High-normal TSH levels tied to all-cause mortality

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Nelson Vergel

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Kosuke Inoue, MD, of the Endocrinology and Diabetes Center, Yokohama Rosai Hospital in Japan, and colleagues evaluated data from National Health and Nutrition Examination Survey III (1988-1994) on 12,584 adults (mean age, 45.4 years; 48.6% men) in the United States to determine the relationship between low-normal thyroid function and all-cause or cause-specific mortalities. Follow-up was conducted for a median of 19.1 years.

Participants were divided into groups based on their TSH concentrations: 0.39 mIU/L to 1.15 mIU/L (low-normal TSH group), 1.16 mIU/L to 1.89 mIU/L (medium-normal TSH group) and 1.9 mIU/L to 4.6 mIU/L (high-normal TSH group).

Through follow-up, there were 3,395 all-cause deaths, including 1,048 CV deaths, 730 cancer deaths and 1,617 deaths from other causes.

Compared with the medium-normal TSH group, the high-normal TSH group (HR = 1.27; 95% CI, 1.1-1.47) and the low-normal TSH group (HR = 1.17; 95% CI, 1.02-1.35) had increased risk for all-cause death. The high-normal TSH group had a higher risk for CV death (HR = 1.3; 95% CI, 1.02-1.67) or cancer death (HR = 1.43; 95% CI, 1.01-2.01) compared with the other two groups.

The risk for all-cause mortality was significantly higher for men in the high-normal TSH group (HR = 1.29; 95% CI, 1.06-1.58) and men in the low-normal TSH group (HR = 1.32; 95% CI, 1.08-1.61) compared with men in the medium-normal TSH group. The risk for all-cause mortality was higher among women in the high-normal TSH group compared with women in the other two groups (HR = 1.24; 95% CI, 1.05-1.46).

In participants younger than 60 years, the risk for all-cause mortality was higher in the high-normal TSH group (HR = 1.49; 95% CI, 1.19-1.86) and the low-normal TSH group (HR = 1.29; 95% CI, 1.03-1.6) compared with the medium-normal TSH group. The high-normal TSH group had a higher prevalence of metabolic syndrome compared with the medium-normal TSH group (OR = 1.22; 95% CI, 0.96-1.55).

http://www.healio.com/endocrinology...normal-tsh-levels-tied-to-all-cause-mortality
 
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