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Thyroid antibody status, subclinical hypothyroidism, and the risk of coronary heart disease: an individual participant data analysis.
Wednesday,2015-03-04 12:16 America/Los_Angeles — zdrager
| Title | Thyroid antibody status, subclinical hypothyroidism, and the risk of coronary heart disease: an individual participant data analysis. |
| Publication Type | Journal Article |
| Year of Publication | 2014 |
| Authors | Collet, T-H, Bauer, DC, Cappola, AR, Asvold, BO, Weiler, S, Vittinghoff, E, Gussekloo, J, Bremner, A, Elzen, WPJ den, Maciel, RMB, Vanderpump, MPJ, Cornuz, J, Dörr, M, Wallaschofski, H, Newman, AB, Sgarbi, JA, Razvi, S, Völzke, H, Walsh, JP, Aujesky, D, Rodondi, N |
| Corporate/Institutional Authors | Thyroid Studies Collaboration, |
| Journal | J Clin Endocrinol Metab |
| Volume | 99 |
| Issue | 9 |
| Pagination | 3353-62 |
| Date Published | 2014 Sep |
| ISSN | 1945-7197 |
| Keywords | Adult, Aged, Aged, 80 and over, Autoantibodies, Coronary Disease, Female, Humans, Hypothyroidism, Incidence, Male, Middle Aged, Prevalence, Prognosis, Risk Factors, Seroepidemiologic Studies, Severity of Illness Index, Young Adult |
| Abstract | <p><b>CONTEXT: </b>Subclinical hypothyroidism has been associated with increased risk of coronary heart disease (CHD), particularly with thyrotropin levels of 10.0 mIU/L or greater. The measurement of thyroid antibodies helps predict the progression to overt hypothyroidism, but it is unclear whether thyroid autoimmunity independently affects CHD risk.</p><p><b>OBJECTIVE: </b>The objective of the study was to compare the CHD risk of subclinical hypothyroidism with and without thyroid peroxidase antibodies (TPOAbs).</p><p><b>DATA SOURCES AND STUDY SELECTION: </b>A MEDLINE and EMBASE search from 1950 to 2011 was conducted for prospective cohorts, reporting baseline thyroid function, antibodies, and CHD outcomes.</p><p><b>DATA EXTRACTION: </b>Individual data of 38 274 participants from six cohorts for CHD mortality followed up for 460 333 person-years and 33 394 participants from four cohorts for CHD events.</p><p><b>DATA SYNTHESIS: </b>Among 38 274 adults (median age 55 y, 63% women), 1691 (4.4%) had subclinical hypothyroidism, of whom 775 (45.8%) had positive TPOAbs. During follow-up, 1436 participants died of CHD and 3285 had CHD events. Compared with euthyroid individuals, age- and gender-adjusted risks of CHD mortality in subclinical hypothyroidism were similar among individuals with and without TPOAbs [hazard ratio (HR) 1.15, 95% confidence interval (CI) 0.87-1.53 vs HR 1.26, CI 1.01-1.58, P for interaction = .62], as were risks of CHD events (HR 1.16, CI 0.87-1.56 vs HR 1.26, CI 1.02-1.56, P for interaction = .65). Risks of CHD mortality and events increased with higher thyrotropin, but within each stratum, risks did not differ by TPOAb status.</p><p><b>CONCLUSIONS: </b>CHD risk associated with subclinical hypothyroidism did not differ by TPOAb status, suggesting that biomarkers of thyroid autoimmunity do not add independent prognostic information for CHD outcomes.</p> |
| DOI | 10.1210/jc.2014-1250 |
| Alternate Journal | J. Clin. Endocrinol. Metab. |
| PubMed ID | 24915118 |
| PubMed Central ID | PMC4154087 |
| Grant List | P30 AG024827 / AG / NIA NIH HHS / United States R01 AG-15928 / AG / NIA NIH HHS / United States R01 HL075366 / HL / NHLBI NIH HHS / United States N01-HC-80007 / HC / NHLBI NIH HHS / United States R01 AG015928 / AG / NIA NIH HHS / United States U01 HL080295 / HL / NHLBI NIH HHS / United States K24 AR051895 / AR / NIAMS NIH HHS / United States R01 HL-075366 / HL / NHLBI NIH HHS / United States N01 HC015103 / HC / NHLBI NIH HHS / United States P30-AG-024827 / AG / NIA NIH HHS / United States AG-032317 / AG / NIA NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States N01-HC-85086 / HC / NHLBI NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States AG-027058 / AG / NIA NIH HHS / United States N01 HC-55222 / HC / NHLBI NIH HHS / United States N01 HC-75150 / HC / NHLBI NIH HHS / United States R01 AG-20098 / AG / NIA NIH HHS / United States R01 AG020098 / AG / NIA NIH HHS / United States R01 AG032317 / AG / NIA NIH HHS / United States N01HC75150 / HL / NHLBI NIH HHS / United States N01-HC-85079 / HC / NHLBI NIH HHS / United States U01HL080295 / HL / NHLBI NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States R01 AG023629 / AG / NIA NIH HHS / United States R01 AG027058 / AG / NIA NIH HHS / United States N01 HC045133 / HC / NHLBI NIH HHS / United States N01 HC035129 / HC / NHLBI NIH HHS / United States R56 AG023629 / AG / NIA NIH HHS / United States |