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Subclinical Hypothyroidism Is Associated With Increased Risk for All-Cause and Cardiovascular Mortality in Adults
Open accessAbstract
Objectives This study sought to evaluate the relationship between subclinical hypothyroidism (SCH) and all-cause and cardiovascular disease (CVD) mortality.Background SCH may increase the risks of hypercholesterolemia and atherosclerosis. The associations between SCH and all-cause or CVD mortality are uncertain, on the basis of the results of previous studies.Methods A baseline cohort of 115,746 participants without a history of thyroid disease, ≥20 years of age, was recruited in Taiwan. SCH was defined as a serum thyroid-stimulating hormone (TSH) level of 5.0 to 19.96 mIU/l with normal total thyroxine concentrations. Euthyroidism was defined as a serum TSH level of 0.47 to 4.9 mIU/l. Cox proportional hazards regression analysis was used to estimate the relative risks (RRs) of death from all-cause and CVD for adults with SCH during a 10-year follow-up period.Results There were 3,669 deaths during the follow-up period; 680 deaths were due to CVD. Compared with subjects with euthyroidism, after adjustment for age, sex, body mass index, diabetes, hypertension, dyslipidemia, smoking, alcohol consumption, betel nut chewing, physical activity, income, and education level, the RRs (95% confidence interval) of deaths from all-cause and CVD among subjects with SCH were 1.30 (1.02 to 1.66), and 1.68 (1.02 to 2.76), respectively.Conclusions Adult Taiwanese with SCH had an increased risk for all-cause mortality and CVD death.
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“Moreover, in primary studies in euthyroid or subclinically hypothyroid patients,13 and in the related meta-analyses and reviews,14 15 16 17 18 19 20 thyroid function testing was done only at baseline.”
From Thyroid replacement therapy, thyroid stimulating hormone concentrations, and long term health outcomes in patients with hypothyroidism: longitudinal study (2019) · cites this paper as [13]
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Metadata
- Authors
- Tseng, F.-Y., Lin, W.-Y., Lin, C.-C., Lee, L.-T., Li, T.-C., Sung, P.-K., & Huang, K.-C.
- Affiliations
- National Taiwan University (TW)
- China Medical University (TW)
- Asia University (TW)
- National Taiwan University Hospital (TW)
- Corresponding author
- Huang, Kuo-Chin
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2012-08
- Volume
- 60
- Issue
- 8
- Pages
- 730-737
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W2081641269
- Cited by
- 212
- References
- 52
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 30 · 2023: 15 · 2022: 15 · 2021: 10 · 2020: 12 · 2019: 13 · 2018: 17 · 2017: 12 · 2016: 15 · 2015: 18 · 2014: 23 · 2013: 19 · 2012: 1
- FWCI
- 15.52
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Taiwan Department of Health Clinical Trial and Research Center (DOH101-TD-B-111-004)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Keywords
- subclinical hypothyroidism, all-cause mortality, cardiovascular mortality, thyroid-stimulating hormone, euthyroidism, cardiovascular disease, hypercholesterolemia, atherosclerosis, Taiwanese adults
- MeSH terms
- Adult, Age Factors, Aged, Cardiovascular Diseases, Female, Follow-Up Studies, Humans, Hyperlipidemias, Hypertension, Hypothyroidism, Male, Middle Aged, Surveys and Questionnaires, Research Design, Risk Factors, Sex Factors, Taiwan, Thyrotropin, Cohort Studies, Biomarkers, Body Mass Index, Proportional Hazards Models, Diabetes Complications
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