Changes in thyroid function and evolution of subclinical thyroid disease in older men
Authors' conclusion
In older men TSH concentration increased over time, while FT4 concentration showed little change. Subclinical or overt hypothyroidism evolved in one fifth of initially euthyroid men, age and higher baseline TSH predicted this outcome. Increased surveillance for thyroid dysfunction may be justified in older men, especially those with high-normal TSH.
Study context
- Population
- Community-dwelling men aged ≥70 years without known or current thyroid disease; Thyroid stimulating hormone (TSH) and free thyroxine (FT4) at baseline and follow-up899 euthyroid at baseline
- Participants
- 994 men
- Outcome
- Prevalence and incidence of subclinical thyroid dysfunction
- Follow-up
- After 8.7 ± 0.9 years
Methodological detailscommunity-dwelling
- Community-dwelling
Main finding
As reported in the abstract
8.7 ± 0.9 years
- Baseline SCH
- 85 men (8.6%)
- Baseline subclinical hyperthyroidism
- 10 (1.0%)
- Remained euthyroid (of 899)
- 713 (79.3%)
- Developed subclinical/overt hypothyroidism (of 899)
- 180 (20.0%)
- Developed subclinical/overt hyperthyroidism (of 899)
- 6 (0.7%)
Observational data: associations, not effects.
Further findings
Correlation of TSH and FT4 changes with baseline values
- Change in TSH vs baseline TSH, r (p < .05)
- r = .16
- Change in FT4 vs baseline FT4, inverse r (p < .05)
- r = −0.35
Predictors of progression from euthyroid to subclinical/overt hypothyroidism
- Age, fully-adjusted OR per year
- 1.09 (95% CI 1.02-1.17, p = .006)
- Baseline TSH, OR per 2.7-fold increase
- 65.4 (CI 31.9-134, p < .001)
- Only higher age and baseline TSH predicted progression
Baseline TSH ≥2.34 mIU/L for predicting subclinical/overt hypothyroidism
- Sensitivity
- 76%
- Specificity
- 77%
Original publication
Changes in thyroid function and evolution of subclinical thyroid disease in older men. Clin Endocrinol (Oxf). Published 7 December 2023. doi:10.
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