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Relationship Between Circulating Thyroid‐Stimulating Hormone, Free Thyroxine, and Free Triiodothyronine Concentrations and 9‐Year Mortality in Euthyroid Elderly Adults
Author(s) -
Ceresini Graziano,
Marina Michela,
Lauretani Fulvio,
Maggio Marcello,
Bandinelli Stefania,
Ceda Gian P.,
Ferrucci Luigi
Publication year - 2016
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.14029
Subject(s) - medicine , euthyroid , hazard ratio , quartile , confounding , triiodothyronine , proportional hazards model , confidence interval , endocrinology , thyroid stimulating hormone , population , hormone , environmental health
Objectives To determine the association between plasma thyroid‐stimulating hormone ( TSH ), free triiodothyronine ( FT 3), and free thyroxine ( FT 4) levels and all‐cause mortality in older adults who had levels of all three hormones in the normal range. Design Longitudinal. Setting Community‐based. Participants Euthyroid Invecchiare in Chianti study participants aged 65 and older (N = 815). Measurements Plasma TSH , FT 3, and FT 4 levels were predictors, and 9‐year all‐cause mortality was the outcome. Cox proportional hazards models adjusted for confounders were used to examine the relationship between TSH , FT 3, and FT 4 quartiles and all‐cause mortality over 9 years of follow‐up. Results During follow‐up (mean person‐years 8,643.7, range 35.4–16,985.0), 181 deaths occurred (22.2%). Participants with TSH in the lowest quartile had higher mortality than the rest of the population. After adjusting for multiple confounders, participants with TSH in the lowest quartile (hazard ratio = 2.22, 95% confidence interval = 1.19–4.22) had significantly higher all‐cause mortality than those with TSH in the highest quartile. Neither FT 3 nor FT 4 was associated with mortality. Conclusion In elderly euthyroid subjects, normal‐low TSH is an independent risk factor for all‐cause mortality.