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Cited by 120Thyroid Disorders and TreatmentsThyroid and Parathyroid SurgeryThyroid Cancer Diagnosis and Treatment

The DOI matches its Crossref record; 80 of the 81 references it cites were found in a registry or an index.

The Association of Thyroid Dysfunction with All-Cause and Circulatory Mortality: Is There a Causal Relationship?

Völzke, Henry, Schwahn, Christian, Wallaschofski, Henri, Dörr, Marcus·2007·The Journal of Clinical Endocrinology & Metabolism
DOI 10.1210/jc.2007-0179
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Abstract

CONTEXT: Currently there is ongoing debate on whether subclinical and overt thyroid dysfunction may exert deleterious effects on the cardiovascular system with the consequence of increased mortality in affected individuals. We systematically review studies on the relation of thyroid dysfunction with all-cause and circulatory mortality questioning whether thyroid dysfunction is a causal factor for mortality. METHODS: Two investigators independently searched the MEDLINE database. All case-control and cohort studies published in peer-reviewed journals were selected. Studies on nonthyroidal illness or low-T3 syndrome and reports from highly selected populations were not considered. Risk estimates from studies with appropriate adjustment for confounders were metaanalyzed. RESULTS: Four among eight studies performed to investigate the association between hyperthyroidism and mortality revealed an increased risk of either all-cause or circulatory mortality. Only the minority of studies, however, adjusted analyses for relevant confounders besides age, sex, and race. Studies after radioiodine therapy were generally biased by indication. Findings from 11 studies that investigated the relation between hypothyroidism and mortality were highly discrepant and partly even mutually exclusive. Some of these discrepancies are explained by confounding and selection. CONCLUSIONS: The currently available evidence for a causal relation of both hyperthyroidism and hypothyroidism with mortality is weak and should particularly not be used to decide whether patients with subclinical thyroid conditions should be treated. Very old individuals might represent an exception from this rule and may benefit from mildly reduced thyroid function, but this has to be substantiated by further research.

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Metadata

Authors
Völzke, H., Schwahn, C., Wallaschofski, H., & Dörr, M.
Affiliations
  • Institute of Epidemiology and Social Medicine (H.V., C.S.), University of Greifswald, D-17487 Greifswald, Germany
  • Universität Greifswald (DE)
  • Departments of Cardiology (M.D.), University of Greifswald, D-17487 Greifswald, Germany
ORCID
Schwahn, Christian
Venue
The Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Published
2007-07-01
Volume
92
Issue
7
Pages
2421-2429
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
DOI
10.1210/jc.2007-0179
OpenAlex
W2114636478
Cited by
120
References
81
Citations by year
2026: 1 · 2025: 1 · 2024: 1 · 2023: 1 · 2022: 1 · 2021: 2 · 2020: 6 · 2019: 2 · 2018: 1 · 2017: 2 · 2015: 10 · 2014: 11 · 2013: 11 · 2012: 17
FWCI
2.02
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • PubMed (publishedVersion)
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 › Thyroid Cancer Diagnosis and Treatment
Keywords
thyroid dysfunction, hyperthyroidism, hypothyroidism, subclinical thyroid dysfunction, all-cause mortality, circulatory disease mortality, cardiovascular mortality, radioiodine therapy, confounding, selection bias, causal relationship, elderly patients
MeSH terms
Cardiovascular Diseases, Cause of Death, Humans, Hyperthyroidism, Risk Factors

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