Impact of Thyroid Hormone Therapy on Atherosclerosis in the Elderly With Subclinical Hypothyroidism: A Randomized Trial

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Impact of Thyroid Hormone Therapy on Atherosclerosis in the Elderly With Subclinical Hypothyroidism : A Randomized Trial. / Blum, Manuel R; Gencer, Baris; Adam, Luise; Feller, Martin; Collet, Tinh-Hai; da Costa, Bruno R; Moutzouri, Elisavet; Dopheide, Jörn; Depairon, Michèle; Sykiotis, Gerasimos P; Kearney, Patricia; Gussekloo, Jacobijn; Westendorp, Rudi; Stott, David J; Bauer, Douglas C; Rodondi, Nicolas.

In: The Journal of clinical endocrinology and metabolism, Vol. 103, No. 8, 2018, p. 2988-2997.

Research output: Contribution to journalJournal articleResearchpeer-review

Harvard

Blum, MR, Gencer, B, Adam, L, Feller, M, Collet, T-H, da Costa, BR, Moutzouri, E, Dopheide, J, Depairon, M, Sykiotis, GP, Kearney, P, Gussekloo, J, Westendorp, R, Stott, DJ, Bauer, DC & Rodondi, N 2018, 'Impact of Thyroid Hormone Therapy on Atherosclerosis in the Elderly With Subclinical Hypothyroidism: A Randomized Trial', The Journal of clinical endocrinology and metabolism, vol. 103, no. 8, pp. 2988-2997. https://doi.org/10.1210/jc.2018-00279

APA

Blum, M. R., Gencer, B., Adam, L., Feller, M., Collet, T-H., da Costa, B. R., ... Rodondi, N. (2018). Impact of Thyroid Hormone Therapy on Atherosclerosis in the Elderly With Subclinical Hypothyroidism: A Randomized Trial. The Journal of clinical endocrinology and metabolism, 103(8), 2988-2997. https://doi.org/10.1210/jc.2018-00279

Vancouver

Blum MR, Gencer B, Adam L, Feller M, Collet T-H, da Costa BR et al. Impact of Thyroid Hormone Therapy on Atherosclerosis in the Elderly With Subclinical Hypothyroidism: A Randomized Trial. The Journal of clinical endocrinology and metabolism. 2018;103(8):2988-2997. https://doi.org/10.1210/jc.2018-00279

Author

Blum, Manuel R ; Gencer, Baris ; Adam, Luise ; Feller, Martin ; Collet, Tinh-Hai ; da Costa, Bruno R ; Moutzouri, Elisavet ; Dopheide, Jörn ; Depairon, Michèle ; Sykiotis, Gerasimos P ; Kearney, Patricia ; Gussekloo, Jacobijn ; Westendorp, Rudi ; Stott, David J ; Bauer, Douglas C ; Rodondi, Nicolas. / Impact of Thyroid Hormone Therapy on Atherosclerosis in the Elderly With Subclinical Hypothyroidism : A Randomized Trial. In: The Journal of clinical endocrinology and metabolism. 2018 ; Vol. 103, No. 8. pp. 2988-2997.

Bibtex

@article{f0c3990b379a45648a2329f29e80a27a,
title = "Impact of Thyroid Hormone Therapy on Atherosclerosis in the Elderly With Subclinical Hypothyroidism: A Randomized Trial",
abstract = "Context: Subclinical hypothyroidism (SHypo) has been associated with atherosclerosis, but no conclusive clinical trials assessing the levothyroxine impact on carotid atherosclerosis exist.Objective: To assess the impact of treatment of SHypo with levothyroxine on carotid atherosclerosis.Design and Setting: Randomized, double-blind, placebo-controlled trial nested within the Thyroid Hormone Replacement for Subclinical Hypothyroidism trial.Participants: Participants aged ≥65 years with SHypo [thyroid-stimulating hormone (TSH), 4.60 to 19.99 mIU/L; free thyroxine level within reference range].Intervention: Levothyroxine dose-titrated to achieve TSH normalization or placebo, including mock titrations.Main Outcome Measures: Carotid intima media thickness (CIMT), maximum plaque thickness measured with ultrasound.Results: One hundred eighty-five participants (mean age 74.1 years, 47{\%} women, 96 randomized to levothyroxine) underwent carotid ultrasound. Overall mean TSH ± SD was 6.35 ± 1.95 mIU/L at baseline and decreased to 3.55 ± 2.14 mIU/L with levothyroxine compared with 5.29 ± 2.21 mIU/L with placebo (P < 0.001). After a median treatment of 18.4 months (interquartile range 12.2 to 30.0 months), mean CIMT was 0.85 ± 0.14 mm under levothyroxine and 0.82 ± 0.13 mm under placebo [between-group difference = 0.02 mm; 95{\%} CI, -0.01 to 0.06; P = 0.30]. The proportion of carotid plaque was similar (n = 135; 70.8{\%} under levothyroxine and 75.3{\%} under placebo; P = 0.46). Maximum carotid plaque thickness was 2.38 ± 0.92 mm under levothyroxine and 2.37 ± 0.91 mm under placebo (between-group difference -0.03; 95{\%} CI, -0.34 to 0.29; P = 0.86). There were no significant interactions between levothyroxine treatment and mean CIMT, according to sex, baseline TSH (categories 4.6 to 6.9, 7.0 to 9.9, and ≥10 mIU/L), or established cardiovascular disease (all P for interaction ≥ 0.14).Conclusion: Normalization of TSH with levothyroxine was associated with no difference in CIMT and carotid atherosclerosis in older persons with SHypo.",
author = "Blum, {Manuel R} and Baris Gencer and Luise Adam and Martin Feller and Tinh-Hai Collet and {da Costa}, {Bruno R} and Elisavet Moutzouri and J{\"o}rn Dopheide and Mich{\`e}le Depairon and Sykiotis, {Gerasimos P} and Patricia Kearney and Jacobijn Gussekloo and Rudi Westendorp and Stott, {David J} and Bauer, {Douglas C} and Nicolas Rodondi",
year = "2018",
doi = "10.1210/jc.2018-00279",
language = "English",
volume = "103",
pages = "2988--2997",
journal = "Journal of Clinical Endocrinology and Metabolism",
issn = "0021-972X",
publisher = "Oxford University Press",
number = "8",

}

RIS

TY - JOUR

T1 - Impact of Thyroid Hormone Therapy on Atherosclerosis in the Elderly With Subclinical Hypothyroidism

T2 - A Randomized Trial

AU - Blum, Manuel R

AU - Gencer, Baris

AU - Adam, Luise

AU - Feller, Martin

AU - Collet, Tinh-Hai

AU - da Costa, Bruno R

AU - Moutzouri, Elisavet

AU - Dopheide, Jörn

AU - Depairon, Michèle

AU - Sykiotis, Gerasimos P

AU - Kearney, Patricia

AU - Gussekloo, Jacobijn

AU - Westendorp, Rudi

AU - Stott, David J

AU - Bauer, Douglas C

AU - Rodondi, Nicolas

PY - 2018

Y1 - 2018

N2 - Context: Subclinical hypothyroidism (SHypo) has been associated with atherosclerosis, but no conclusive clinical trials assessing the levothyroxine impact on carotid atherosclerosis exist.Objective: To assess the impact of treatment of SHypo with levothyroxine on carotid atherosclerosis.Design and Setting: Randomized, double-blind, placebo-controlled trial nested within the Thyroid Hormone Replacement for Subclinical Hypothyroidism trial.Participants: Participants aged ≥65 years with SHypo [thyroid-stimulating hormone (TSH), 4.60 to 19.99 mIU/L; free thyroxine level within reference range].Intervention: Levothyroxine dose-titrated to achieve TSH normalization or placebo, including mock titrations.Main Outcome Measures: Carotid intima media thickness (CIMT), maximum plaque thickness measured with ultrasound.Results: One hundred eighty-five participants (mean age 74.1 years, 47% women, 96 randomized to levothyroxine) underwent carotid ultrasound. Overall mean TSH ± SD was 6.35 ± 1.95 mIU/L at baseline and decreased to 3.55 ± 2.14 mIU/L with levothyroxine compared with 5.29 ± 2.21 mIU/L with placebo (P < 0.001). After a median treatment of 18.4 months (interquartile range 12.2 to 30.0 months), mean CIMT was 0.85 ± 0.14 mm under levothyroxine and 0.82 ± 0.13 mm under placebo [between-group difference = 0.02 mm; 95% CI, -0.01 to 0.06; P = 0.30]. The proportion of carotid plaque was similar (n = 135; 70.8% under levothyroxine and 75.3% under placebo; P = 0.46). Maximum carotid plaque thickness was 2.38 ± 0.92 mm under levothyroxine and 2.37 ± 0.91 mm under placebo (between-group difference -0.03; 95% CI, -0.34 to 0.29; P = 0.86). There were no significant interactions between levothyroxine treatment and mean CIMT, according to sex, baseline TSH (categories 4.6 to 6.9, 7.0 to 9.9, and ≥10 mIU/L), or established cardiovascular disease (all P for interaction ≥ 0.14).Conclusion: Normalization of TSH with levothyroxine was associated with no difference in CIMT and carotid atherosclerosis in older persons with SHypo.

AB - Context: Subclinical hypothyroidism (SHypo) has been associated with atherosclerosis, but no conclusive clinical trials assessing the levothyroxine impact on carotid atherosclerosis exist.Objective: To assess the impact of treatment of SHypo with levothyroxine on carotid atherosclerosis.Design and Setting: Randomized, double-blind, placebo-controlled trial nested within the Thyroid Hormone Replacement for Subclinical Hypothyroidism trial.Participants: Participants aged ≥65 years with SHypo [thyroid-stimulating hormone (TSH), 4.60 to 19.99 mIU/L; free thyroxine level within reference range].Intervention: Levothyroxine dose-titrated to achieve TSH normalization or placebo, including mock titrations.Main Outcome Measures: Carotid intima media thickness (CIMT), maximum plaque thickness measured with ultrasound.Results: One hundred eighty-five participants (mean age 74.1 years, 47% women, 96 randomized to levothyroxine) underwent carotid ultrasound. Overall mean TSH ± SD was 6.35 ± 1.95 mIU/L at baseline and decreased to 3.55 ± 2.14 mIU/L with levothyroxine compared with 5.29 ± 2.21 mIU/L with placebo (P < 0.001). After a median treatment of 18.4 months (interquartile range 12.2 to 30.0 months), mean CIMT was 0.85 ± 0.14 mm under levothyroxine and 0.82 ± 0.13 mm under placebo [between-group difference = 0.02 mm; 95% CI, -0.01 to 0.06; P = 0.30]. The proportion of carotid plaque was similar (n = 135; 70.8% under levothyroxine and 75.3% under placebo; P = 0.46). Maximum carotid plaque thickness was 2.38 ± 0.92 mm under levothyroxine and 2.37 ± 0.91 mm under placebo (between-group difference -0.03; 95% CI, -0.34 to 0.29; P = 0.86). There were no significant interactions between levothyroxine treatment and mean CIMT, according to sex, baseline TSH (categories 4.6 to 6.9, 7.0 to 9.9, and ≥10 mIU/L), or established cardiovascular disease (all P for interaction ≥ 0.14).Conclusion: Normalization of TSH with levothyroxine was associated with no difference in CIMT and carotid atherosclerosis in older persons with SHypo.

U2 - 10.1210/jc.2018-00279

DO - 10.1210/jc.2018-00279

M3 - Journal article

VL - 103

SP - 2988

EP - 2997

JO - Journal of Clinical Endocrinology and Metabolism

JF - Journal of Clinical Endocrinology and Metabolism

SN - 0021-972X

IS - 8

ER -

ID: 203559568