Duration of thyroid dysfunction correlates with all-cause mortality. the OPENTHYRO Register Cohort.

<h4>Introduction and aim</h4>The association between thyroid dysfunction and mortality is controversial. Moreover, the impact of duration of thyroid dysfunction is unclarified. Our aim was to investigate the correlation between biochemically assessed thyroid function as well as dysfuncti...

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Autores principales:	Anne Sofie Laulund, Mads Nybo, Thomas Heiberg Brix, Bo Abrahamsen, Henrik Løvendahl Jørgensen, Laszlo Hegedüs
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/2f17d8c1950c4a889362b7af2952ce81
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spelling	oai:doaj.org-article:2f17d8c1950c4a889362b7af2952ce812021-11-25T05:55:23ZDuration of thyroid dysfunction correlates with all-cause mortality. the OPENTHYRO Register Cohort.1932-620310.1371/journal.pone.0110437https://doaj.org/article/2f17d8c1950c4a889362b7af2952ce812014-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0110437https://doaj.org/toc/1932-6203<h4>Introduction and aim</h4>The association between thyroid dysfunction and mortality is controversial. Moreover, the impact of duration of thyroid dysfunction is unclarified. Our aim was to investigate the correlation between biochemically assessed thyroid function as well as dysfunction duration and mortality.<h4>Methods</h4>Register-based follow-up study of 239,768 individuals with a serum TSH measurement from hospitals and/or general practice in Funen, Denmark. Measurements were performed at a single laboratory from January 1st 1995 to January 1st 2011. Cox regression was used for mortality analyses and Charlson Comorbidity Index (CCI) was used as comorbidity score.<h4>Results</h4>Hazard ratios (HR) with 95% confidence intervals (CI) for mortality with decreased (<0.3 mIU/L) or elevated (>4.0 mIU/L) levels of TSH were 2.22; 2.14-2.30; P<0.0001 and 1.28; 1.22-1.35; P<0.0001, respectively. Adjusting for age, gender, CCI and diagnostic setting attenuated the risk estimates (HR 1.23; 95% CI: 1.19-1.28; P<0.0001, mean follow-up time 7.7 years, and HR 1.07; 95% CI: 1.02-1.13; P = 0.004, mean follow-up time 7.2 years) for decreased and elevated values of TSH, respectively. Mortality risk increased by a factor 1.09; 95% CI: 1.08-1.10; P<0.0001 or by a factor 1.03; 95% CI: 1.02-1.04; P<0.0001 for each six months a patient suffered from decreased or elevated TSH, respectively. Subdividing according to degree of thyroid dysfunction, overt hyperthyroidism (HRovert 1.12; 95% CI: 1.06-1.19; P<0.0001), subclinical hyperthyroidism (HRsubclinical 1.09; 95% CI: 1.02-1.17; P = 0.02) and overt hypothyroidism (HRovert 1.57; 95% CI: 1.34-1.83; P<0.0001), but not subclinical hypothyroidism (HRsubclinical 1.03; 95% CI: 0.97-1.09; P = 0.4) were associated with increased mortality.<h4>Conclusions and relevance</h4>In a large-scale, population-based cohort with long-term follow-up (median 7.4 years), overt and subclinical hyperthyroidism and overt but not subclinical hypothyroidism were associated with increased mortality. Excess mortality with increasing duration of decreased or elevated serum TSH suggests the importance of timely intervention in individuals with thyroid dysfunction.Anne Sofie LaulundMads NyboThomas Heiberg BrixBo AbrahamsenHenrik Løvendahl JørgensenLaszlo HegedüsPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 10, p e110437 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Anne Sofie Laulund Mads Nybo Thomas Heiberg Brix Bo Abrahamsen Henrik Løvendahl Jørgensen Laszlo Hegedüs Duration of thyroid dysfunction correlates with all-cause mortality. the OPENTHYRO Register Cohort.
description	<h4>Introduction and aim</h4>The association between thyroid dysfunction and mortality is controversial. Moreover, the impact of duration of thyroid dysfunction is unclarified. Our aim was to investigate the correlation between biochemically assessed thyroid function as well as dysfunction duration and mortality.<h4>Methods</h4>Register-based follow-up study of 239,768 individuals with a serum TSH measurement from hospitals and/or general practice in Funen, Denmark. Measurements were performed at a single laboratory from January 1st 1995 to January 1st 2011. Cox regression was used for mortality analyses and Charlson Comorbidity Index (CCI) was used as comorbidity score.<h4>Results</h4>Hazard ratios (HR) with 95% confidence intervals (CI) for mortality with decreased (<0.3 mIU/L) or elevated (>4.0 mIU/L) levels of TSH were 2.22; 2.14-2.30; P<0.0001 and 1.28; 1.22-1.35; P<0.0001, respectively. Adjusting for age, gender, CCI and diagnostic setting attenuated the risk estimates (HR 1.23; 95% CI: 1.19-1.28; P<0.0001, mean follow-up time 7.7 years, and HR 1.07; 95% CI: 1.02-1.13; P = 0.004, mean follow-up time 7.2 years) for decreased and elevated values of TSH, respectively. Mortality risk increased by a factor 1.09; 95% CI: 1.08-1.10; P<0.0001 or by a factor 1.03; 95% CI: 1.02-1.04; P<0.0001 for each six months a patient suffered from decreased or elevated TSH, respectively. Subdividing according to degree of thyroid dysfunction, overt hyperthyroidism (HRovert 1.12; 95% CI: 1.06-1.19; P<0.0001), subclinical hyperthyroidism (HRsubclinical 1.09; 95% CI: 1.02-1.17; P = 0.02) and overt hypothyroidism (HRovert 1.57; 95% CI: 1.34-1.83; P<0.0001), but not subclinical hypothyroidism (HRsubclinical 1.03; 95% CI: 0.97-1.09; P = 0.4) were associated with increased mortality.<h4>Conclusions and relevance</h4>In a large-scale, population-based cohort with long-term follow-up (median 7.4 years), overt and subclinical hyperthyroidism and overt but not subclinical hypothyroidism were associated with increased mortality. Excess mortality with increasing duration of decreased or elevated serum TSH suggests the importance of timely intervention in individuals with thyroid dysfunction.
format	article
author	Anne Sofie Laulund Mads Nybo Thomas Heiberg Brix Bo Abrahamsen Henrik Løvendahl Jørgensen Laszlo Hegedüs
author_facet	Anne Sofie Laulund Mads Nybo Thomas Heiberg Brix Bo Abrahamsen Henrik Løvendahl Jørgensen Laszlo Hegedüs
author_sort	Anne Sofie Laulund
title	Duration of thyroid dysfunction correlates with all-cause mortality. the OPENTHYRO Register Cohort.
title_short	Duration of thyroid dysfunction correlates with all-cause mortality. the OPENTHYRO Register Cohort.
title_full	Duration of thyroid dysfunction correlates with all-cause mortality. the OPENTHYRO Register Cohort.
title_fullStr	Duration of thyroid dysfunction correlates with all-cause mortality. the OPENTHYRO Register Cohort.
title_full_unstemmed	Duration of thyroid dysfunction correlates with all-cause mortality. the OPENTHYRO Register Cohort.
title_sort	duration of thyroid dysfunction correlates with all-cause mortality. the openthyro register cohort.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/2f17d8c1950c4a889362b7af2952ce81
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Duration of thyroid dysfunction correlates with all-cause mortality. the OPENTHYRO Register Cohort.

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