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Scientific article
Open access
English

Thyroid Antibody Status, Subclinical Hypothyroidism, and the Risk of Coronary Heart Disease: An Individual Participant Data Analysis

Published inThe journal of clinical endocrinology and metabolism, vol. 99, no. 9, p. 3353-3362
Publication date2014-09-01
Abstract

Context: Subclinical hypothyroidism has been associated with increased risk of coronary heart disease (CHD), particularly with thyrotropin levels of 10.0 mIU/L or greater. The measurement of thyroid antibodies helps predict the progression to overt hypothyroidism, but it is unclear whether thyroid autoimmunity independently affects CHD risk.

Objective: The objective of the study was to compare the CHD risk of subclinical hypothyroidism with and without thyroid peroxidase antibodies (TPOAbs).

Data sources and study selection: A MEDLINE and EMBASE search from 1950 to 2011 was conducted for prospective cohorts, reporting baseline thyroid function, antibodies, and CHD outcomes.

Data extraction: Individual data of 38 274 participants from six cohorts for CHD mortality followed up for 460 333 person-years and 33 394 participants from four cohorts for CHD events.

Data synthesis: Among 38 274 adults (median age 55 y, 63% women), 1691 (4.4%) had subclinical hypothyroidism, of whom 775 (45.8%) had positive TPOAbs. During follow-up, 1436 participants died of CHD and 3285 had CHD events. Compared with euthyroid individuals, age- and gender-adjusted risks of CHD mortality in subclinical hypothyroidism were similar among individuals with and without TPOAbs [hazard ratio (HR) 1.15, 95% confidence interval (CI) 0.87-1.53 vs HR 1.26, CI 1.01-1.58, P for interaction = .62], as were risks of CHD events (HR 1.16, CI 0.87-1.56 vs HR 1.26, CI 1.02-1.56, P for interaction = .65). Risks of CHD mortality and events increased with higher thyrotropin, but within each stratum, risks did not differ by TPOAb status.

Conclusions: CHD risk associated with subclinical hypothyroidism did not differ by TPOAb status, suggesting that biomarkers of thyroid autoimmunity do not add independent prognostic information for CHD outcomes.

eng
Keywords
  • Adult
  • Aged
  • Aged, 80 and over
  • Autoantibodies / blood
  • Autoantibodies / immunology
  • Coronary Disease / epidemiology
  • Coronary Disease / mortality
  • Female
  • Humans
  • Hypothyroidism / epidemiology
  • Hypothyroidism / immunology
  • Hypothyroidism / mortality
  • Incidence
  • Male
  • Middle Aged
  • Prevalence
  • Prognosis
  • Risk Factors
  • Seroepidemiologic Studies
  • Severity of Illness Index
  • Young Adult
Affiliation Not a UNIGE publication
Research group
Citation (ISO format)
COLLET, Tinh-Hai et al. Thyroid Antibody Status, Subclinical Hypothyroidism, and the Risk of Coronary Heart Disease: An Individual Participant Data Analysis. In: The journal of clinical endocrinology and metabolism, 2014, vol. 99, n° 9, p. 3353–3362. doi: 10.1210/jc.2014-1250
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Identifiers
ISSN of the journal0021-972X
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