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    Higher free thyroxine levels are associated with all-cause mortality in euthyroid older men: The Health in Men Study

    Access Status
    Open access via publisher
    Authors
    Yeap, B.
    Alfonso, Helman
    Hankey, G.
    Flicker, L.
    Golledge, J.
    Norman, P.
    Chubb, S.
    Date
    2013
    Type
    Journal Article
    
    Metadata
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    Citation
    Yeap, B. and Alfonso, H. and Hankey, G. and Flicker, L. and Golledge, J. and Norman, P. and Chubb, S. 2013. Higher free thyroxine levels are associated with all-cause mortality in euthyroid older men: The Health in Men Study. European Journal of Endocrinology. 169 (4): pp. 401-408.
    Source Title
    European Journal of Endocrinology
    DOI
    10.1530/EJE-13-0306
    ISSN
    0804-4643
    School
    Epidemiology and Biostatistics
    URI
    http://hdl.handle.net/20.500.11937/26296
    Collection
    • Curtin Research Publications
    Abstract

    Objective: Thyroid dysfunction predicts poorer health outcomes, but the relationship between thyroid hormone levels within the reference range and mortality in older adults remains unclear. In this study, we examined the associations between the concentrations of free thyroxine (FT4) and TSH and allcause mortality in older men without thyroid disease. Subjects and methods: We performed a longitudinal study in community-dwelling men aged 70-89 years. Men with thyroid disease or taking thyroid-related medications were excluded. Baseline FT4 and TSH levels were assayed. Incident deaths were ascertained using data linkage. Results: There were 3885 men without thyroid disease followed for (meanGS.D.) 6.4G1.5 years, during which time 837 had died (21.5%). Men who had died had higher baseline FT4 levels (16.2G2.3 vs 15.8G2.1 pmol/l, P!0.001), but comparable TSH levels (2.4G1.5 vs 2.3G1.5 mIU/l, PZ0.250). After accounting for age, smoking, physical factors and medical comorbidities, higher circulating FT4 levels predicted all-cause mortality (quartile Q4 vs quartiles Q1-Q3: FT4 levelsR17.32 vs!17.32 pmol/l: adjusted hazard ratio (HR)Z1.19, 95% CIZ1.02-1.39, PZ0.025). TSH levels did not predict mortality. After excluding men with subclinical hyperthyroidism or hypothyroidism, there were 3442 men and 737 who had died (21.4%). In these men, higher FT4 levels remained independently associated with all-cause mortality (quartile Q4 vs quartiles Q1-Q3: adjusted HRZ1.19, 95% CIZ1.02-1.41, PZ0.032). Conclusions: Higher FT4 levels are associated with all-cause mortality in euthyroid older men, independently of conventional risk factors and medical comorbidities. Additional research is needed to determine whether or not this relationship is causal and to clarify the utility of thyroid function testing to stratify mortality risk in ageing men. © 2013 European Society of Endocrinology.

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