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Thyroid Function Within the Reference Range and the Risk of Stroke: An Individual Participant Data Analysis.
Thursday,2016-12-08 15:55 America/Los_Angeles — ecterry
| Title | Thyroid Function Within the Reference Range and the Risk of Stroke: An Individual Participant Data Analysis. |
| Publication Type | Journal Article |
| Year of Publication | 2016 |
| Authors | Chaker, L, Baumgartner, C, Elzen, WPJ den, Collet, T-H, Ikram, AM, Blum, MR, Dehghan, A, Drechsler, C, Luben, RN, Portegies, MLP, Iervasi, G, Medici, M, Stott, DJ, Dullaart, RP, Ford, I, Bremner, A, Newman, AB, Wanner, C, Sgarbi, JA, Dörr, M, Longstreth, WT, Psaty, BM, Ferrucci, L, Maciel, RMB, Westendorp, RG, J Jukema, W, Ceresini, G, Imaizumi, M, Hofman, A, Bakker, SJL, Franklyn, JA, Khaw, K-T, Bauer, DC, Walsh, JP, Razvi, S, Gussekloo, J, Völzke, H, Franco, OH, Cappola, AR, Rodondi, N, Peeters, RP |
| Corporate/Institutional Authors | Thyroid Studies Collaboration, |
| Journal | J Clin Endocrinol Metab |
| Volume | 101 |
| Issue | 11 |
| Pagination | 4270-4282 |
| Date Published | 2016 Nov |
| ISSN | 1945-7197 |
| Abstract | <p><b>CONTEXT: </b>The currently applied reference ranges for thyroid function are under debate. Despite evidence that thyroid function within the reference range is related with several cardiovascular disorders, its association with the risk of stroke has not been evaluated previously.</p><p><b>DESIGN AND SETTING: </b>We identified studies through a systematic literature search and the Thyroid Studies Collaboration, a collaboration of prospective cohort studies. Studies measuring baseline TSH, free T4, and stroke outcomes were included, and we collected individual participant data from each study, including thyroid function measurements and incident all stroke (combined fatal and nonfatal) and fatal stroke. The applied reference range for TSH levels was between 0.45 and 4.49 mIU/L.</p><p><b>RESULTS: </b>We collected individual participant data on 43 598 adults with TSH within the reference range from 17 cohorts, with a median follow-up of 11.6 years (interquartile range 5.1-13.9), including 449 908 person-years. Age- and sex-adjusted pooled hazard ratio for TSH was 0.78 (95% confidence interval [CI] 0.65-0.95 across the reference range of TSH) for all stroke and 0.83 (95% CI 0.62-1.09) for fatal stroke. For the free T4 analyses, the hazard ratio was 1.08 (95% CI 0.99-1.15 per SD increase) for all stroke and 1.10 (95% CI 1.04-1.19) for fatal stroke. This was independent of cardiovascular risk factors including systolic blood pressure, total cholesterol, smoking, and prevalent diabetes.</p><p><b>CONCLUSION: </b>Higher levels of TSH within the reference range may decrease the risk of stroke, highlighting the need for further research focusing on the clinical consequences associated with differences within the reference range of thyroid function.</p> |
| DOI | 10.1210/jc.2016-2255 |
| Alternate Journal | J. Clin. Endocrinol. Metab. |
| PubMed ID | 27603906 |
| PubMed Central ID | PMC5095234 |
| Grant List | U01 HL080295 / HL / NHLBI NIH HHS / United States UL1 TR000128 / TR / NCATS NIH HHS / United States HHSN268200800007C / HL / NHLBI NIH HHS / United States K24 AG042765 / AG / NIA NIH HHS / United States U01 AG042124 / AG / NIA NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States U01 AG042145 / AG / NIA NIH HHS / United States R01 NR012459 / NR / NINR NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States HHSN268201200036C / HL / NHLBI NIH HHS / United States U01 AG042168 / AG / NIA NIH HHS / United States U01 AG042140 / AG / NIA NIH HHS / United States R01 HL080295 / HL / NHLBI NIH HHS / United States R01 AG028050 / AG / NIA NIH HHS / United States R01 AG032317 / AG / NIA NIH HHS / United States N01HC85082 / HL / NHLBI NIH HHS / United States N01HC85083 / HL / NHLBI NIH HHS / United States U01 AG027810 / AG / NIA NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States R01 AG023629 / AG / NIA NIH HHS / United States N01HC85080 / HL / NHLBI NIH HHS / United States R56 AG023629 / AG / NIA NIH HHS / United States U01 AG042143 / AG / NIA NIH HHS / United States U01 AG042139 / AG / NIA NIH HHS / United States U01 AR066160 / AR / NIAMS NIH HHS / United States N01HC85081 / HL / NHLBI NIH HHS / United States |
ePub date:
16/11