Graziano Ceresini1, Michela Marina1, Fulvio Lauretani2, Marcello Maggio1, Stefania Bandinelli3, Gian P Ceda1, Luigi Ferrucci4. 1. Endocrinology of Aging Unit, Department of Clinical and Experimental Medicine, University Hospital of Parma, Parma, Italy. 2. Geriatric Unit, University Hospital of Parma, Parma, Italy. 3. Geriatric Unit, Azienda Sanitaria di Firenze Toscana, Firenze, Italy. 4. National Institute on Aging, Baltimore, Maryland.
Abstract
OBJECTIVES: To determine the association between plasma thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4) levels and all-cause mortality in older adults who had levels of all three hormones in the normal range. DESIGN: Longitudinal. SETTING: Community-based. PARTICIPANTS: Euthyroid Invecchiare in Chianti study participants aged 65 and older (N = 815). MEASUREMENTS: Plasma TSH, FT3, and FT4 levels were predictors, and 9-year all-cause mortality was the outcome. Cox proportional hazards models adjusted for confounders were used to examine the relationship between TSH, FT3, and FT4 quartiles and all-cause mortality over 9 years of follow-up. RESULTS: During follow-up (mean person-years 8,643.7, range 35.4-16,985.0), 181 deaths occurred (22.2%). Participants with TSH in the lowest quartile had higher mortality than the rest of the population. After adjusting for multiple confounders, participants with TSH in the lowest quartile (hazard ratio = 2.22, 95% confidence interval = 1.19-4.22) had significantly higher all-cause mortality than those with TSH in the highest quartile. Neither FT3 nor FT4 was associated with mortality. CONCLUSION: In elderly euthyroid subjects, normal-low TSH is an independent risk factor for all-cause mortality.
OBJECTIVES: To determine the association between plasma thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4) levels and all-cause mortality in older adults who had levels of all three hormones in the normal range. DESIGN: Longitudinal. SETTING: Community-based. PARTICIPANTS: Euthyroid Invecchiare in Chianti study participants aged 65 and older (N = 815). MEASUREMENTS: Plasma TSH, FT3, and FT4 levels were predictors, and 9-year all-cause mortality was the outcome. Cox proportional hazards models adjusted for confounders were used to examine the relationship between TSH, FT3, and FT4 quartiles and all-cause mortality over 9 years of follow-up. RESULTS: During follow-up (mean person-years 8,643.7, range 35.4-16,985.0), 181 deaths occurred (22.2%). Participants with TSH in the lowest quartile had higher mortality than the rest of the population. After adjusting for multiple confounders, participants with TSH in the lowest quartile (hazard ratio = 2.22, 95% confidence interval = 1.19-4.22) had significantly higher all-cause mortality than those with TSH in the highest quartile. Neither FT3 nor FT4 was associated with mortality. CONCLUSION: In elderly euthyroid subjects, normal-low TSH is an independent risk factor for all-cause mortality.
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