Cited by 477Thyroid Disorders and TreatmentsThyroid and Parathyroid SurgeryThyroid Cancer Diagnosis and Treatment

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Meta-analysis: Subclinical Thyroid Dysfunction and the Risk for Coronary Heart Disease and Mortality

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Ochs, Nicolas, Auer, Reto, Bauer, Douglas C., Nanchen, David, Gussekloo, Jacobijn, Cornuz, Jacques, Rodondi, Nicolas·2008·Annals of Internal Medicine

DOI 10.7326/0003-4819-148-11-200806030-00225

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Abstract

BACKGROUND: Data on the association between subclinical thyroid dysfunction and coronary heart disease (CHD) and mortality are conflicting. PURPOSE: To summarize prospective evidence about the relationship between subclinical thyroid dysfunction and CHD and mortality. DATA SOURCES: MEDLINE (1950 to January 2008) without language restrictions and reference lists of retrieved articles were searched. STUDY SELECTION: Two reviewers screened and selected cohort studies that measured thyroid function and then followed persons prospectively to assess CHD or mortality. DATA EXTRACTION: By using a standardized protocol and forms, 2 reviewers independently abstracted and assessed studies. DATA SYNTHESIS: Ten of 12 identified studies involved population-based cohorts that included 14 449 participants. All 10 population-based cohort studies examined risks associated with subclinical hypothyroidism (2134 CHD events and 2822 deaths), whereas only 5 examined risks associated with subclinical hyperthyroidism (1392 CHD events and 1993 deaths). In a random-effects model, the relative risk (RR) for subclinical hypothyroidism for CHD was 1.20 (95% CI, 0.97 to 1.49; P for heterogeneity = 0.14; I(2 )= 33.4%). Risk estimates were lower when higher-quality studies were pooled (RR, 1.02 to 1.08) and were higher among participants younger than 65 years (RR, 1.51 [CI, 1.09 to 2.09] for studies with mean participant age <65 years and 1.05 [CI, 0.90 to 1.22] for studies with mean participant age > or =65 years). The RR was 1.18 (CI, 0.98 to 1.42) for cardiovascular mortality and 1.12 (CI, 0.99 to 1.26) for total mortality. For subclinical hyperthyroidism, the RR was 1.21 (CI, 0.88 to 1.68) for CHD, 1.19 (CI, 0.81 to 1.76) for cardiovascular mortality, and 1.12 (CI, 0.89 to 1.42) for total mortality (P for heterogeneity >0.50; I(2 )= 0% for all studies). LIMITATIONS: Individual studies adjusted for different potential confounders, and 1 study provided only unadjusted data. Publication bias or selective reporting of outcomes could not be excluded. CONCLUSION: Subclinical hypothyroidism and hyperthyroidism may be associated with a modest increased risk for CHD and mortality, with lower risk estimates when pooling higher-quality studies and larger CIs for subclinical hyperthyroidism.

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Authors: Ochs, N., Auer, R., Bauer, D. C., Nanchen, D., Gussekloo, J., Cornuz, J., & Rodondi, N.
Affiliations: University of California, San Francisco (US)
ORCID: Auer, Reto
Bauer, Douglas C.
Nanchen, David
Gussekloo, Jacobijn
Cornuz, Jacques
Rodondi, Nicolas
Venue: Annals of Internal Medicine
Publisher: American College of Physicians
Published: 2008-06-03
Volume: 148
Issue: 11
Pages: 832-845
ISSN: 0003-4819 (ISSN-L)
1539-3704
DOI: 10.7326/0003-4819-148-11-200806030-00225
OpenAlex: W2120863778
Cited by: 477
References: 70
Citations by year: 2026: 7 · 2025: 7 · 2024: 10 · 2023: 15 · 2022: 19 · 2021: 18 · 2020: 26 · 2019: 27 · 2018: 22 · 2017: 29 · 2016: 32 · 2015: 30 · 2014: 36 · 2013: 40 · 2012: 46
FWCI: 5.14
Type: journal article
Language: en
Open access: green
iris.unil.ch
Licence: www.acpjournals.org/journal/aim/text-and-data-mining (tdm)
Locations: Annals of Internal Medicine (publishedVersion)
PubMed (publishedVersion)
IRIS (submittedVersion)
SERVAL (Université de Lausanne) (submittedVersion)
SERVAL (Université de Lausanne) (submittedVersion, other-oa)
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: subclinical thyroid dysfunction, subclinical hypothyroidism, subclinical hyperthyroidism, coronary artery disease, cardiovascular mortality, all-cause mortality, thyroid function, prospective cohort, age as confounder, study quality heterogeneity, relative risk estimation, subgroup analysis
MeSH terms: Coronary Disease, Female, Humans, Hyperthyroidism, Hypothyroidism, Male, Prospective Studies, Risk Factors, Thyroid Function Tests, Thyrotropin

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Meta-analysis: Subclinical Thyroid Dysfunction and the Risk for Coronary Heart Disease and Mortality

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