caa a22 4500 606240330 CHVBK 20210128101307.0 cr unu---uuuuu 210128e20151201xx s 000 0 eng 10.1007/s00508-015-0846-z doi (NATIONALLICENCE)springer-10.1007/s00508-015-0846-z Subclinical hypothyroidism and mortality in a large Austrian cohort: a possible impact on treatment? [Elektronische Daten] [Florian Maria Kovar, I-Fei Fang, Thomas Perkmann, Helmuth Haslacher, Georg Slavka, Manuela Födinger, Georg Endler, Oswald F. Wagner] Summary: Background : Clinical implications of subclinical hypothyroidism (SCH) are still matter of intense debate, resulting in the controversial discussion whether subclinical hypothyroidism should be treated. We performed a cohort study to evaluate the impact of subclinical hypothyroidism on vascular and overall mortality. Methods : Between 02/1993 and 03/2004, a total of 103,135 persons attending the General Hospital Vienna with baseline serum thyrotropin (TSH, thyroid-stimulating hormone) and free thyroxin (fT4) measurements could be enrolled in a retrospective cohort study. Subclinical hypothyroidism was defined by elevated TSH ranging from 4.5 to 20.0mIU/L and normal fT4 concentration (0.7-1.7ng/dL). Overall and vascular mortality as primary endpoints were assessed via record linkage with the Austrian Death Registry. Results: A total of 80,490 subjects fulfilled inclusion criteria of whom 3934 participants (3.7 %) were classified as SCH (868 males and 3066 females, median age 48 years). The mean follow-up among the 80,490 subjects was 4.1 years yielding an observation period of 373,301 person-years at risk. In a multivariate Cox regression model adjusted for age and gender TSH levels showed a dose-dependent association with all-cause mortality. The association between SCH and overall or vascular mortality was stronger in men below 60 years compared to older males or females. Conclusion: Our data support the hypothesis that SCH might represent an independent risk factor for overall and vascular mortality, especially in men below 60 years. Whether this group would benefit from replacement therapy should be evaluated in interventional studies. Springer-Verlag Wien, 2015 Subclinical hypothyroidism nationallicence All-cause vascular mortality nationallicence All-cause mortality nationallicence Kovar Florian Maria Department for Trauma Surgery, Medical University of Vienna, Vienna, Austria aut Fang I-Fei Central Laboratory, Wilhelminenspital der Stadt Wien, Vienna, Austria aut Perkmann Thomas Department of Medical and Chemical Laboratory Diagnostics, Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Vienna, AKH-Wien Waehringer Guertel 18-20, 1090, Vienna, Austria aut Haslacher Helmuth Department of Medical and Chemical Laboratory Diagnostics, Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Vienna, AKH-Wien Waehringer Guertel 18-20, 1090, Vienna, Austria aut Slavka Georg Central Laboratory, Wilhelminenspital der Stadt Wien, Vienna, Austria aut Födinger Manuela Department of Medical and Chemical Laboratory Diagnostics, Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Vienna, AKH-Wien Waehringer Guertel 18-20, 1090, Vienna, Austria aut Endler Georg Department of Medical and Chemical Laboratory Diagnostics, Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Vienna, AKH-Wien Waehringer Guertel 18-20, 1090, Vienna, Austria aut Wagner Oswald F. Department of Medical and Chemical Laboratory Diagnostics, Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Vienna, AKH-Wien Waehringer Guertel 18-20, 1090, Vienna, Austria aut Wiener klinische Wochenschrift Springer Vienna 127/23-24(2015-12-01), 924-930 0043-5325 127:23-24<924 2015 127 508 https://doi.org/10.1007/s00508-015-0846-z text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00508-015-0846-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kovar Florian Maria Department for Trauma Surgery, Medical University of Vienna, Vienna, Austria aut NATIONALLICENCE 700 1- Fang I-Fei Central Laboratory, Wilhelminenspital der Stadt Wien, Vienna, Austria aut NATIONALLICENCE 700 1- Perkmann Thomas Department of Medical and Chemical Laboratory Diagnostics, Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Vienna, AKH-Wien Waehringer Guertel 18-20, 1090, Vienna, Austria aut NATIONALLICENCE 700 1- Haslacher Helmuth Department of Medical and Chemical Laboratory Diagnostics, Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Vienna, AKH-Wien Waehringer Guertel 18-20, 1090, Vienna, Austria aut NATIONALLICENCE 700 1- Slavka Georg Central Laboratory, Wilhelminenspital der Stadt Wien, Vienna, Austria aut NATIONALLICENCE 700 1- Födinger Manuela Department of Medical and Chemical Laboratory Diagnostics, Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Vienna, AKH-Wien Waehringer Guertel 18-20, 1090, Vienna, Austria aut NATIONALLICENCE 700 1- Endler Georg Department of Medical and Chemical Laboratory Diagnostics, Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Vienna, AKH-Wien Waehringer Guertel 18-20, 1090, Vienna, Austria aut NATIONALLICENCE 700 1- Wagner Oswald F. Department of Medical and Chemical Laboratory Diagnostics, Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Vienna, AKH-Wien Waehringer Guertel 18-20, 1090, Vienna, Austria aut NATIONALLICENCE 773 0- Wiener klinische Wochenschrift Springer Vienna 127/23-24(2015-12-01), 924-930 0043-5325 127:23-24<924 2015 127 508