Changes in thyroid function and evolution of subclinical thyroid disease in older men
Tan, Stephanie Y., Chubb, S.A. Paul, Flicker, Leon, Almeida, Osvaldo P., Golledge, Jonathan, Hankey, Graeme J., and Yeap, Bu B. (2024) Changes in thyroid function and evolution of subclinical thyroid disease in older men. Clinical Endocrinology, 100 (2). pp. 170-180.
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Abstract
Objective: Prevalence of subclinical thyroid disease increases with age, but optimal detection and surveillance strategies remain unclear particularly for older men. We aimed to assess thyroid stimulating hormone (TSH) and free thyroxine (FT4) concentrations and their longitudinal changes, to determine the prevalence and incidence of subclinical thyroid dysfunction in older men.
Design, Participants and Measurements: Longitudinal study of 994 community-dwelling men aged ≥70 years without known or current thyroid disease, with TSH and FT4 concentrations assessed at baseline and follow-up (after 8.7 ± 0.9 years). Factors associated with incident subclinical thyroid dysfunction were examined by logistic regression and receiver operating characteristic analyses.
Results: At baseline, 85 men (8.6%) had subclinical hypothyroidism and 10 (1.0%) subclinical hyperthyroidism. Among 899 men euthyroid at baseline (mean age 75.0 ± 3.0 years), 713 (79.3%) remained euthyroid, 180 (20.0%) developed subclinical/overt hypothyroidism, and 6 (0.7%) subclinical/overt hyperthyroidism. Change in TSH correlated with baseline TSH (r =.16, p <.05). Change in FT4 correlated inversely with baseline FT4 (r = −0.35, p <.05). Only higher age and baseline TSH predicted progression from euthyroid to subclinical/overt hypothyroidism (fully-adjusted odds ratio [OR] per year=1.09, 95% confidence interval [CI] = 1.02-1.17, p =.006; per 2.7-fold increase in TSH OR = 65.4, CI = 31.9-134, p <.001). Baseline TSH concentration ≥2.34 mIU/L had 76% sensitivity and 77% specificity for predicting development of subclinical/overt hypothyroidism.
Conclusions: In older men TSH concentration increased over time, while FT4 concentration showed little change. Subclinical or overt hypothyroidism evolved in one fifth of initially euthyroid men, age and higher baseline TSH predicted this outcome. Increased surveillance for thyroid dysfunction may be justified in older men, especially those with high-normal TSH.
Item ID: | 81450 |
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Item Type: | Article (Research - C1) |
ISSN: | 1365-2265 |
Keywords: | ageing, free thyroxine, hypothyroidism, men, subclinical hyperthyroidism, subclinical hypothyroidism, thyroid-stimulating hormone |
Copyright Information: | © 2023 The Authors. Clinical Endocrinology published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
Funders: | National Health and Medical Research Council (NHMRC) |
Date Deposited: | 11 Mar 2024 22:54 |
FoR Codes: | 32 BIOMEDICAL AND CLINICAL SCIENCES > 3201 Cardiovascular medicine and haematology > 320199 Cardiovascular medicine and haematology not elsewhere classified @ 100% |
SEO Codes: | 20 HEALTH > 2001 Clinical health > 200105 Treatment of human diseases and conditions @ 100% |
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