Loading...
Subclinical hyperthyroidism is associated with increased risk of vertebral fractures in older men
Svensson, J. Ohlsson, C. Karlsson, M. K. Lorentzon, M. Lewerin, C. Mellstrom, D.
Svensson, J.
Ohlsson, C.
Karlsson, M. K.
Lorentzon, M.
Lewerin, C.
Mellstrom, D.
Abstract
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.
Keywords
fracture risk, oldermen, serumthyroid-stimulating hormone, subclinical hyperthyroidism, vertebral fracture
Date
2021
Type
Journal article
Journal
Osteoporosis International
Book
Volume
32
Issue
Page Range
2257-2265
Article Number
ACU Department
Mary MacKillop Institute for Health Research
Faculty of Health Sciences
Faculty of Health Sciences
Collections
Relation URI
Source URL
Event URL
Open Access Status
Published as ‘gold’ (paid) open access
License
CC BY-NC 4.0
File Access
Open