Thyroid Function and All-cause Mortality in the Context of Multimorbidity: Results From 2 Population-based Studies
Authors' conclusion
We show an association between higher free T4 and mortality for individuals with multimorbidity, whereas lower free T3 was associated with poor survival in individuals with multimorbidity. Our results extend findings from patient populations to people with multimorbidity from the general population. Future research is needed to investigate whether these findings extend to levothyroxine users.
Study context
- Population
- Participants with thyroid function measurements and recorded disease status from PREVEND (mean age 53.0 years) and the Rotterdam Study (mean age 64.9 years)PREVEND 5537
- Exposure
- Thyroid function (per 1-unit Z-score increment) and all-cause mortality across no disease, 1 disease and multimorbidity
- Outcome
- All-cause mortality
Methodological detailsPREVEND and Rotterdam Study, Cox proportional hazards models
- PREVEND and Rotterdam Study
- Cox proportional hazards models
Main finding
As reported in the abstract
All-cause mortality per 1-unit increase in free T4 Z-score (Rotterdam Study)
Hazard ratio (CI)P value
No disease
1.07(1.03–1.12)
1 disease
1.09(1.04–1.15)
Multimorbidity
1.21(1.11–1.31)
P < 0.001for trendPer 1-unit increase in free T4 Z-score, as printed
Observational data: associations, not effects.
Further findings
| Outcome | HR (CI) | P value | |
|---|---|---|---|
| All-cause mortality per 1-unit increase in free T3 Z-score1 disease · per 1-unit increase in free T3 Z-score | 0.82 (0.70–0.97) | ||
| All-cause mortality per 1-unit increase in free T3 Z-scoreMultimorbidity · per 1-unit increase in free T3 Z-score | 0.80 (0.61–1.05) | P for trend = 0.002 | |
| 0.512Hazard ratio (log scale) |
Original publication
Thyroid Function and All-cause Mortality in the Context of Multimorbidity: Results From 2 Population-based Studies. J Clin Endocrinol Metab. Published 25 July 2025. doi:10.
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