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Cited by 52Thyroid Disorders and TreatmentsThyroid and Parathyroid SurgeryHormonal and reproductive studies

Association of Thyroid Hormone Therapy with Mortality in Subclinical Hypothyroidism: A Systematic Review and Meta-Analysis

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Peng, Carol Chiung-Hui, Huang, Huei-Kai, Wu, Brian Bo-Chang, Chang, Rachel Huai-En, Tu, Yu-Kang, Munir, Kashif M·2021·The Journal of Clinical Endocrinology & Metabolism
DOI 10.1210/clinem/dgaa777
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Abstract

Context: Benefits of thyroid hormone therapy on mortality in adults with subclinical hypothyroidism remain undetermined. Objective: To summarize the impact of thyroid hormone therapy on mortality in adults with subclinical hypothyroidism. Data Sources: PubMed, Embase, Scopus, Web of Science, and Clinicaltrials.gov from inception until April 25, 2020. Study Selection: Studies comparing the effect of thyroid hormone therapy with that of placebo or no therapy in adults with subclinical hypothyroidism on all-cause and/or cardiovascular mortality. Data Extraction: Two reviewers independently extracted data and performed quality assessments. Random-effects models for meta-analyses were used. Data Synthesis: Five observational studies and 2 randomized controlled trials with 21 055 adults were included. Overall, thyroid hormone therapy was not significantly associated with all-cause (pooled relative risk [RR] = 0.95, 95% confidence interval [CI]: 0.75-1.22, P = .704) or cardiovascular (pooled RR = 0.99, 95% CI: 0.82-1.20, P = .946) mortality. Subgroup analyses revealed that in younger adults (aged <65-70 years), thyroid hormone therapy was significantly associated with a lower all-cause (pooled RR = 0.50, 95% CI: 0.29-0.85, P = .011) and cardiovascular (pooled RR = 0.54, 95% CI: 0.37-0.80, P = .002) mortality. However, no significant association between thyroid hormone therapy and mortality was observed in older adults (aged ≥65-70 years). Conclusions: Use of thyroid hormone therapy does not provide protective effects on mortality in older adults with subclinical hypothyroidism. However, thyroid hormone therapy for subclinical hypothyroidism may show benefits on morality in adults aged <65 to 70 years.

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Crossref · 10.1210/clinem/dgaa777

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  • Levothyroxine therapy is associated with a significant reduction in all-cause mortality in patients with subclinical hypothyroidism younger than 65 years.

    “The results showed that LT4 therapy was associated with a significant reduction in all-cause (RR = 0.50, CI 0.29–0.85, p = 0.011) and cardiovascular (RR = 0.54, 95% CI 0.37–0.80, p = 0.002) mortality in patients younger than 65 years, but not in older patients [34].”

    From Thyroid and heart, a clinically relevant relationship (2021) · cites this paper as [34]

  • Levothyroxine therapy is associated with a significant reduction in cardiovascular mortality in patients with subclinical hypothyroidism younger than 65 years.

    “The results showed that LT4 therapy was associated with a significant reduction in all-cause (RR = 0.50, CI 0.29–0.85, p = 0.011) and cardiovascular (RR = 0.54, 95% CI 0.37–0.80, p = 0.002) mortality in patients younger than 65 years, but not in older patients [34].”

    From Thyroid and heart, a clinically relevant relationship (2021) · cites this paper as [34]

  • Levothyroxine therapy is not associated with reduction in all-cause or cardiovascular mortality in older patients with subclinical hypothyroidism.

    “The results showed that LT4 therapy was associated with a significant reduction in all-cause (RR = 0.50, CI 0.29–0.85, p = 0.011) and cardiovascular (RR = 0.54, 95% CI 0.37–0.80, p = 0.002) mortality in patients younger than 65 years, but not in older patients [34].”

    From Thyroid and heart, a clinically relevant relationship (2021) · cites this paper as [34]

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Authors
Peng, C. C.-H., Huang, H.-K., Wu, B. B.-C., Chang, R. H.-E., Tu, Y.-K., & Munir, K. M.
Affiliations
  • University of Maryland Medical Center (US)
  • National Taiwan University (TW)
  • University of Maryland, Baltimore (US)
  • Johns Hopkins University (US)
Corresponding author
  • Peng, Carol Chiung-Hui
  • Munir, Kashif M
ORCID
Venue
The Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Published
2020-10-27
Volume
106
Issue
1
Pages
292-303
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
DOI
10.1210/clinem/dgaa777
OpenAlex
W3037158984
Cited by
52
References
42
Citations by year
2026: 7 · 2025: 8 · 2024: 9 · 2023: 11 · 2022: 7 · 2021: 10
FWCI
1.07
Type
journal article
Language
en
Open access
Licence
academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • PubMed (publishedVersion)
Funders
Johns Hopkins University
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, thyroid hormone replacement, levothyroxine, mortality, cardiovascular mortality, all-cause mortality, older adults
MeSH terms
Adult, Aged, Cardiovascular Diseases, Cause of Death, Female, Humans, Hypothyroidism, Male, Middle Aged, Mortality, Thyroid Hormones, Asymptomatic Diseases

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