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Defining Optimal Health Range for Thyroid Function Based on the Risk of Cardiovascular Disease.

Layal Chaker1,2,3, Tim I M Korevaar1,2,3, Dimitris Rizopoulos4

  • 1Academic Center for Thyroid Diseases, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands.

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|May 19, 2017
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Summary
This summary is machine-generated.

Optimal thyroid function ranges may depend on cardiovascular disease risk, not just population distribution. Higher free thyroxine (FT4) levels are linked to increased cardiovascular disease (CVD) mortality risk, suggesting personalized health ranges.

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Area of Science:

  • Endocrinology
  • Cardiovascular Medicine
  • Epidemiology

Background:

  • Thyroid-stimulating hormone (TSH) and free thyroxine (FT4) reference ranges are population-based, not disease-risk-based.
  • Current ranges may not reflect optimal health or minimize disease risk.

Purpose of the Study:

  • To define optimal health ranges for thyroid function (TSH and FT4) based on cardiovascular disease (CVD) mortality risk.
  • To investigate the association between thyroid function and CVD mortality risk.

Main Methods:

  • Analysis of 9233 participants from the Rotterdam Study with a median follow-up of 8.8 years.
  • Calculation of 10-year absolute CVD mortality risks using Fine and Gray competing risk models.
  • Nonlinear modeling of TSH and FT4 percentiles with adjustments for sex and age.

Main Results:

  • Higher free thyroxine (FT4) levels (>90th percentile) were associated with increased 10-year CVD mortality risk (>7.5%).
  • In men, FT4 levels >97th percentile showed a 10.8% CVD mortality risk.
  • For individuals aged ≥65, FT4 levels above the 97th percentile indicated ≥15.0% CVD mortality risk.

Conclusions:

  • Optimal thyroid function ranges may be sex- and age-dependent and should consider disease risk.
  • Absolute CVD mortality risks vary across TSH and FT4 levels.
  • Further replication in diverse populations is needed.