Thyroid Function Within the Normal Range and Risk of Coronary Heart Disease: An Individual Participant Data Analysis of 14 Cohorts

Research output: Contribution to journalJournal articleResearchpeer-review

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Thyroid Function Within the Normal Range and Risk of Coronary Heart Disease : An Individual Participant Data Analysis of 14 Cohorts. / Åsvold, Bjørn O; Vatten, Lars J; Bjøro, Trine; Bauer, Douglas C; Bremner, Alexandra; Cappola, Anne R; Ceresini, Graziano; den Elzen, Wendy P J; Ferrucci, Luigi; Franco, Oscar H; Franklyn, Jayne A; Gussekloo, Jacobijn; Iervasi, Giorgio; Imaizumi, Misa; Kearney, Patricia M; Khaw, Kay-Tee; Maciel, Rui M B; Newman, Anne B; Peeters, Robin P; Psaty, Bruce M; Razvi, Salman; Sgarbi, José A; Stott, David J; Trompet, Stella; Vanderpump, Mark P J; Völzke, Henry; Walsh, John P; Westendorp, Rudi G J; Rodondi, Nicolas; Thyroid Studies Collaboration.

In: J A M A Internal Medicine, Vol. 175, No. 6, 06.2015, p. 1037-47.

Research output: Contribution to journalJournal articleResearchpeer-review

Harvard

Åsvold, BO, Vatten, LJ, Bjøro, T, Bauer, DC, Bremner, A, Cappola, AR, Ceresini, G, den Elzen, WPJ, Ferrucci, L, Franco, OH, Franklyn, JA, Gussekloo, J, Iervasi, G, Imaizumi, M, Kearney, PM, Khaw, K-T, Maciel, RMB, Newman, AB, Peeters, RP, Psaty, BM, Razvi, S, Sgarbi, JA, Stott, DJ, Trompet, S, Vanderpump, MPJ, Völzke, H, Walsh, JP, Westendorp, RGJ, Rodondi, N & Thyroid Studies Collaboration 2015, 'Thyroid Function Within the Normal Range and Risk of Coronary Heart Disease: An Individual Participant Data Analysis of 14 Cohorts', J A M A Internal Medicine, vol. 175, no. 6, pp. 1037-47. https://doi.org/10.1001/jamainternmed.2015.0930

APA

Åsvold, B. O., Vatten, L. J., Bjøro, T., Bauer, D. C., Bremner, A., Cappola, A. R., ... Thyroid Studies Collaboration (2015). Thyroid Function Within the Normal Range and Risk of Coronary Heart Disease: An Individual Participant Data Analysis of 14 Cohorts. J A M A Internal Medicine, 175(6), 1037-47. https://doi.org/10.1001/jamainternmed.2015.0930

Vancouver

Åsvold BO, Vatten LJ, Bjøro T, Bauer DC, Bremner A, Cappola AR et al. Thyroid Function Within the Normal Range and Risk of Coronary Heart Disease: An Individual Participant Data Analysis of 14 Cohorts. J A M A Internal Medicine. 2015 Jun;175(6):1037-47. https://doi.org/10.1001/jamainternmed.2015.0930

Author

Åsvold, Bjørn O ; Vatten, Lars J ; Bjøro, Trine ; Bauer, Douglas C ; Bremner, Alexandra ; Cappola, Anne R ; Ceresini, Graziano ; den Elzen, Wendy P J ; Ferrucci, Luigi ; Franco, Oscar H ; Franklyn, Jayne A ; Gussekloo, Jacobijn ; Iervasi, Giorgio ; Imaizumi, Misa ; Kearney, Patricia M ; Khaw, Kay-Tee ; Maciel, Rui M B ; Newman, Anne B ; Peeters, Robin P ; Psaty, Bruce M ; Razvi, Salman ; Sgarbi, José A ; Stott, David J ; Trompet, Stella ; Vanderpump, Mark P J ; Völzke, Henry ; Walsh, John P ; Westendorp, Rudi G J ; Rodondi, Nicolas ; Thyroid Studies Collaboration. / Thyroid Function Within the Normal Range and Risk of Coronary Heart Disease : An Individual Participant Data Analysis of 14 Cohorts. In: J A M A Internal Medicine. 2015 ; Vol. 175, No. 6. pp. 1037-47.

Bibtex

@article{2f1d86b6959b43c0bf146bccddd03169,
title = "Thyroid Function Within the Normal Range and Risk of Coronary Heart Disease: An Individual Participant Data Analysis of 14 Cohorts",
abstract = "IMPORTANCE: Some experts suggest that serum thyrotropin levels in the upper part of the current reference range should be considered abnormal, an approach that would reclassify many individuals as having mild hypothyroidism. Health hazards associated with such thyrotropin levels are poorly documented, but conflicting evidence suggests that thyrotropin levels in the upper part of the reference range may be associated with an increased risk of coronary heart disease (CHD).OBJECTIVE: To assess the association between differences in thyroid function within the reference range and CHD risk.DESIGN, SETTING, AND PARTICIPANTS: Individual participant data analysis of 14 cohorts with baseline examinations between July 1972 and April 2002 and with median follow-up ranging from 3.3 to 20.0 years. Participants included 55 412 individuals with serum thyrotropin levels of 0.45 to 4.49 mIU/L and no previously known thyroid or cardiovascular disease at baseline.EXPOSURES: Thyroid function as expressed by serum thyrotropin levels at baseline.MAIN OUTCOMES AND MEASURES: Hazard ratios (HRs) of CHD mortality and CHD events according to thyrotropin levels after adjustment for age, sex, and smoking status.RESULTS: Among 55 412 individuals, 1813 people (3.3{\%}) died of CHD during 643 183 person-years of follow-up. In 10 cohorts with information on both nonfatal and fatal CHD events, 4666 of 48 875 individuals (9.5{\%}) experienced a first-time CHD event during 533 408 person-years of follow-up. For each 1-mIU/L higher thyrotropin level, the HR was 0.97 (95{\%} CI, 0.90-1.04) for CHD mortality and 1.00 (95{\%} CI, 0.97-1.03) for a first-time CHD event. Similarly, in analyses by categories of thyrotropin, the HRs of CHD mortality (0.94 [95{\%} CI, 0.74-1.20]) and CHD events (0.97 [95{\%} CI, 0.83-1.13]) were similar among participants with the highest (3.50-4.49 mIU/L) compared with the lowest (0.45-1.49 mIU/L) thyrotropin levels. Subgroup analyses by sex and age group yielded similar results.CONCLUSIONS AND RELEVANCE: Thyrotropin levels within the reference range are not associated with risk of CHD events or CHD mortality. This finding suggests that differences in thyroid function within the population reference range do not influence the risk of CHD. Increased CHD risk does not appear to be a reason for lowering the upper thyrotropin reference limit.",
author = "{\AA}svold, {Bj{\o}rn O} and Vatten, {Lars J} and Trine Bj{\o}ro and Bauer, {Douglas C} and Alexandra Bremner and Cappola, {Anne R} and Graziano Ceresini and {den Elzen}, {Wendy P J} and Luigi Ferrucci and Franco, {Oscar H} and Franklyn, {Jayne A} and Jacobijn Gussekloo and Giorgio Iervasi and Misa Imaizumi and Kearney, {Patricia M} and Kay-Tee Khaw and Maciel, {Rui M B} and Newman, {Anne B} and Peeters, {Robin P} and Psaty, {Bruce M} and Salman Razvi and Sgarbi, {Jos{\'e} A} and Stott, {David J} and Stella Trompet and Vanderpump, {Mark P J} and Henry V{\"o}lzke and Walsh, {John P} and Westendorp, {Rudi G J} and Nicolas Rodondi and {Thyroid Studies Collaboration}",
year = "2015",
month = "6",
doi = "10.1001/jamainternmed.2015.0930",
language = "English",
volume = "175",
pages = "1037--47",
journal = "J A M A Internal Medicine",
issn = "2168-6106",
publisher = "The JAMA Network",
number = "6",

}

RIS

TY - JOUR

T1 - Thyroid Function Within the Normal Range and Risk of Coronary Heart Disease

T2 - An Individual Participant Data Analysis of 14 Cohorts

AU - Åsvold, Bjørn O

AU - Vatten, Lars J

AU - Bjøro, Trine

AU - Bauer, Douglas C

AU - Bremner, Alexandra

AU - Cappola, Anne R

AU - Ceresini, Graziano

AU - den Elzen, Wendy P J

AU - Ferrucci, Luigi

AU - Franco, Oscar H

AU - Franklyn, Jayne A

AU - Gussekloo, Jacobijn

AU - Iervasi, Giorgio

AU - Imaizumi, Misa

AU - Kearney, Patricia M

AU - Khaw, Kay-Tee

AU - Maciel, Rui M B

AU - Newman, Anne B

AU - Peeters, Robin P

AU - Psaty, Bruce M

AU - Razvi, Salman

AU - Sgarbi, José A

AU - Stott, David J

AU - Trompet, Stella

AU - Vanderpump, Mark P J

AU - Völzke, Henry

AU - Walsh, John P

AU - Westendorp, Rudi G J

AU - Rodondi, Nicolas

AU - Thyroid Studies Collaboration

PY - 2015/6

Y1 - 2015/6

N2 - IMPORTANCE: Some experts suggest that serum thyrotropin levels in the upper part of the current reference range should be considered abnormal, an approach that would reclassify many individuals as having mild hypothyroidism. Health hazards associated with such thyrotropin levels are poorly documented, but conflicting evidence suggests that thyrotropin levels in the upper part of the reference range may be associated with an increased risk of coronary heart disease (CHD).OBJECTIVE: To assess the association between differences in thyroid function within the reference range and CHD risk.DESIGN, SETTING, AND PARTICIPANTS: Individual participant data analysis of 14 cohorts with baseline examinations between July 1972 and April 2002 and with median follow-up ranging from 3.3 to 20.0 years. Participants included 55 412 individuals with serum thyrotropin levels of 0.45 to 4.49 mIU/L and no previously known thyroid or cardiovascular disease at baseline.EXPOSURES: Thyroid function as expressed by serum thyrotropin levels at baseline.MAIN OUTCOMES AND MEASURES: Hazard ratios (HRs) of CHD mortality and CHD events according to thyrotropin levels after adjustment for age, sex, and smoking status.RESULTS: Among 55 412 individuals, 1813 people (3.3%) died of CHD during 643 183 person-years of follow-up. In 10 cohorts with information on both nonfatal and fatal CHD events, 4666 of 48 875 individuals (9.5%) experienced a first-time CHD event during 533 408 person-years of follow-up. For each 1-mIU/L higher thyrotropin level, the HR was 0.97 (95% CI, 0.90-1.04) for CHD mortality and 1.00 (95% CI, 0.97-1.03) for a first-time CHD event. Similarly, in analyses by categories of thyrotropin, the HRs of CHD mortality (0.94 [95% CI, 0.74-1.20]) and CHD events (0.97 [95% CI, 0.83-1.13]) were similar among participants with the highest (3.50-4.49 mIU/L) compared with the lowest (0.45-1.49 mIU/L) thyrotropin levels. Subgroup analyses by sex and age group yielded similar results.CONCLUSIONS AND RELEVANCE: Thyrotropin levels within the reference range are not associated with risk of CHD events or CHD mortality. This finding suggests that differences in thyroid function within the population reference range do not influence the risk of CHD. Increased CHD risk does not appear to be a reason for lowering the upper thyrotropin reference limit.

AB - IMPORTANCE: Some experts suggest that serum thyrotropin levels in the upper part of the current reference range should be considered abnormal, an approach that would reclassify many individuals as having mild hypothyroidism. Health hazards associated with such thyrotropin levels are poorly documented, but conflicting evidence suggests that thyrotropin levels in the upper part of the reference range may be associated with an increased risk of coronary heart disease (CHD).OBJECTIVE: To assess the association between differences in thyroid function within the reference range and CHD risk.DESIGN, SETTING, AND PARTICIPANTS: Individual participant data analysis of 14 cohorts with baseline examinations between July 1972 and April 2002 and with median follow-up ranging from 3.3 to 20.0 years. Participants included 55 412 individuals with serum thyrotropin levels of 0.45 to 4.49 mIU/L and no previously known thyroid or cardiovascular disease at baseline.EXPOSURES: Thyroid function as expressed by serum thyrotropin levels at baseline.MAIN OUTCOMES AND MEASURES: Hazard ratios (HRs) of CHD mortality and CHD events according to thyrotropin levels after adjustment for age, sex, and smoking status.RESULTS: Among 55 412 individuals, 1813 people (3.3%) died of CHD during 643 183 person-years of follow-up. In 10 cohorts with information on both nonfatal and fatal CHD events, 4666 of 48 875 individuals (9.5%) experienced a first-time CHD event during 533 408 person-years of follow-up. For each 1-mIU/L higher thyrotropin level, the HR was 0.97 (95% CI, 0.90-1.04) for CHD mortality and 1.00 (95% CI, 0.97-1.03) for a first-time CHD event. Similarly, in analyses by categories of thyrotropin, the HRs of CHD mortality (0.94 [95% CI, 0.74-1.20]) and CHD events (0.97 [95% CI, 0.83-1.13]) were similar among participants with the highest (3.50-4.49 mIU/L) compared with the lowest (0.45-1.49 mIU/L) thyrotropin levels. Subgroup analyses by sex and age group yielded similar results.CONCLUSIONS AND RELEVANCE: Thyrotropin levels within the reference range are not associated with risk of CHD events or CHD mortality. This finding suggests that differences in thyroid function within the population reference range do not influence the risk of CHD. Increased CHD risk does not appear to be a reason for lowering the upper thyrotropin reference limit.

U2 - 10.1001/jamainternmed.2015.0930

DO - 10.1001/jamainternmed.2015.0930

M3 - Journal article

VL - 175

SP - 1037

EP - 1047

JO - J A M A Internal Medicine

JF - J A M A Internal Medicine

SN - 2168-6106

IS - 6

ER -

ID: 140394559