Thyroid function test variability and cardiovascular morbidity in hyperthyroidism.
Clin Endocrinol (Oxf)
; 99(4): 428-436, 2023 10.
Article
em En
| MEDLINE
| ID: mdl-37497807
ABSTRACT
OBJECTIVE:
The variability of thyroid function tests (TFTs) during antithyroid drug (ATD) therapy and its association with adverse health outcomes have not been previously studied. The aim of this study was to evaluate the association of TFT variability and cardiovascular morbidity during ATD therapy.DESIGN:
Retrospective cohort study. PATIENTS AND MEASUREMENTS Hyperthyroid patients (n = 394) treated with ATD therapy at Tampere University Hospital between March 2016 and December 2018 were followed up for a median time of 1.5 years (interquartile range 0.8-2.0). The coefficients of variation (CVs) of the follow-up thyroid-stimulating hormone (TSH), free thyroxine (fT4) and free triiodothyronine (fT3) measurements were determined. The associations of TFT variability and baseline clinical factors with cardiovascular disease (CVD) -associated hospital visits were assessed with logistic regression analyses.RESULTS:
In the multivariable analyses, age (odds ratio [OR] 1.06, 95% confidence interval [CI] 1.03-1.09), male gender (OR 2.33, 95% CI 1.03-5.28) and fT4-CV (OR 1.02, 95% CI 1.01-1.04) were independent risk factors for cardiovascular morbidity, whereas baseline positive thyrotropin receptor antibodies (TRAbs) were associated with lower cardiovascular morbidity (OR 0.29, 95% CI 0.14-0.61). When the patients with baseline TRAb positivity were studied separately, fT4-CV was associated with cardiovascular morbidity (OR 1.03, 95% CI 1.00-1.05).CONCLUSIONS:
During ATD therapy, fT4 variability is associated with an increased cardiovascular morbidity. Although positive TRAbs are associated with a lower cardiovascular morbidity compared with hyperthyroidism with negative autoantibodies, the variability of fT4 is associated with cardiovascular morbidity also in patients with positive TRAbs.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doenças Cardiovasculares
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Doença de Graves
/
Hipertireoidismo
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Humans
/
Male
Idioma:
En
Revista:
Clin Endocrinol (Oxf)
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Finlândia