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Subclinical hyperthyroidism is associated with increased risk of vertebral fractures in older men
SUMMARY: In elderly men included in MrOS-Sweden, subclinical hyperthyroidism (SHyper) was markedly associated with increased risk of vertebral fractures. INTRODUCTION: Overt hyperthyroidism is associated with increased risk of fractures. However, only a few studies have investigated whether SHyper i...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer London
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8563553/ https://www.ncbi.nlm.nih.gov/pubmed/34013460 http://dx.doi.org/10.1007/s00198-021-05964-w |
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author | Svensson, J. Ohlsson, C. Karlsson, M. K. Lorentzon, M. Lewerin, C. Mellström, D. |
author_facet | Svensson, J. Ohlsson, C. Karlsson, M. K. Lorentzon, M. Lewerin, C. Mellström, D. |
author_sort | Svensson, J. |
collection | PubMed |
description | SUMMARY: In elderly men included in MrOS-Sweden, subclinical hyperthyroidism (SHyper) was markedly associated with increased risk of vertebral fractures. INTRODUCTION: Overt hyperthyroidism is associated with increased risk of fractures. However, only a few studies have investigated whether SHyper is associated with fracture risk in elderly men. We therefore investigated if SHyper was a risk factor for fractures in Swedish men. METHODS: We followed (median 9.8 years) elderly men (n = 1856; mean age 75, range 69–81 years) participating in the Gothenburg and Malmö subcohorts of the prospective, population-based MrOS-Sweden study. The statistical analyses included Cox proportional hazards regression. SHyper was defined as serum thyroid-stimulating hormone (TSH) < 0.45 mIU/L (n = 38). RESULTS: SHyper was associated with increased risk of all fractures [n = 456; hazard ratio (HR) adjusted for age, study center, and levothyroxine treatment = 1.99, 95% confidence interval (CI): 1.20–3.32], major osteoporotic fractures (MOF, n = 338; HR 2.44, 95% CI: 1.42–4.21), and vertebral fractures (n = 176; HR 3.79, 95% CI: 2.02–7.11). These associations remained after full adjustment for covariates including total hip bone mineral density and in subanalyses including only men with serum free thyroxine ≤ the upper normal limit. However, after exclusion of men receiving levothyroxine treatment, the associations with all fractures and MOF lost significance. CONCLUSIONS: In elderly Swedish men, there was a strong association between SHyper and increased risk of vertebral fractures, whereas the associations with all incident fractures and MOF need to be confirmed in further studies. |
format | Online Article Text |
id | pubmed-8563553 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer London |
record_format | MEDLINE/PubMed |
spelling | pubmed-85635532021-11-04 Subclinical hyperthyroidism is associated with increased risk of vertebral fractures in older men Svensson, J. Ohlsson, C. Karlsson, M. K. Lorentzon, M. Lewerin, C. Mellström, D. Osteoporos Int Original Article SUMMARY: In elderly men included in MrOS-Sweden, subclinical hyperthyroidism (SHyper) was markedly associated with increased risk of vertebral fractures. INTRODUCTION: Overt hyperthyroidism is associated with increased risk of fractures. However, only a few studies have investigated whether SHyper is associated with fracture risk in elderly men. We therefore investigated if SHyper was a risk factor for fractures in Swedish men. METHODS: We followed (median 9.8 years) elderly men (n = 1856; mean age 75, range 69–81 years) participating in the Gothenburg and Malmö subcohorts of the prospective, population-based MrOS-Sweden study. The statistical analyses included Cox proportional hazards regression. SHyper was defined as serum thyroid-stimulating hormone (TSH) < 0.45 mIU/L (n = 38). RESULTS: SHyper was associated with increased risk of all fractures [n = 456; hazard ratio (HR) adjusted for age, study center, and levothyroxine treatment = 1.99, 95% confidence interval (CI): 1.20–3.32], major osteoporotic fractures (MOF, n = 338; HR 2.44, 95% CI: 1.42–4.21), and vertebral fractures (n = 176; HR 3.79, 95% CI: 2.02–7.11). These associations remained after full adjustment for covariates including total hip bone mineral density and in subanalyses including only men with serum free thyroxine ≤ the upper normal limit. However, after exclusion of men receiving levothyroxine treatment, the associations with all fractures and MOF lost significance. CONCLUSIONS: In elderly Swedish men, there was a strong association between SHyper and increased risk of vertebral fractures, whereas the associations with all incident fractures and MOF need to be confirmed in further studies. Springer London 2021-05-19 2021 /pmc/articles/PMC8563553/ /pubmed/34013460 http://dx.doi.org/10.1007/s00198-021-05964-w Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc/4.0/Open Access This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Original Article Svensson, J. Ohlsson, C. Karlsson, M. K. Lorentzon, M. Lewerin, C. Mellström, D. Subclinical hyperthyroidism is associated with increased risk of vertebral fractures in older men |
title | Subclinical hyperthyroidism is associated with increased risk of vertebral fractures in older men |
title_full | Subclinical hyperthyroidism is associated with increased risk of vertebral fractures in older men |
title_fullStr | Subclinical hyperthyroidism is associated with increased risk of vertebral fractures in older men |
title_full_unstemmed | Subclinical hyperthyroidism is associated with increased risk of vertebral fractures in older men |
title_short | Subclinical hyperthyroidism is associated with increased risk of vertebral fractures in older men |
title_sort | subclinical hyperthyroidism is associated with increased risk of vertebral fractures in older men |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8563553/ https://www.ncbi.nlm.nih.gov/pubmed/34013460 http://dx.doi.org/10.1007/s00198-021-05964-w |
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