High Thyrotropin Levels and Risk of Mortality in the Elderly With Subclinical Hypothyroidism: A Systematic Review and Meta-analysis
Authors' conclusion
High thyrotropin levels are not associated with increased risk for all-cause mortality as well as cardiovascular-related mortality in older adults aged ≥60 years with subclinical hypothyroidism, suggesting an unnecessity in initialing treatment.
Study context
- Population
- Older adults aged ≥60 years with SCH; cohort studies from 8 databases, inception to March 23, 2022
- Participants
- 44,514 adults13 studies
- Comparison
- SCH vs euthyroid older adults
- Outcome
- All-cause or CV-related mortality
Methodological detailsrandom-effects models, multivariate-adjusted hazard ratios (HRs), Newcastle-Ottawa Scale quality assessment
- Random-effects models
- Multivariate-adjusted HRs
- Newcastle-Ottawa Scale quality assessment
Pooled result
As reported in the abstract
SCH vs EuthyroidPooled hazard ratio (95% CI)
All-cause mortality; I2 = 94%
1.18(0.95–1.45)
CV-related mortality; I2 = 0%
1.08(0.94–1.23)
Further pooled results
| Outcome | Pooled HR (95% CI) | |
|---|---|---|
| All-cause and CV-related mortality, subgroup TSH ≥10 mIU/LSCHvs EuthyroidAll-cause mortality, TSH ≥10 mIU/L; I2 = 22% | 1.53 (0.81–2.88) | |
| All-cause and CV-related mortality, subgroup TSH ≥10 mIU/LSCHvs EuthyroidCV-related mortality, TSH ≥10 mIU/L; I2 = 43% | 1.35 (0.63–2.86) | |
| 0.20.5125Pooled hazard ratio (log scale) |
All-cause and CV-related mortality, subgroup TSH ≥10 mIU/L
- Results remained the same with TSH ≥10 mIU/L only
Original publication
High Thyrotropin Levels and Risk of Mortality in the Elderly With Subclinical Hypothyroidism: A Systematic Review and Meta-analysis. Endocr Pract. Published 2 December 2022. doi:10.
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