| An analysis of the natural course of subclinical hyperthyroidism. | |
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MedLine Citation:
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PMID: 19402203 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Our aim was to evaluate the incidence rate of overt hyperthyroidism in a cohort of patients with subclinical hyperthyroidism and to assess the potential risk factors for the development of overt thyroid hyperfunction. METHODS: We performed a retrospective analysis in 75 patients (68 women, mean age 62.2 +/- 14.2 years) with subclinical hyperthyroidism and different grades of serum thyrotropin (TSH) suppression. Incidence rate of overt hyperthyroidism and survival time, ie, time without requiring therapy for overt hyperthyroidism, were studied. RESULTS: Thirty-four patients (45.3%) developed overt hyperthyroidism and 15 (20.0%) reverted to normal TSH values. The incidence rate of overt hyperthyroidism was 9.69 cases per 100 patient-year in the whole population and 4.12, 7.41, and 29.63 cases per 100 patient-year in subjects with initial TSH values of 0.30 to 0.49, 0.10 to 0.29, and <0.10 mU/L, respectively. Kaplan-Meier analysis of survival time curves showed that the development of overt thyroid hyperfunction was significantly related to the presence of symptoms of hyperthyroidism (P < 0.05) and low (<0.10 mU/L) TSH concentrations (P < 0.001). A stepwise multivariate Cox regression analysis showed that both symptoms and low TSH values were significant factors for progression to overt thyrotoxicosis. CONCLUSIONS: TSH concentration is the most powerful predictor in the outcome of patients with subclinical hyperthyroidism. Our results suggest that patients with values under 0.10 mU/L have the highest probability to develop overt thyroid hyperfunction. In patients with TSH values higher than this value, the risk of progression is notably lower. |
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Authors:
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Juan J Díez; Pedro Iglesias |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The American journal of the medical sciences Volume: 337 ISSN: 0002-9629 ISO Abbreviation: Am. J. Med. Sci. Publication Date: 2009 Apr |
Date Detail:
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Created Date: 2009-04-28 Completed Date: 2009-05-13 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370506 Medline TA: Am J Med Sci Country: United States |
Other Details:
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Languages: eng Pagination: 225-32 Citation Subset: AIM; IM |
Affiliation:
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Department of Endocrinology , Hospital Ramón y Cajal, Madrid, Spain. jdiez.hrc@salud.madrid.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Disease Progression Female Humans Hyperthyroidism / blood*, diagnosis, epidemiology*, physiopathology Kaplan-Meiers Estimate Male Middle Aged Proportional Hazards Models Retrospective Studies Risk Factors Thyroid Gland / physiopathology Thyrotropin / blood* Thyroxine / blood Triiodothyronine / blood |
| Chemical | |
Reg. No./Substance:
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6893-02-3/Triiodothyronine; 7488-70-2/Thyroxine; 9002-71-5/Thyrotropin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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