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1 août 2017
- doi: 10.1210/jc.2017-00410
- issn: 0021-972X
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L. Chaker et al., « Defining Optimal Health Range for Thyroid Function Based on the Risk of Cardiovascular Disease. », Serveur académique Lausannois, ID : 10.1210/jc.2017-00410
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Résumé
Reference ranges of thyroid-stimulating hormone (TSH) and free thyroxine (FT4) are defined by their distribution in apparently healthy populations (2.5th and 97.5th percentiles), irrespective of disease risk, and are used as cutoffs for defining and clinically managing thyroid dysfunction. To provide proof of concept in defining optimal health ranges of thyroid function based on cardiovascular disease (CVD) mortality risk. In all, 9233 participants from the Rotterdam Study (mean age, 65.0 years) were followed up (median, 8.8 years) from baseline to date of death or end of follow-up period (2012), whichever came first (689 cases of CVD mortality). We calculated 10-year absolute risks of CVD mortality (defined according to the SCORE project) using a Fine and Gray competing risk model per percentiles of TSH and FT4, modeled nonlinearly and with sex and age adjustments. Overall, FT4 level >90th percentile was associated with a predicted 10-year CVD mortality risk >7.5% (P = 0.005). In men, FT4 level >97th percentile was associated with a risk of 10.8% (P < 0.001). In participants aged ≥65 years, absolute risk estimates were