No Effect of Levothyroxine on Hemoglobin in Older Adults With Subclinical Hypothyroidism: Pooled Results From 2 Randomized Controlled Trials.

Autor:	Du Puy RS; Department of Public Health and Primary Care, Leiden University Medical Center, ZA Leiden, the Netherlands., Poortvliet RKE; Department of Public Health and Primary Care, Leiden University Medical Center, ZA Leiden, the Netherlands., Mooijaart SP; Department of Internal Medicine, section Gerontology and Geriatrics, Leiden University Medical Center, ZA Leiden, the Netherlands.; Institute for Evidence-based Medicine in Old age, ZA Leiden, the Netherlands., Stott DJ; Department of Geriatric Medicine, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK., Quinn T; Department of Geriatric Medicine, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK., Sattar N; Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK., Westendorp RGJ; Department of Public Health, University of Copenhagen, Copenhagen, Denmark.; Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark., Kearney PM; School of Public Health, University College Cork, Cork, Ireland., McCarthy VJC; School of Nursing and Midwifery, University College Cork, Cork, Ireland., Byrne S; School of Pharmacy, University College Cork, Cork, Cork, Ireland., Rodondi N; Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.; Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland., Baretella O; Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.; Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland., Collet TH; Service of Endocrinology, Diabetes, Nutrition and Therapeutic Education, Geneva University Hospitals, Switzerland., van Heemst D; Department of Internal Medicine, section Gerontology and Geriatrics, Leiden University Medical Center, ZA Leiden, the Netherlands., Dekkers OM; Department of Endocrinology and metabolic disorders, Leiden University Medical Center, ZA Leiden, the Netherlands., Jukema JW; Department of Cardiology, Leiden University Medical Center, ZA Leiden, the Netherlands.; Netherlands Heart Institute, EP Utrecht, the Netherlands., Smit JWA; Radboud University Medical Center, GA Nijmegen, the Netherlands., Gussekloo J; Department of Public Health and Primary Care, Leiden University Medical Center, ZA Leiden, the Netherlands.; Department of Internal Medicine, section Gerontology and Geriatrics, Leiden University Medical Center, ZA Leiden, the Netherlands., den Elzen WPJ; Atalmedial Diagnostics Centre, EC Amsterdam, the Netherlands.; Amsterdam UMC, Department of Clinical Chemistry, Amsterdam Public Health Research Institute, HV Amsterdam, the Netherlands.
Jazyk:	angličtina
Zdroj:	The Journal of clinical endocrinology and metabolism [J Clin Endocrinol Metab] 2022 May 17; Vol. 107 (6), pp. e2339-e2347.
DOI:	10.1210/clinem/dgac106
Abstrakt:	Context: Subclinical thyroid dysfunction and anemia are common disorders, and both have increasing prevalence with advancing age. Objective: The aim of this study was to assess whether levothyroxine treatment leads to a rise in hemoglobin levels in older persons with subclinical hypothyroidism. Methods: This preplanned combined analysis of 2 randomized controlled trials included community-dwelling persons aged 65 years and older with subclinical hypothyroidism who were randomly assigned to levothyroxine or placebo treatment. The levothyroxine dose was periodically titrated aiming at thyroid stimulating hormone (TSH) level within the reference range, with mock titrations in the placebo group. The main outcome measure was the change in hemoglobin level after 12 months. Results: Analyses included 669 participants (placebo n = 337, levothyroxine n = 332) with a median age of 75 years (range, 65-97) and mean baseline hemoglobin of 13.8 ± 1.3 g/dL. Although levothyroxine treatment resulted in a reduction in TSH from baseline after 12 months of follow-up compared with placebo, the change in hemoglobin level was not different between the levothyroxine and the placebo groups (-0.03 g/dL [95% CI, -0.16 to 0.11]). Similar results were found in stratified analyses including sex, age, or TSH levels. No difference in change of hemoglobin levels after 12 months was identified in 69 participants with anemia at baseline (-0.33 g/dL [95% CI, -0.87 to 0.21]). Conclusion: In persons aged 65 years and older with subclinical hypothyroidism, treatment with levothyroxine does not lead to a rise in hemoglobin levels, regardless of the presence of anemia. (© The Author(s) 2022. Published by Oxford University Press on behalf of the Endocrine Society.)
Databáze:	MEDLINE
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