Subclinical hyperthyroidism is associated with increased risk of vertebral fractures in older men
(2021) In Osteoporosis International 32(11). p.2257-2265- 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... (More)
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.
(Less)
- author
- Svensson, J. ; Ohlsson, C. ; Karlsson, M. K. LU ; Lorentzon, M. ; Lewerin, C. and Mellström, D.
- organization
- publishing date
- 2021
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Fracture risk, Older men, Serum thyroid-stimulating hormone, Subclinical hyperthyroidism, Vertebral fracture
- in
- Osteoporosis International
- volume
- 32
- issue
- 11
- pages
- 2257 - 2265
- publisher
- Springer
- external identifiers
-
- scopus:85106042735
- pmid:34013460
- ISSN
- 0937-941X
- DOI
- 10.1007/s00198-021-05964-w
- language
- English
- LU publication?
- yes
- additional info
- Funding Information: Open access funding provided by University of Gothenburg. This work was supported by the Swedish state under the agreement between the Swedish government and the county councils, the ALF-agreement (ALFGBG-722371 and ALFGBG-437971).
- id
- 2c5d11b2-755e-4489-9f44-d38d99f85ee1
- date added to LUP
- 2021-06-09 15:29:36
- date last changed
- 2024-12-01 06:38:33
@article{2c5d11b2-755e-4489-9f44-d38d99f85ee1,
abstract = {{<p>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.</p>}},
author = {{Svensson, J. and Ohlsson, C. and Karlsson, M. K. and Lorentzon, M. and Lewerin, C. and Mellström, D.}},
issn = {{0937-941X}},
keywords = {{Fracture risk; Older men; Serum thyroid-stimulating hormone; Subclinical hyperthyroidism; Vertebral fracture}},
language = {{eng}},
number = {{11}},
pages = {{2257--2265}},
publisher = {{Springer}},
series = {{Osteoporosis International}},
title = {{Subclinical hyperthyroidism is associated with increased risk of vertebral fractures in older men}},
url = {{http://dx.doi.org/10.1007/s00198-021-05964-w}},
doi = {{10.1007/s00198-021-05964-w}},
volume = {{32}},
year = {{2021}},
}