(3):472-9. (PMID: 23018684); J Clin Endocrinol Metab. 2004 Jul;89(7):3365-70. (PMID: 15240616); Clin Endocrinol (Oxf). 2011 Jun;74(6):769-75. (PMID: 21521278); Arch Intern Med. 2007 Jul 9;167(13):1428-32. (PMID: 17620538); J Clin Endocrinol Metab. 2005 Sep;90(9):5483-8. (PMID: 16148345); Thyroid. 2014 Dec;24(12):1670-751. (PMID: 25266247); JAMA. 2006 Mar 1;295(9):1033-41. (PMID: 16507804); J Clin Endocrinol Metab. 2005 Jul;90(7):4019-24. (PMID: 15870128); JAMA. 2004 Jan 14;291(2):228-38. (PMID: 14722150); J Clin Endocrinol Metab. 2007 Nov;92(11):4236-40. (PMID: 17684054); J Clin Endocrinol Metab. 2009 Apr;94(4):1342-5. (PMID: 19126628); J Clin Endocrinol Metab. 2013 Sep;98(9):3562-71. (PMID: 23824418); Eur J Endocrinol. 2006 May;154(5):633-7. (PMID: 16645008); J Clin Endocrinol Metab. 2003 Jun;88(6):2438-44. (PMID: 12788839); Eur J Heart Fail. 2014 Feb;16(2):217-26. (PMID: 24464626); Arch Intern Med. 2008 Nov 10;168(20):2219-24. (PMID: 19001198); J Clin Endocrinol Metab. 2007 Mar;92(3):841-5. (PMID: 17200168); Mol Cell Endocrinol. 2010 Mar 25;316(2):165-71. (PMID: 19540303); Clin Endocrinol (Oxf). 1993 Nov;39(5):499-518. (PMID: 8252737); Ann Intern Med. 2004 Jan 20;140(2):128-41. (PMID: 14734337); Clin Endocrinol (Oxf). 1995 Jul;43(1):55-68. (PMID: 7641412); J Clin Endocrinol Metab. 2012 Mar;97(3):862-70. (PMID: 22238396); Clin Chem. 1998 Dec;44(12):2550-1. (PMID: 9882170); JAMA. 2004 Dec 1;292(21):2591-9. (PMID: 15572717); Circulation. 2012 Aug 28;126(9):1040-9. (PMID: 22821943); Eur J Endocrinol. 2007 Feb;156(2):181-6. (PMID: 17287407); Am J Med. 2012 Aug;125(8):826.e7-12. (PMID: 22608790); Eur J Endocrinol. 2010 Mar;162(3):569-77. (PMID: 19966035); J Clin Endocrinol Metab. 2012 Jan;97(1):93-9. (PMID: 22049180); Nat Rev Endocrinol. 2011 Apr;7(4):232-9. (PMID: 21301488); Thyroid. 1996 Jun;6(3):155-60. (PMID: 8837320); Eur J Endocrinol. 2010 Mar;162(3):579-85. (PMID: 20007334); J Am Coll Cardiol. 2006 Jan 3;47(1):65-71. (PMID: 16386666); Arch Intern Med. 2008 Apr 28;168(8):855-60. (PMID: 18443261); Arch Intern Med. 2005 Nov 28;165(21):2460-6. (PMID: 16314541); Clin Chem. 2010 Jun;56(6):912-20. (PMID: 20395623); Thyroid. 2012 Dec;22(12):1200-35. (PMID: 22954017); J Clin Endocrinol Metab. 2014 Jul;99(7):2467-76. (PMID: 24708095); Arch Intern Med. 2012 May 28;172(10):799-809. (PMID: 22529182); Arch Intern Med. 2007 Jul 23;167(14):1526-32. (PMID: 17646607); Clin Chem. 2011 Jan;57(1):122-7. (PMID: 21097676); Clin Endocrinol (Oxf). 2010 Mar;72(3):404-10. (PMID: 19486022); Clin Endocrinol (Oxf). 2012 Dec;77(6):911-7. (PMID: 22724581) |
| Grant Information: | N01 HC085080 United States HL NHLBI NIH HHS; N01-AG-6-2101 United States AG NIA NIH HHS; UL1 TR000128 United States TR NCATS NIH HHS; R01-NR012459 United States NR NINR NIH HHS; R01 NR012459 United States NR NINR NIH HHS; HHSN268201200036C United States HL NHLBI NIH HHS; N01-AG-6-2106 United States AG NIA NIH HHS; R01 AG032317 United States AG NIA NIH HHS; United Kingdom WT_ Wellcome Trust; N01 AG062101 United States AG NIA NIH HHS; U01 HL080295 United States HL NHLBI NIH HHS; N01 HC085082 United States HL NHLBI NIH HHS; K24 AR051895 United States AR NIAMS NIH HHS; N01-AG-6-2103 United States AG NIA NIH HHS; HHSN268200800007C United States HL NHLBI NIH HHS; N01 HC085086 United States HL NHLBI NIH HHS; N01 HC085083 United States HL NHLBI NIH HHS; United Kingdom DH_ Department of Health; AG-032317 United States AG NIA NIH HHS; K24 AG042765 United States AG NIA NIH HHS; G1000143 United Kingdom MRC_ Medical Research Council; U01 AG042124 United States AG NIA NIH HHS; N01 AG062106 United States AG NIA NIH HHS; U01 AG042145 United States AG NIA NIH HHS; N01 HC055222 United States HL NHLBI NIH HHS; G0401527 United Kingdom MRC_ Medical Research Council; N01 AG062103 United States AG NIA NIH HHS; U01 AG042168 United States AG NIA NIH HHS; N01 HC085079 United States HL NHLBI NIH HHS; R10-AG028050 United States AG NIA NIH HHS; U01 AG042140 United States AG NIA NIH HHS; R01 HL080295 United States HL NHLBI NIH HHS; R01 AG028050 United States AG NIA NIH HHS; United States ImNIH Intramural NIH HHS; HL080295 United States HL NHLBI NIH HHS; U01 AG027810 United States AG NIA NIH HHS; AG-023629 United States AG NIA NIH HHS; R01 AG023629 United States AG NIA NIH HHS; R56 AG023629 United States AG NIA NIH HHS; U01 AG042143 United States AG NIA NIH HHS; N01 HC085081 United States HL NHLBI NIH HHS; U01 AG042139 United States AG NIA NIH HHS; United Kingdom CRUK_ Cancer Research UK; U01 AR066160 United States AR NIAMS NIH HHS; N01 HC55222 United States HC NHLBI NIH HHS |
| Contributed Indexing: | Investigator: N Rodondi; J Gussekloo; DC Bauer; AR Cappola; RP Peeters; BO Åsvold; JP Walsh; JA Franklyn; G Iervasi; M Imaizumi; S Razvi; KT Khaw; H Völzke; JA Sgarbi; RG Westendorp; G Ceresini; WP den Elzen; TH Collet; B da Costa; C Baumgartner; MR Blum; HA van Dorland |
| Substance Nomenclature: | 9002-71-5 (Thyrotropin) |
| Entry Date(s): | Date Created: 20150421 Date Completed: 20150812 Latest Revision: 20250529 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC4732559 |
| DOI: | 10.1001/jamainternmed.2015.0930 |
| PMID: | 25893284 |
| Database: | MEDLINE |
Journal Article; Meta-Analysis; Research Support, N.I.H., Extramural; Research Support, N.I.H., Intramural; Research Support, Non-U.S. Gov't