Hypothyroidism, Sex, and Age Predict Future Thromboembolic Events Among Younger People
| Autor: | Fares Qeadan, Jay A Martinez, Mark R. Burge |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male endocrine system medicine.medical_specialty endocrine system diseases New Mexico Endocrinology Diabetes and Metabolism Clinical Biochemistry Levothyroxine 030204 cardiovascular system & hematology Logistic regression Biochemistry Young Adult 03 medical and health sciences Sex Factors 0302 clinical medicine Endocrinology Hypothyroidism Risk Factors Thromboembolism Internal medicine medicine Humans Euthyroid 030212 general & internal medicine Online Only Articles Subclinical infection business.industry Incidence Biochemistry (medical) Age Factors Retrospective cohort study Odds ratio Middle Aged Prognosis Confidence interval Cohort Female business human activities hormones hormone substitutes and hormone antagonists Follow-Up Studies medicine.drug |
| Zdroj: | J Clin Endocrinol Metab |
| ISSN: | 1945-7197 0021-972X |
| Popis: | Purpose Aberrant thyroid function causes dysregulated metabolic homeostasis. Literature has demonstrated hypercoagulability in hypothyroidism, suggesting a risk for thromboembolic events (TEE). We hypothesize that individuals with hypothyroidism will experience more clinically-diagnosed TEE than euthyroid individuals. Methods De-identified patient data from the University of New Mexico Health Sciences Center were retrieved using thyrotropin (TSH; thyroid-stimulating hormone) for case-finding from 2005 to 2007 and ICD billing codes to identify TEE during the follow-up period of 10 to 12 years. Diagnoses affecting coagulation were excluded and 12 109 unique enrollees were categorized according to TSH concentration as Hyperthyroid (n = 510), Euthyroid (n = 9867), Subclinical Hypothyroid (n = 1405), or Overtly Hypothyroid (n = 327). Analysis with multiple logistic regression provided the odds of TEE while adjusting for covariates. Results There were 228 TEEs in the cohort over 5.1 ± 4.3 years of follow-up. Risk of TEE varied significantly across study groups while adjusting for sex, race/ethnicity, levothyroxine, oral contraceptive therapy, and visit status (outpatient vs non-outpatient), and this risk was modified by age. Overt Hypothyroidism conferred a significantly higher risk of TEE than Euthyroidism below age 35, and Hyperthyroidism conferred an increased risk for TEE at age 20. Analysis also demonstrated a higher age-controlled risk for a subsequent TEE in men compared with women (odds ratio [OR] = 1.36; 95% confidence interval [CI], 1.02–1.81). Subanalysis of smoking status (n = 5068, 86 TEE) demonstrated that smokers have 2.21-fold higher odds of TEE relative to nonsmokers (95% CI, 1.41–3.45). Conclusions In this retrospective cohort study, Overt Hypothyroidism conferred increased risk of TEE over the next decade for individuals younger than 35 years of age, as compared with Euthyroidism. |
| Databáze: | OpenAIRE |
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