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Subclinical thyroid dysfunction and incident hip fracture in older adults

Lee, JS and Bůžková, P and Fink, HA and Vu, J and Carbone, L and Chen, Z and Cauley, J and Bauer, DC and Cappola, AR and Robbins, J (2010) Subclinical thyroid dysfunction and incident hip fracture in older adults. Archives of Internal Medicine, 170 (21). 1876 - 1883. ISSN 0003-9926

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Background: Subclinical thyroid dysfunction is common in older adults and affects bone metabolism, but its effects on fracture risk have not been reported. We sought to determine prospectively whether older men and women with subclinical hyperthyroidism or hypothyroidism have an increased risk of hip fracture. Methods: Prospective cohort of 3567 US community-dwelling adults, 65 years or older, with biochemically defined subclinical thyroid dysfunction or euthyroidism was enrolled from June 10, 1989, through May 30, 1990, and followed up through 2004. Main outcome measures included incidence and hazard ratios (HRs), with 95% confidence intervals (CIs), of confirmed incident hip fractures for groups with subclinical hypothyroidism, subclinical hyperthyroidism, and euthyroidism as defined at baseline. Results: During 39 952 person-years (median follow-up, 13 years), hip fracture incidence (per 1000 menyears) was 13.65 in men with subclinical hyperthyroidism (n = 29) and 10.27 in men with subclinical hypothyroidism (n = 184), both greater than 5.0 in men with euthyroidism (n = 1159). Men with subclinical hypothyroidism had a multivariable-adjusted HR of 2.31 (95% CI, 1.25-4.27); those with subclinical hyperthyroidism, 3.27 (0.99-11.30). After excluding those with baseline use of thyroid-altering medications, men with endogenous subclinical hyperthyroidism had a higher HR of 4.91 (95% CI, 1.13-21.27), as did men with endogenous subclinical hypothyroidism (2.45, 1.27-4.73). Hip fracture incidence (per 1000 women-years) was 8.93 in women with subclinical hypothyroidism (n = 359) and 10.90 in women with subclinical hyperthyroidism (n = 142) compared with 10.18 in women with euthyroidism (n = 1694). No clear association between subclinical dysfunction and fracture was observed in women. Conclusions: Older men with subclinical hyperthyroidism or hypothyroidism are at increased risk for hip fracture. Whether treatment of the subclinical syndrome reduces this risk is unknown. ©2010 American Medical Association. All rights reserved.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Lee, JS
Bůžková, P
Fink, HA
Vu, J
Carbone, L
Chen, Z
Cauley, JJCauley@edc.pitt.eduJCAULEY
Bauer, DC
Cappola, AR
Robbins, J
Date: 22 November 2010
Date Type: Publication
Journal or Publication Title: Archives of Internal Medicine
Volume: 170
Number: 21
Page Range: 1876 - 1883
DOI or Unique Handle: 10.1001/archinternmed.2010.424
Schools and Programs: Graduate School of Public Health > Epidemiology
Refereed: Yes
ISSN: 0003-9926
Date Deposited: 24 Sep 2015 14:43
Last Modified: 02 Feb 2019 21:55


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