Thyroid status and mortality risk in older adults with normal thyrotropin: Sex differences in the milan geriatrics 75+ Cohort Study

Giulia Ogliari, Roelof A.J. Smit, Evie Van Der Spoel, Daniela Mari, Erminio Torresani, Irene Felicetta, Tiziano A. Lucchi, Paolo D. Rossi, D. Van Heemst, Anton J.M. De Craen, Rudi G.J. Westendorp

Research output: Contribution to journalArticle

Abstract

Background: Thresholds of optimal thyroid status in old age are controversial. We investigated the longitudinal association between thyroid parameters and 10-year all-cause mortality risk in older outpatients with normal thyrotropin (TSH) and modification by sex and age. Methods: Baseline TSH, free thyroxine (fT4), and free triiodothyronine (fT3) were assessed in the Milan Geriatrics 75+ Cohort Study. 324 men and 609 women older than 75 years had normal TSH. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated for the associations between thyroid parameters and mortality risk using Cox regression. Sex-stratified analyses were adjusted for sociodemographic factors and comorbidities. Results: 233 men and 367 women died during follow-up. After adjustment, each 1-mU/L higher TSH was associated with decreased mortality risk in men (HR 0.83, 95% CI 0.69-0.98), but not in women (HR 1.09, 95% CI 0.95-1.24) (p for sex interaction = .006). Each 1-ng/L higher fT4 was associated with increased mortality risk in men (HR 1.11, 95% CI 1.02-1.22), but not in women (HR 0.98, 95% CI 0.93-1.04) (p for sex interaction = .013). Each 1-pg/mL higher fT3 was associated with decreased mortality risk in women (HR 0.77, 95% CI 0.60-0.98), but not in men (HR 0.80, 95% CI 0.57-1.13). The inverse association between TSH and mortality was most pronounced in men older than 85 years. Conclusions: Among older outpatients with normal TSH, higher TSH and lower fT4 were associated with decreased mortality risk in men but not in women. When assessing thyroid status, sex and age should be taken into account.

Original languageEnglish
Pages (from-to)554-559
Number of pages6
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Volume72
Issue number4
DOIs
Publication statusPublished - 2017

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Thyrotropin
Sex Characteristics
Geriatrics
Thyroid Gland
Cohort Studies
Confidence Intervals
Mortality
Outpatients
Triiodothyronine
Thyroxine
Comorbidity

Keywords

  • Geriatric cohort
  • Longevity
  • Thyrotropin
  • Thyroxine

ASJC Scopus subject areas

  • Ageing
  • Geriatrics and Gerontology

Cite this

Thyroid status and mortality risk in older adults with normal thyrotropin : Sex differences in the milan geriatrics 75+ Cohort Study. / Ogliari, Giulia; Smit, Roelof A.J.; Van Der Spoel, Evie; Mari, Daniela; Torresani, Erminio; Felicetta, Irene; Lucchi, Tiziano A.; Rossi, Paolo D.; Van Heemst, D.; De Craen, Anton J.M.; Westendorp, Rudi G.J.

In: Journals of Gerontology - Series A Biological Sciences and Medical Sciences, Vol. 72, No. 4, 2017, p. 554-559.

Research output: Contribution to journalArticle

Ogliari, Giulia ; Smit, Roelof A.J. ; Van Der Spoel, Evie ; Mari, Daniela ; Torresani, Erminio ; Felicetta, Irene ; Lucchi, Tiziano A. ; Rossi, Paolo D. ; Van Heemst, D. ; De Craen, Anton J.M. ; Westendorp, Rudi G.J. / Thyroid status and mortality risk in older adults with normal thyrotropin : Sex differences in the milan geriatrics 75+ Cohort Study. In: Journals of Gerontology - Series A Biological Sciences and Medical Sciences. 2017 ; Vol. 72, No. 4. pp. 554-559.
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abstract = "Background: Thresholds of optimal thyroid status in old age are controversial. We investigated the longitudinal association between thyroid parameters and 10-year all-cause mortality risk in older outpatients with normal thyrotropin (TSH) and modification by sex and age. Methods: Baseline TSH, free thyroxine (fT4), and free triiodothyronine (fT3) were assessed in the Milan Geriatrics 75+ Cohort Study. 324 men and 609 women older than 75 years had normal TSH. Hazard ratios (HRs) and 95{\%} confidence intervals (CIs) were calculated for the associations between thyroid parameters and mortality risk using Cox regression. Sex-stratified analyses were adjusted for sociodemographic factors and comorbidities. Results: 233 men and 367 women died during follow-up. After adjustment, each 1-mU/L higher TSH was associated with decreased mortality risk in men (HR 0.83, 95{\%} CI 0.69-0.98), but not in women (HR 1.09, 95{\%} CI 0.95-1.24) (p for sex interaction = .006). Each 1-ng/L higher fT4 was associated with increased mortality risk in men (HR 1.11, 95{\%} CI 1.02-1.22), but not in women (HR 0.98, 95{\%} CI 0.93-1.04) (p for sex interaction = .013). Each 1-pg/mL higher fT3 was associated with decreased mortality risk in women (HR 0.77, 95{\%} CI 0.60-0.98), but not in men (HR 0.80, 95{\%} CI 0.57-1.13). The inverse association between TSH and mortality was most pronounced in men older than 85 years. Conclusions: Among older outpatients with normal TSH, higher TSH and lower fT4 were associated with decreased mortality risk in men but not in women. When assessing thyroid status, sex and age should be taken into account.",
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T2 - Sex differences in the milan geriatrics 75+ Cohort Study

AU - Ogliari, Giulia

AU - Smit, Roelof A.J.

AU - Van Der Spoel, Evie

AU - Mari, Daniela

AU - Torresani, Erminio

AU - Felicetta, Irene

AU - Lucchi, Tiziano A.

AU - Rossi, Paolo D.

AU - Van Heemst, D.

AU - De Craen, Anton J.M.

AU - Westendorp, Rudi G.J.

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N2 - Background: Thresholds of optimal thyroid status in old age are controversial. We investigated the longitudinal association between thyroid parameters and 10-year all-cause mortality risk in older outpatients with normal thyrotropin (TSH) and modification by sex and age. Methods: Baseline TSH, free thyroxine (fT4), and free triiodothyronine (fT3) were assessed in the Milan Geriatrics 75+ Cohort Study. 324 men and 609 women older than 75 years had normal TSH. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated for the associations between thyroid parameters and mortality risk using Cox regression. Sex-stratified analyses were adjusted for sociodemographic factors and comorbidities. Results: 233 men and 367 women died during follow-up. After adjustment, each 1-mU/L higher TSH was associated with decreased mortality risk in men (HR 0.83, 95% CI 0.69-0.98), but not in women (HR 1.09, 95% CI 0.95-1.24) (p for sex interaction = .006). Each 1-ng/L higher fT4 was associated with increased mortality risk in men (HR 1.11, 95% CI 1.02-1.22), but not in women (HR 0.98, 95% CI 0.93-1.04) (p for sex interaction = .013). Each 1-pg/mL higher fT3 was associated with decreased mortality risk in women (HR 0.77, 95% CI 0.60-0.98), but not in men (HR 0.80, 95% CI 0.57-1.13). The inverse association between TSH and mortality was most pronounced in men older than 85 years. Conclusions: Among older outpatients with normal TSH, higher TSH and lower fT4 were associated with decreased mortality risk in men but not in women. When assessing thyroid status, sex and age should be taken into account.

AB - Background: Thresholds of optimal thyroid status in old age are controversial. We investigated the longitudinal association between thyroid parameters and 10-year all-cause mortality risk in older outpatients with normal thyrotropin (TSH) and modification by sex and age. Methods: Baseline TSH, free thyroxine (fT4), and free triiodothyronine (fT3) were assessed in the Milan Geriatrics 75+ Cohort Study. 324 men and 609 women older than 75 years had normal TSH. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated for the associations between thyroid parameters and mortality risk using Cox regression. Sex-stratified analyses were adjusted for sociodemographic factors and comorbidities. Results: 233 men and 367 women died during follow-up. After adjustment, each 1-mU/L higher TSH was associated with decreased mortality risk in men (HR 0.83, 95% CI 0.69-0.98), but not in women (HR 1.09, 95% CI 0.95-1.24) (p for sex interaction = .006). Each 1-ng/L higher fT4 was associated with increased mortality risk in men (HR 1.11, 95% CI 1.02-1.22), but not in women (HR 0.98, 95% CI 0.93-1.04) (p for sex interaction = .013). Each 1-pg/mL higher fT3 was associated with decreased mortality risk in women (HR 0.77, 95% CI 0.60-0.98), but not in men (HR 0.80, 95% CI 0.57-1.13). The inverse association between TSH and mortality was most pronounced in men older than 85 years. Conclusions: Among older outpatients with normal TSH, higher TSH and lower fT4 were associated with decreased mortality risk in men but not in women. When assessing thyroid status, sex and age should be taken into account.

KW - Geriatric cohort

KW - Longevity

KW - Thyrotropin

KW - Thyroxine

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