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Subclinical Hypothyroidism and the Risk of Stroke Events and Fatal Stroke: An Individual Participant Data Analysis.
Friday,2015-08-28 10:17 America/Los_Angeles — zdrager
| Title | Subclinical Hypothyroidism and the Risk of Stroke Events and Fatal Stroke: An Individual Participant Data Analysis. |
| Publication Type | Journal Article |
| Year of Publication | 2015 |
| Authors | Chaker, L, Baumgartner, C, Elzen, WPJ den, Ikram, AM, Blum, MR, Collet, T-H, Bakker, SJL, Dehghan, A, Drechsler, C, Luben, RN, Hofman, A, Portegies, MLP, Medici, M, Iervasi, G, Stott, DJ, Ford, I, Bremner, A, Wanner, C, Ferrucci, L, Newman, AB, Dullaart, RP, Sgarbi, JA, Ceresini, G, Maciel, RMB, Westendorp, RG, J Jukema, W, Imaizumi, M, Franklyn, JA, Bauer, DC, Walsh, JP, Razvi, S, Khaw, K-T, Cappola, AR, Völzke, H, Franco, OH, Gussekloo, J, Rodondi, N, Peeters, RP |
| Corporate/Institutional Authors | Thyroid Studies Collaboration, |
| Journal | J Clin Endocrinol Metab |
| Volume | 100 |
| Issue | 6 |
| Pagination | 2181-91 |
| Date Published | 2015 Jun |
| ISSN | 1945-7197 |
| Keywords | Adult, Asymptomatic Diseases, Female, Humans, Hypothyroidism, Incidence, Male, Risk Factors, Stroke, Thyrotropin |
| Abstract | <p><b>OBJECTIVE: </b>The objective was to determine the risk of stroke associated with subclinical hypothyroidism.</p><p><b>DATA SOURCES AND STUDY SELECTION: </b>Published prospective cohort studies were identified through a systematic search through November 2013 without restrictions in several databases. Unpublished studies were identified through the Thyroid Studies Collaboration. We collected individual participant data on thyroid function and stroke outcome. Euthyroidism was defined as TSH levels of 0.45-4.49 mIU/L, and subclinical hypothyroidism was defined as TSH levels of 4.5-19.9 mIU/L with normal T4 levels.</p><p><b>DATA EXTRACTION AND SYNTHESIS: </b>We collected individual participant data on 47 573 adults (3451 subclinical hypothyroidism) from 17 cohorts and followed up from 1972-2014 (489 192 person-years). Age- and sex-adjusted pooled hazard ratios (HRs) for participants with subclinical hypothyroidism compared to euthyroidism were 1.05 (95% confidence interval [CI], 0.91-1.21) for stroke events (combined fatal and nonfatal stroke) and 1.07 (95% CI, 0.80-1.42) for fatal stroke. Stratified by age, the HR for stroke events was 3.32 (95% CI, 1.25-8.80) for individuals aged 18-49 years. There was an increased risk of fatal stroke in the age groups 18-49 and 50-64 years, with a HR of 4.22 (95% CI, 1.08-16.55) and 2.86 (95% CI, 1.31-6.26), respectively (p trend 0.04). We found no increased risk for those 65-79 years old (HR, 1.00; 95% CI, 0.86-1.18) or ≥ 80 years old (HR, 1.31; 95% CI, 0.79-2.18). There was a pattern of increased risk of fatal stroke with higher TSH concentrations.</p><p><b>CONCLUSIONS: </b>Although no overall effect of subclinical hypothyroidism on stroke could be demonstrated, an increased risk in subjects younger than 65 years and those with higher TSH concentrations was observed.</p> |
| DOI | 10.1210/jc.2015-1438 |
| Alternate Journal | J. Clin. Endocrinol. Metab. |
| PubMed ID | 25856213 |
| PubMed Central ID | PMC4454799 |
| Grant List | AG023629,19 / AG / NIA NIH HHS / United States G1000143 / / Medical Research Council / United Kingdom HHSN268200800007C / / PHS HHS / United States HHSN268201200036C / / PHS HHS / United States HL080295 / HL / NHLBI NIH HHS / United States K24AG042765 / AG / NIA NIH HHS / United States N01-AG-6-2101 / AG / NIA NIH HHS / United States N01-AG-6-2103 / AG / NIA NIH HHS / United States N01-AG-6-2106 / AG / NIA NIH HHS / United States N01HC55222 / HC / NHLBI NIH HHS / United States N01HC85079 / HC / NHLBI NIH HHS / United States N01HC85080 / HC / NHLBI NIH HHS / United States N01HC85081 / HC / NHLBI NIH HHS / United States N01HC85082 / HC / NHLBI NIH HHS / United States N01HC85083 / HC / NHLBI NIH HHS / United States N01HC85086 / HC / NHLBI NIH HHS / United States R01-AG028050 / AG / NIA NIH HHS / United States R01-NR012459 / NR / NINR NIH HHS / United States R01AG032317 / AG / NIA NIH HHS / United States U01 AG027810 / AG / NIA NIH HHS / United States U01 AG042124 / AG / NIA NIH HHS / United States U01 AG042139 / AG / NIA NIH HHS / United States U01 AG042140 / AG / NIA NIH HHS / United States U01 AG042143 / AG / NIA NIH HHS / United States U01 AG042145 / AG / NIA NIH HHS / United States U01 AG042168 / AG / NIA NIH HHS / United States U01 AR066160 / AR / NIAMS NIH HHS / United States U01 AR066160 / AR / NIAMS NIH HHS / United States UL1 TR000128 / TR / NCATS NIH HHS / United States |