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Erschienen in: Wiener klinische Wochenschrift 23-24/2015

01.12.2015 | original article

Subclinical hypothyroidism and mortality in a large Austrian cohort: a possible impact on treatment?

verfasst von: MD Florian Maria Kovar, I-Fei Fang, Thomas Perkmann, Helmuth Haslacher, Georg Slavka, Manuela Födinger, Georg Endler, MD Prof. Oswald F. Wagner

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 23-24/2015

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Summary

Background

Clinical implications of subclinical hypothyroidism (SCH) are still matter of intense debate, resulting in the controversial discussion whether subclinical hypothyroidism should be treated. We performed a cohort study to evaluate the impact of subclinical hypothyroidism on vascular and overall mortality.

Methods

Between 02/1993 and 03/2004, a total of 103,135 persons attending the General Hospital Vienna with baseline serum thyrotropin (TSH, thyroid-stimulating hormone) and free thyroxin (fT4) measurements could be enrolled in a retrospective cohort study. Subclinical hypothyroidism was defined by elevated TSH ranging from 4.5 to 20.0 mIU/L and normal fT4 concentration (0.7–1.7 ng/dL). Overall and vascular mortality as primary endpoints were assessed via record linkage with the Austrian Death Registry.

Results

A total of 80,490 subjects fulfilled inclusion criteria of whom 3934 participants (3.7 %) were classified as SCH (868 males and 3066 females, median age 48 years). The mean follow-up among the 80,490 subjects was 4.1 years yielding an observation period of 373,301 person-years at risk. In a multivariate Cox regression model adjusted for age and gender TSH levels showed a dose-dependent association with all-cause mortality. The association between SCH and overall or vascular mortality was stronger in men below 60 years compared to older males or females.

Conclusion

Our data support the hypothesis that SCH might represent an independent risk factor for overall and vascular mortality, especially in men below 60 years. Whether this group would benefit from replacement therapy should be evaluated in interventional studies.
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Metadaten
Titel
Subclinical hypothyroidism and mortality in a large Austrian cohort: a possible impact on treatment?
verfasst von
MD Florian Maria Kovar
I-Fei Fang
Thomas Perkmann
Helmuth Haslacher
Georg Slavka
Manuela Födinger
Georg Endler
MD Prof. Oswald F. Wagner
Publikationsdatum
01.12.2015
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe 23-24/2015
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-015-0846-z