Titre
Subclinical Hypothyroidism and the Risk of Stroke Events and Fatal Stroke: An Individual Participant Data Analysis.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Auteur(s)
Chaker, L.
Auteure/Auteur
Baumgartner, C.
Auteure/Auteur
den Elzen, W.P.
Auteure/Auteur
Ikram, M.A.
Auteure/Auteur
Blum, M.R.
Auteure/Auteur
Collet, T.H.
Auteure/Auteur
Bakker, S.J.
Auteure/Auteur
Dehghan, A.
Auteure/Auteur
Drechsler, C.
Auteure/Auteur
Luben, R.N.
Auteure/Auteur
Hofman, A.
Auteure/Auteur
Portegies, M.L.
Auteure/Auteur
Medici, M.
Auteure/Auteur
Iervasi, G.
Auteure/Auteur
Stott, D.J.
Auteure/Auteur
Ford, I.
Auteure/Auteur
Bremner, A.
Auteure/Auteur
Wanner, C.
Auteure/Auteur
Ferrucci, L.
Auteure/Auteur
Newman, A.B.
Auteure/Auteur
Dullaart, R.P.
Auteure/Auteur
Sgarbi, J.A.
Auteure/Auteur
Ceresini, G.
Auteure/Auteur
Maciel, R.M.
Auteure/Auteur
Westendorp, R.G.
Auteure/Auteur
Jukema, J.W.
Auteure/Auteur
Imaizumi, M.
Auteure/Auteur
Franklyn, J.A.
Auteure/Auteur
Bauer, D.C.
Auteure/Auteur
Walsh, J.P.
Auteure/Auteur
Razvi, S.
Auteure/Auteur
Khaw, K.T.
Auteure/Auteur
Cappola, A.R.
Auteure/Auteur
Völzke, H.
Auteure/Auteur
Franco, O.H.
Auteure/Auteur
Gussekloo, J.
Auteure/Auteur
Rodondi, N.
Auteure/Auteur
Peeters, R.P.
Auteure/Auteur
Groupes de travail
Thyroid Studies Collaboration
Liens vers les personnes
Liens vers les unités
ISSN
1945-7197
Statut éditorial
Publié
Date de publication
2015
Volume
100
Numéro
6
Première page
2181
Dernière page/numéro d’article
2191
Peer-reviewed
Oui
Langue
anglais
Notes
Document Type: Review, mais systematic search
Résumé
OBJECTIVE: The objective was to determine the risk of stroke associated with subclinical hypothyroidism.
DATA SOURCES AND STUDY SELECTION: Published prospective cohort studies were identified through a systematic search through November 2013 without restrictions in several databases. Unpublished studies were identified through the Thyroid Studies Collaboration. We collected individual participant data on thyroid function and stroke outcome. Euthyroidism was defined as TSH levels of 0.45-4.49 mIU/L, and subclinical hypothyroidism was defined as TSH levels of 4.5-19.9 mIU/L with normal T4 levels.
DATA EXTRACTION AND SYNTHESIS: We collected individual participant data on 47 573 adults (3451 subclinical hypothyroidism) from 17 cohorts and followed up from 1972-2014 (489 192 person-years). Age- and sex-adjusted pooled hazard ratios (HRs) for participants with subclinical hypothyroidism compared to euthyroidism were 1.05 (95% confidence interval [CI], 0.91-1.21) for stroke events (combined fatal and nonfatal stroke) and 1.07 (95% CI, 0.80-1.42) for fatal stroke. Stratified by age, the HR for stroke events was 3.32 (95% CI, 1.25-8.80) for individuals aged 18-49 years. There was an increased risk of fatal stroke in the age groups 18-49 and 50-64 years, with a HR of 4.22 (95% CI, 1.08-16.55) and 2.86 (95% CI, 1.31-6.26), respectively (p trend 0.04). We found no increased risk for those 65-79 years old (HR, 1.00; 95% CI, 0.86-1.18) or ≥ 80 years old (HR, 1.31; 95% CI, 0.79-2.18). There was a pattern of increased risk of fatal stroke with higher TSH concentrations.
CONCLUSIONS: Although no overall effect of subclinical hypothyroidism on stroke could be demonstrated, an increased risk in subjects younger than 65 years and those with higher TSH concentrations was observed.
DATA SOURCES AND STUDY SELECTION: Published prospective cohort studies were identified through a systematic search through November 2013 without restrictions in several databases. Unpublished studies were identified through the Thyroid Studies Collaboration. We collected individual participant data on thyroid function and stroke outcome. Euthyroidism was defined as TSH levels of 0.45-4.49 mIU/L, and subclinical hypothyroidism was defined as TSH levels of 4.5-19.9 mIU/L with normal T4 levels.
DATA EXTRACTION AND SYNTHESIS: We collected individual participant data on 47 573 adults (3451 subclinical hypothyroidism) from 17 cohorts and followed up from 1972-2014 (489 192 person-years). Age- and sex-adjusted pooled hazard ratios (HRs) for participants with subclinical hypothyroidism compared to euthyroidism were 1.05 (95% confidence interval [CI], 0.91-1.21) for stroke events (combined fatal and nonfatal stroke) and 1.07 (95% CI, 0.80-1.42) for fatal stroke. Stratified by age, the HR for stroke events was 3.32 (95% CI, 1.25-8.80) for individuals aged 18-49 years. There was an increased risk of fatal stroke in the age groups 18-49 and 50-64 years, with a HR of 4.22 (95% CI, 1.08-16.55) and 2.86 (95% CI, 1.31-6.26), respectively (p trend 0.04). We found no increased risk for those 65-79 years old (HR, 1.00; 95% CI, 0.86-1.18) or ≥ 80 years old (HR, 1.31; 95% CI, 0.79-2.18). There was a pattern of increased risk of fatal stroke with higher TSH concentrations.
CONCLUSIONS: Although no overall effect of subclinical hypothyroidism on stroke could be demonstrated, an increased risk in subjects younger than 65 years and those with higher TSH concentrations was observed.
PID Serval
serval:BIB_97B34C008875
PMID
Open Access
Oui
Date de création
2015-10-05T12:08:50.727Z
Date de création dans IRIS
2025-05-21T01:47:33Z
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Nom
5_25856213_Postprint.pdf
Version du manuscrit
preprint
Taille
776.48 KB
Format
Adobe PDF
PID Serval
serval:BIB_97B34C008875.P001
URN
urn:nbn:ch:serval-BIB_97B34C0088756
Somme de contrôle
(MD5):e954c15306bbc05418f3435d24ec86ba