Subclinical Hypothyroidism, Weight Change, and Body Composition in the Elderly: The Cardiovascular Health Study
Open accessAbstract
BACKGROUND: Subclinical hypothyroidism is common in the elderly, yet its relationship with weight and body composition is unclear. OBJECTIVE: We examined the relationship between subclinical hypothyroidism and weight change and body composition in older adults. METHODS: A total of 427 subclinically hypothyroid and 2864 euthyroid U.S. individuals ≥65 years old enrolled in the Cardiovascular Health Study and not taking thyroid preparations were included. Analyses of 6-year weight change were performed, compared by thyroid status. A cross-sectional analysis of thyroid status and body composition was performed in a subset of 1276 participants who had dual-energy x-ray absorptiometry scans. Models were risk factor-adjusted and stratified by sex. RESULTS: Overall, participants lost weight during follow-up (-0.38 kg/y in men, -0.37 kg/y in women). Subclinical hypothyroidism, when assessed at a single time point or persisting over 2 years, was not associated with a difference in weight change compared with euthyroidism. Subclinical hypothyroidism was also not associated with differences in lean mass, fat mass, or percent fat compared with euthyroidism. A TSH level 1 mU/L higher within the euthyroid or subclinical hypothyroid range was associated with a 0.51-kg higher baseline weight in women only (P < .001) but not with weight change in either sex. A 1 ng/dL higher free T4 level was associated with lower baseline weight and 0.32 kg/y greater weight loss in women only (P = .003). Baseline weight and weight change did not differ by T3 levels. CONCLUSIONS: Our data do not support a clinically significant impact of subclinical hypothyroidism on weight status in the elderly.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Most population-based studies in healthy non-LT4-treated subjects have shown a direct correlation between serum TSH levels within the reference range and body weight, BMI, or fat mass.
“Most population-based studies in healthy (non-LT4 treated) subjects have shown a direct correlation between serum TSH levels within the reference range and body weight, BMI, or fat mass (reviewed by Garin et al .) (40)”
From Effects of levothyroxine replacement or suppressive therapy on energy expenditure and body composition (2016) · cites this paper as [40]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Flegal, K. M., Kit, B. K., Orpana, H., & Graubard, B. I. (2013) · JAMA · doi:10.1001/jama.2012.113905 · Cited by 3,998 · see citing works
The Cardiovascular Health Study: design and rationale.
Fried, L. P., Borhani, N. O., Enright, P., Furberg, C. D., Gardin, J. M., Kronmal, R. A., Kuller, L. H., Manolio, T. A., Mittelmark, M. B., Newman, A., et al. (1991) · Annals of Epidemiology · doi:10.1016/1047-2797(91)90005-w · Cited by 3,652 · see citing works
Self-citationThe effect of age on the association between body-mass index and mortality
Stevens, J., Cai, J., Pamuk, E. R., Williamson, D. F., Thun, M. J., & Wood, J. L. (1998) · New England Journal of Medicine · doi:10.1056/nejm199801013380101 · Cited by 1,611 · see citing works
Medical Consequences of Obesity
Bray, G. A. (2004) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2004-0535 · Cited by 1,559 · see citing works
Hak, A. E., Pols, H. A. P., Visser, T. J., Drexhage, H. A., Hofman, A., & Witteman, J. C. M. (2000) · Annals of Internal Medicine · doi:10.7326/0003-4819-132-4-200002150-00004 · Cited by 1,336 · see citing works
Cooper, D. S., & Biondi, B. (2012) · The Lancet · doi:10.1016/s0140-6736(11)60276-6 · Cited by 1,039 · see citing works
Knudsen, N., Laurberg, P., Rasmussen, L. B., Bülow, I., Perrild, H., Ovesen, L., & Jørgensen, T. (2005) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2004-2225 · Cited by 753 · see citing works
Razvi, S., Ingoe, L., Keeka, G., Oates, C., McMillan, C., & Weaver, J. U. (2007) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2006-1869 · Cited by 389 · see citing works
Fox, C. S. (2008) · Archives of Internal Medicine · doi:10.1001/archinte.168.6.587 · Cited by 303 · see citing works
Serum TSH is positively associated with BMI
Nyrnes, A., Jorde, R., & Sundsfjord, J. (2005) · International Journal of Obesity · doi:10.1038/sj.ijo.0803112 · Cited by 274 · see citing works
Isidori, A. M., Strollo, F., Morè, M., Caprio, M., Aversa, A., Moretti, C., Frajese, G., Riondino, G., & Fabbri, A. (2000) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.85.5.6572 · Cited by 268 · see citing works
Iacobellis, G., Ribaudo, M. C., Zappaterreno, A., Iannucci, C. V., & Leonetti, F. (2005) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2005.02247.x · Cited by 253 · see citing works
Epidemiology of Obesity in the Western Hemisphere
Ford, E. S., & Mokdad, A. H. (2008) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2008-1356 · Cited by 248 · see citing works
A high normal TSH is associated with the metabolic syndrome
Ruhla, S., Weickert, M. O., Arafat, A. M., Osterhoff, M. A., Isken, F., Spranger, J., Schöfl, C., Pfeiffer, A. F. H., & Möhlig, M. (2009) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2009.03698.x · Cited by 225 · see citing works
A 6-month randomized trial of thyroxine treatment in women with mild subclinical hypothyroidism
Kong, W. M., Sheikh, M. H., Lumb, P. J., Freedman, D. B., Crook, M. A., Doré, C. J., & Finer, N. (2002) · The American Journal of Medicine · doi:10.1016/s0002-9343(02)01022-7 · Cited by 223 · see citing works
The effect of body weight and weight loss on thyroid volume and function in obese women
Sarı, R., Balcı, M. K., Altunbaş, H., & Karayalçın, Ü. (2003) · Clinical Endocrinology · doi:10.1046/j.1365-2265.2003.01836.x · Cited by 190 · see citing works
Circulating leptin and thyroid dysfunction
Zimmermann‐Belsing, T., Brabant, G. E., Holst, J. J., & Feldt‐Rasmussen, U. (2003) · European Journal of Endocrinology · doi:10.1530/eje.0.1490257 · Cited by 170 · see citing works
Lack of association between serum TSH or free T4 and body mass index in euthyroid subjects
Manji, N., Boelaert, K., Sheppard, M. C., Holder, R. L., Gough, S. C. L., & Franklyn, J. A. (2006) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2006.02433.x · Cited by 167 · see citing works
Pinkney, J. H., Goodrick, S., Katz, J., Johnson, A. B., Lightman, S. L., Coppack, S. W., & Mohamed‐Ali, V. (1998) · Clinical Endocrinology · doi:10.1046/j.1365-2265.1998.00573.x · Cited by 167 · see citing works
The relationship between serum thyrotropin and components of metabolic syndrome
Lai, Y., Wang, J., Jiang, F., Wang, B., Chen, Y., Li, M., Liu, H., Li, C., Xue, H., Li, N., et al. (2010) · Endocrine Journal · doi:10.1507/endocrj.k10e-272 · Cited by 157 · see citing works
Body Fatness and Markers of Thyroid Function among U.S. Men and Women
Kitahara, C. M., Platz, E. A., Ladenson, P. W., Mondul, A. M., Menke, A., & de González, A. B. (2012) · PLoS ONE · doi:10.1371/journal.pone.0034979 · Cited by 150 · see citing works
Changes in Lipoprotein(a) Levels in Overt and Subclinical Hypothyroidism Before and During Treatment
Tzotzas, T., Krassas, G. E., Κωνσταντινίδης, Θ. Κ., & Bougoulia, M. (2000) · Thyroid · doi:10.1089/thy.2000.10.803 · Cited by 150 · see citing works
Influence of obesity and surgical weight loss on thyroid hormone levels
Chikunguwo, S. M., Brethauer, S. A., Nirujogi, V., Pitt, T., Udomsawaengsup, S., Chand, B., & Schauer, P. R. (2007) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2007.07.011 · Cited by 150 · see citing works
Association of Serum TSH with High Body Mass Differs between Smokers and Never-Smokers
Åsvold, B. O., Bjøro, T., & Vatten, L. J. (2009) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2009-1180 · Cited by 149 · see citing works
Svare, A., Nilsen, T. I. L., Bjøro, T., Åsvold, B. O., & Langhammer, A. (2011) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2011.04009.x · Cited by 113 · see citing works
Karmisholt, J., Andersen, S., & Laurberg, P. (2010) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2010-1521 · Cited by 103 · see citing works
Free thyroxine is an independent predictor of subcutaneous fat in euthyroid individuals
Alevizaki, M. K., Saltiki, K., Voidonikola, P. T., Mantzou, A., Papamichael, C. M., & Stamatelopoulos, K. S. (2009) · European Journal of Endocrinology · doi:10.1530/eje-09-0441 · Cited by 95 · see citing works
Makepeace, A., Bremner, A., O'Leary, P. C., Leedman, P. J., Feddema, P., Michelangeli, V. P., & Walsh, J. P. (2008) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2008.03239.x · Cited by 90 · see citing works
Ambrosi, B., Masserini, B., Iorio, L., Delnevo, A., Malavazos, A. E., Morricone, L. F., Sburlati, L. F., & Orsi, E. (2010) · Journal of Endocrinological Investigation · doi:10.1007/bf03346663 · Cited by 77 · see citing works
Associations between subclinical thyroid disease and metabolic syndrome
Wang, C., Chang, T., & Chen, M.-F. (2012) · Endocrine Journal · doi:10.1507/endocrj.ej12-0076 · Cited by 75 · see citing works
Thyroid hormone levels predict the change in body weight: a prospective study
Soriguer, F., Valdés, S., Morcillo, S., Esteva, I., Almaraz, M. C., de Adana, M. S. R., Tapia, M. J., Domínguez, M., Gutiérrez‐Repiso, C., Rubio‐Martín, E., et al. (2011) · European Journal of Clinical Investigation · doi:10.1111/j.1365-2362.2011.02526.x · Cited by 72 · see citing works
Higher free thyroxine levels are associated with frailty in older men: the Health In Men Study
Yeap, B. B., Alfonso, H. S., Chubb, S. A. P., Walsh, J. P., Hankey, G. J., Almeida, O. P., & Flicker, L. A. (2011) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2011.04290.x · Cited by 61 · see citing works
TOTH, M. J., GARDNER, A. W., ARCIERO, P. J., CALLES-ESCANDON, J., & POEHLMAN, E. T. (1998) · Clinical Science · doi:10.1042/cs0950059 · Cited by 56 · see citing works
Relationship Between Thyrotropin and Body Mass Index in Euthyroid Subjects
Díez, J. J., & Iglesias, P. (2010) · Experimental and Clinical Endocrinology & Diabetes · doi:10.1055/s-0030-1265133 · Cited by 53 · see citing works
Subclinical Hypothyroidism has Little Influences on Muscle Mass or Strength in Elderly People
Moon, M. K., Lee, Y. J., Choi, S. H., Lim, S., Yang, E. J., Lim, J.-Y., Paik, N.-J., Kim, K. W., Park, K. S., Jang, H. C., et al. (2010) · Journal of Korean Medical Science · doi:10.3346/jkms.2010.25.8.1176 · Cited by 48 · see citing works
Somwaru, L. L., Arnold, A., & Cappola, A. R. (2011) · The Journals of Gerontology Series A · doi:10.1093/gerona/glr063 · Cited by 44 · see citing works
Self-citationRelationship between serum TSH level with obesity and NAFLD in euthyroid subjects
Zhang, J., Sun, H., Chen, L., Zheng, J., Hu, X., Wang, S., & Chen, T. (2012) · Journal of Huazhong University of Science and Technology [Medical Sciences] · doi:10.1007/s11596-012-0008-8 · Cited by 42 · see citing works
Boivin, M., Camirand, A., Carli, F., Hoffer, L. J., & Silva, J. E. (2000) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.85.5.6585 · Cited by 38 · see citing works
Westerink, J., van der Graaf, Y., Faber, D. R., Visseren, F. L. J., & on behalf of the SMART study group (2010) · European Journal of Clinical Investigation · doi:10.1111/j.1365-2362.2010.02391.x · Cited by 24 · see citing works
Is There a Reversal in the Effect of Obesity on Mortality in Old Age?
Cohen‐Mansfield, J., & Perach, R. (2011) · Journal of Aging Research · doi:10.4061/2011/765071 · Cited by 22 · see citing works
Toth, M. J., GARDNER, A. W., Arciero, P. J., et al. (1998) · Clinical Science · doi:10.1042/cs19980014 · Cited by 19 · see citing works
Souza, A. D. M., & Sichieri, R. (2011) · Obesity Facts · doi:10.1159/000327843 · Cited by 7 · see citing works
Mehran, L., Amouzegar, A., Delshad, H., & Azizi, F. (2012) · PubMed · Cited by 7 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Thyroid Function in the Euthyroid Range and Adverse Outcomes in Older Adults
Cappola, A. R., Arnold, A. M., Wulczyn, K., Carlson, M., Robbins, J., & Psaty, B. M. (2015) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2014-3586 · Cited by 201 · see citing works
Self-citationSamuels, M. H., Kolobova, I., Smeraglio, A., Peters, D., Purnell, J. Q., & Schuff, K. G. (2016) · Thyroid · doi:10.1089/thy.2015.0345 · Cited by 87 · see citing works
Samuels, M. H., Kolobova, I., Niederhausen, M., Purnell, J. Q., & Schuff, K. G. (2018) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2018-01203 · Cited by 35 · see citing works
- Authors
- Garin, M. C., Arnold, A. M., Lee, J. S., Tracy, R. P., & Cappola, A. R.
- Affiliations
- University of Pennsylvania (US)
- University of Washington (US)
- VA Palo Alto Health Care System (US)
- University of Vermont (US)
- Corresponding author
- Cappola, Anne R.
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2014-04-01
- Volume
- 99
- Issue
- 4
- Pages
- 1220-1226
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- PMC
- PMC3973778
- OpenAlex
- W2166725638
- Cited by
- 38
- References
- 43
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 3 · 2023: 2 · 2022: 1 · 2021: 2 · 2020: 3 · 2019: 5 · 2018: 6 · 2017: 2 · 2016: 4 · 2015: 3 · 2014: 4
- FWCI
- 3.49
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (n01hc085082-026, n01hc085081-021, n01hc085079-024, n01hc085083-027, n01hc085080-026, n01hc085086-022, n01hc55222-0-0-0)
- National Institute on Aging (N01HC85081, N01HC85079, N01-HC-85080, N01-HC-85082, R56AG023629, R01AG032317, HHSN268200800007C, N01-HC-85083, AG023629, HL080295, N01‐HC‐85086, R01AG023629, HHSN268201200036C)
- National Heart, Lung, and Blood Institute (N01-HC-85081, N01 HC085086, AG-023629, N01HC-85083, N01 HC085079, N01 HC085083, N01HC85082, N01 HC85086, N01 HC085080, HHSN 268200800007C, N01HC85080, N01 HC55222, HHSN268201200036C, N01HC085082, U01HL080295, N01 HC055222, N01 HC085081, HL080295, R01HL080295, N01-HC85079)
- National Institute of Diabetes and Digestive and Kidney Diseases (T32DK007314)
- National Institute of Neurological Disorders and Stroke (AG023629, HHSN268200800007C, N01-HC-85080, HL080295, N01-HC-85083, N01HC85082, N01-HC-85081, N01-HC-85086, N01 HC-55222, N01HC85079, HHSN268201200036C)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Keywords
- subclinical hypothyroidism, weight change, body composition, older adults, thyroid-stimulating hormone, free thyroxine, lean body mass, fat mass, weight loss, sex differences, Cardiovascular Health Study
- MeSH terms
- Aged, Aged, 80 and over, Body Composition, Female, Humans, Hypothyroidism, Male, Thyroid Gland, Cohort Studies, Weight Loss, Body Mass Index, Asymptomatic Diseases
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
