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- Levothyroxine Dose and Fracture Risk According to the Osteoporosis Status in Elderly Women
- Young-Jin Ko, Ji Young Kim, Joongyub Lee, Hong-Ji Song, Ju-Young Kim, Nam-Kyong Choi, Byung-Joo Park
- J Prev Med Public Health. 2014;47(1):36-46. Published online January 29, 2014
- DOI: https://doi.org/10.3961/jpmph.2014.47.1.36
- 12,033 View
- 171 Download
- 23 Crossref
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Abstract
PDF Objectives To evaluate the association between fracture risk and levothyroxine use in elderly women with hypothyroidism, according to previous osteoporosis history.
Methods We conducted a cohort study from the Korean Health Insurance Review and Assessment Service claims database from January 2005 to June 2006. The study population comprised women aged ≥65 years who had been diagnosed with hypothyroidism and prescribed levothyroxine monotherapy. We excluded patients who met any of the following criteria: previous fracture history, hyperthyroidism, thyroid cancer, or pituitary disorder; low levothyroxine adherence; or a follow-up period <90 days. We categorized the daily levothyroxine doses into 4 groups: ≤50 µg/d, 51 to 100 µg/d, 101 to 150 µg/d, and >150 µg/d. The hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated with the Cox proportional hazard model, and subgroup analyses were performed according to the osteoporosis history and osteoporosis-specific drug prescription status.
Results Among 11 155 cohort participants, 35.6% had previous histories of osteoporosis. The adjusted HR of fracture for the >150 µg/d group, compared with the 51 to 100 µg/d group, was 1.56 (95% CI, 1.03 to 2.37) in osteoporosis subgroup. In the highly probable osteoporosis subgroup, restricted to patients who were concurrently prescribed osteoporosis-specific drugs, the adjusted HR of fracture for the >150 µg/d group, compared with the 51 to 100 µg/d group, was 1.93 (95% CI, 1.14 to 3.26).
Conclusions While further studies are needed, physicians should be concerned about potential levothyroxine overtreatment in elderly osteoporosis patients.
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Summary
Citations
Citations to this article as recorded by
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Justyna Kuliczkowska-Płaksej, Aleksandra Zdrojowy-Wełna, Aleksandra Jawiarczyk-Przybyłowska, Łukasz Gojny, Marek Bolanowski
Reviews in Endocrine and Metabolic Disorders.2024;[Epub] CrossRef - Evaluation and Management of Bone Health in Patients with Thyroid Diseases: A Position Statement of the Korean Thyroid Association
A Ram Hong, Ho-Cheol Kang
Endocrinology and Metabolism.2023; 38(2): 175. CrossRef - Refractory Hypothyroidism: Unraveling the Complexities of Diagnosis and Management
Juan Eduardo Quiroz-Aldave, Marcio José Concepción-Zavaleta, María del Carmen Durand-Vásquez, Luis Alberto Concepción-Urteaga, Elman Rolando Gamarra-Osorio, Jacsel Suárez-Rojas, Luciana del Pilar Rafael-Robles, José Paz-Ibarra, Alejandro Román-González
Endocrine Practice.2023; 29(12): 1007. CrossRef - Assessing the cardiovascular effects of levothyroxine use in an ageing United Kingdom population (ACEL-UK) protocol: a cohort and target trial emulation study
Mia Holley, Salman Razvi, Rosie Dew, Ian Maxwell, Scott Wilkes
Thyroid Research.2023;[Epub] CrossRef - Understanding Worry About Risks Associated With Thyroid Hormone Therapy: A National Survey of Endocrinologists, Family Physicians, and Geriatricians
Kimi Shah, David Reyes-Gastelum, Brittany L. Gay, Maria Papaleontiou
Endocrine Practice.2022; 28(1): 25. CrossRef - Evaluation and Management of Bone Health in Patients with Thyroid Diseases: a Position Statement from the Korean Thyroid Association
A Ram Hong, Hwa Young Ahn, Bu Kyung Kim, Seong Hee Ahn, So Young Park, Min-Hee Kim, Jeongmin Lee, Sun Wook Cho, Ho-Cheol Kang
International Journal of Thyroidology.2022; 15(1): 1. CrossRef - Levothyroxine Therapy in Elderly Patients With Hypothyroidism
Grigoris Effraimidis, Torquil Watt, Ulla Feldt-Rasmussen
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- Cardiovascular Health Metrics and All-cause and Cardiovascular Disease Mortality Among Middle-aged Men in Korea: The Seoul Male Cohort Study
- Ji Young Kim, Young-Jin Ko, Chul Woo Rhee, Byung-Joo Park, Dong-Hyun Kim, Jong-Myon Bae, Myung-Hee Shin, Moo-Song Lee, Zhong Min Li, Yoon-Ok Ahn
- J Prev Med Public Health. 2013;46(6):319-328. Published online November 28, 2013
- DOI: https://doi.org/10.3961/jpmph.2013.46.6.319
- 14,807 View
- 158 Download
- 51 Crossref
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Abstract
PDF
Objectives This study estimated the association of cardiovascular health behaviors with the risk of all-cause and cardiovascular disease (CVD) mortality in middle-aged men in Korea.
Methods In total, 12 538 men aged 40 to 59 years were enrolled in 1993 and followed up through 2011. Cardiovascular health metrics defined the following lifestyle behaviors proposed by the American Heart Association: smoking, physical activity, body mass index, diet habit score, total cholesterol, blood pressure, and fasting blood glucose. The cardiovascular health metrics score was calculated as a single categorical variable, by assigning 1 point to each ideal healthy behavior. A Cox proportional hazards regression model was used to estimate the hazard ratio of cardiovascular health behavior. Population attributable risks (PARs) were calculated from the significant cardiovascular health metrics.
Results There were 1054 total and 171 CVD deaths over 230 690 person-years of follow-up. The prevalence of meeting all 7 cardiovascular health metrics was 0.67%. Current smoking, elevated blood pressure, and high fasting blood glucose were significantly associated with all-cause and CVD mortality. The adjusted PARs for the 3 significant metrics combined were 35.2% (95% confidence interval [CI], 21.7 to 47.4) and 52.8% (95% CI, 22.0 to 74.0) for all-cause and CVD mortality, respectively. The adjusted hazard ratios of the groups with a 6-7 vs. 0-2 cardiovascular health metrics score were 0.42 (95% CI, 0.31 to 0.59) for all-cause mortality and 0.10 (95% CI, 0.03 to 0.29) for CVD mortality.
Conclusions Among cardiovascular health behaviors, not smoking, normal blood pressure, and recommended fasting blood glucose levels were associated with reduced risks of all-cause and CVD mortality. Meeting a greater number of cardiovascular health metrics was associated with a lower risk of all-cause and CVD mortality.
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Summary
Citations
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