Higher serum free thyroxine levels are associated with increased risk of hip fractures in older men
Authors' conclusion
In conclusion, serum FT4, but not serum TSH, is a predictor of hip fracture risk in elderly Swedish men. Additionally, there was an association between FT4 (per SD increase) and the risk of MOF.
Study context
- Population
- Elderly Swedish men (mean age 75, range 69–81 yr), MrOS-Sweden; men receiving levothyroxine excluded
- Participants
- 1,825 men
- Exposure
- Serum free thyroxine (FT4) and thyroid-stimulating hormone (TSH) levels vs fracture risk
- Outcome
- Major osteoporotic fractures (MOFs) and hip fractures
- Follow-up
- Median 12.2 yr
Methodological detailsMrOS-Sweden Gothenburg and Malmö subcohorts, Cox proportional hazards regression
- MrOS-Sweden Gothenburg and Malmö subcohorts
- Cox proportional hazards regression
Main finding
As reported in the abstract
Fracture risk per SD increase in FT4 (total cohort)
MOF (n = 479): fully adjusted HR per SD FT4 increase
1.14
95% CI 1.05–1.24
Hip fracture (n = 207): HR per SD FT4 increase
1.18
95% CI 1.04–1.33
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Hip fracture, highest vs three lower FT4 quartilesHighest FT4 quartilevs Three lower FT4 quartilesTotal population, fully adjusted | 1.45 (1.04–2.02) | |
| Hip fracture, highest vs three lower FT4 quartilesHighest FT4 quartilevs Three lower FT4 quartilesMen with normal TSH, fully adjusted | 1.51 (1.07–2.12) | |
| 0.512Hazard ratio (log scale) |
MOF, highest vs three lower FT4 quartiles
- Risk of MOF not statistically different
Men with normal TSH (n = 1658): FT4 per SD increase
- FT4 significantly associated with increased risk of MOF and hip fractures
Serum TSH and fracture risk
- TSH not associated with fracture risk after full adjustment
Original publication
Higher serum free thyroxine levels are associated with increased risk of hip fractures in older men. J Bone Miner Res. Published 4 January 2024. doi:10.
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