Association between increased serum thyrotropin concentration and the
					oldest old: what do we know?

Duarte, Glaucia Cruzes; Cendoroglo, Maysa Seabra; Araújo, Lara Miguel Quirino; Almada Filho, Clineu de Mello

doi:10.1590/S1679-45082015RW2874

Acessibilidade / Reportar erro

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

REVIEW • Einstein (São Paulo) 13 (1) • Jan-Mar 2015 • https://doi.org/10.1590/S1679-45082015RW2874 copy

Association between increased serum thyrotropin concentration and the oldest old: what do we know?

Authorship SCIMAGO INSTITUTIONS RANKINGS

To assess studies that evaluate the relation between serum thyrotropin concentration, very old subjects, and their events. We searched the PubMed, SciELO, and LILACS databases for articles published between 2004 and 2012. Our search was restricted to studies involving humans aged 65 years or older, and written in English, Spanish, or Portuguese. Studies that evaluated the association between elevated serum thyrotropin concentration among elderly subjects with subclinical hypothyroidism were chosen since at least in part they included a subpopulation of individuals aged 80 years and above. Thirteen studies were selected. No significant increase in risk of cardiovascular events, coronary heart disease, or total mortality was observed. Elevated thyrotropin concentration was associated with longevity. More randomized controlled trials are required to better define the potential benefits of elevated thyrotropin concentration in this oldest old population, hormone replacement, and longevity.

Hypothyroidism; Aged; 80 and over

Author	Year	Study design	n	Age	TSH (upper limit) (mIU/L)	Follow-up	Endpoints	Exclusion criteria	Outcomes/results
Gussekloo et al.⁽ ²2 Gussekloo J, van Exel E, Craen AJ, Meinders AE, Frölich M, Western RG. Thyroid status, disability and cognitive function and survival in old age. JAMA. 2004;292(21):2591-9. ⁾	2004	Prospective cohort	704	80-84	4.8	4 years	Thyroid status, disability, cognition, survival	N/A	Abnormally high levels of TSH may prolong life span
Surks et al.⁽ ⁵5 Surks MI, Hollowell JG. Age specific distribution of serum thyrotropin and antithyroid antibodies in the US population: implications for the prevalence of subclinical hypothyroidism. J Clin Endocrinol Metab. 2007;92(12):4575-82. ⁾	2007	SR of cohort	16,533	12-80+	4.5	N/A	Prevalence of SCH	Report of thyroid disease, goiter, or use of thyroid-related medications	SCH is overestimated, unless an age-specific range for TSH is used
Rodondi et al.⁽ ⁷7 Rodondi N, den Elzen WP, Bauer DC, Cappola AR, Razvi S, Walsh JP, Asvold BO, Iervasi G, Imaizumi M, Collet TH, Bremner A, Maisonneuve P, Sgarbi JA, Khaw KT, Vanderpump MP, Newman AB, Cornuz J, Franklyn JA, Westendorp RG, Vittinghoff E, Gussekloo J; Thyroid Studies Collaboration. Subclinical hypothyroidism and the risk of coronary heart disease and mortality. JAMA. 2010;304(12):1365-74. ⁾	2010	SR of prospective cohort	55,287	18-100	4.5	Variable	CHD and CHD mortality	Mainly symptomatic individuals and/or overt hypothyroidism	SCH associated with risk of CHD and CHD mortality in individuals with TSH>10 mIU/L
Hogervorst et al.⁽ ⁹9 Hogervorst E, Huppert F, Matthews FE, Brayne C. Thyroid function and cognitive decline in the MRC Cognitive Function and Ageing Study. Psychoneuroendocrinology. 2008;33(7):1013-22. ⁾	2008	Prospective cohort	1,047	64-94	4.8	2 years	Cognition	Physical frailty or severe cognitive impairment	High log TSH levels associated with lower MMSE scores
Van den Beld et al.⁽ ¹¹11 Van den Beld A, Visser TJ, Feelders RA, Grobbee DE, Lamberts SW. Thyroid hormone concentrations, disease, physical function and mortality in elderly men. J Clin Endocrinol Metab. 2005;90(12):6403-9. ⁾	2005	Cross-sectional	403	73-94	4.3	4 years	Thyroid hormones, physical function, mortality	Females, individuals who did not live independently, severe mobility problems, severe systemic disease, physical or mental incapacity to visit study center	Low serum fT4 associated with better 4-year survival, reflecting an adaptive mechanism to prevent excessive catabolism
Atzmon et al.⁽ ¹⁴14 Atzmon G, Barzilai N, Hollowell JG, Surks MI, Gabriely I. Extreme longevity is associated with increased serum thyrotropin. J Clin Endocrinol Metab. 2009;94(4):1251-4. ⁾	2009	Case-control	232	97+	4.0	NA	Longevity and TSH	NA	TSH higher in centenarians and may contribute to longevity
Atzmon et al.⁽ ¹⁵15 Aztmon G, Barzilai N, Surks MI, Gabriely I. Genetic predisposition to elevated serum thyrotropin is associated with exceptional longevity. J Clin Endocrinol Metab. 2009;94(12):4768-75. ⁾	2009	Case-control	598	69-85+	4.0	NA	Genetic of high TSH and longevity	NA	SNPs in the TSHR contribute to decreased thyroid function and longevity
Rozing et al.⁽ ¹⁶16 Rozing MP, Houwing-Duistermaat JJ, Slagboom PE, Beekman M, Frölich M, de Craen AJ, et al. Familial longevity is associated with decreased thyroid function. J Clin Endocrinol Metab. 2010;95(11):4979-84. ⁾	2010	Cross-sectional	859	89+	4.8	N/A	Longevity and thyroid function	N/A	Low thyroid activity constitutes a heritable phenotype and contributes to familial longevity
Corsonello et al.⁽ ¹⁷17 Corsonello A, Montesanto A, Berardelli M, De Rango F, Dato S, Mari V, et al. A cross-section analysis of FT3 age-related changes in a group of old and oldest-old subjects, including centenarians’ relatives, shows that a down-regulated thyroid function has a familial component and is related to longevity. Age Ageing. 2010;39(6):723-7. ⁾	2010	Cross-sectional	604	60-85+	4.2	N/A	Longevity and thyroid function	N/A	Decreased thyroid function related to longevity
Spencer et al.⁽ ¹⁹19 Spencer CA, Hollowell JG, Kazarosyan M, Braverman LE. National Health and Nutrition Examination Survey III thyroid-stimulating hormone (TSH)-thyroperoxidase antibody relationships demonstrate that TSH upper reference limits may be skewed by occult thyroid dysfunction. J Clin Endocrinol Metab. 2007;92(11):4236-40. ⁾	2008	SR of cohort	16,088	12-80+	4.5	NA	TSH and aTPO	Report of thyroid disease or use of thyroid-related medications	Upper limits of TSH may be skewed by aTPO-negative individuals with occult autoimmune thyroid dysfunction
Duarte et al.⁽ ²⁰20 Duarte GC, Tomimori EK, Camargo RY, Rubio IG, Wajngarten M, Rodrigues AG, et al. The prevalence of thyroid dysfunction in elderly cardiology patients with mild excessive iodine intake in the urban area of São Paulo. Clinics. 2009;64 (2):135-42. ⁾	2009	Case-control	399	60-92	4.0	NA	Prevalence of thyroid dysfunction in the elderly	Report of thyroid or liver disease, thyroid surgery, radioactive iodine therapy, radiologic tests with contrast media or use of thyroid-related medications	The elderly have higher prevalence of hypothyroidism and thyroid nodules; one-third have elevated urinary iodine excretion and autoimmune thyroiditis
Benseñor et al.⁽ ²¹21 Benseñor IM, Goulart AC, Lotufo PA, Menezes PR, Scazufca M. Prevalence of thyroid disorders among older people: results from the São Paulo Ageing & Health Study. Cad. Saúde Pública. 2011;27(1):155-61. ⁾	2011	Cross-sectional	1,373	65-80+	5.0	N/A	Prevalence of thyroid dysfunction in the elderly	N/A	Prevalence of thyroid disease in men, and undiagnosed hypothyroidism is higher
Tonial et al.⁽ ²²22 Tonial R, Rosa LA, Rosa MI, Basso FO, Argente JS. Prevalência de hipotireoidismo em residentes das seis instituições para idosos do município de Criciúma – SC. Arq Catarinenses Med. 2007;36(4):37-41. ⁾	2007	Cross-sectional	109	60-80	5.6	N/A	Prevalence of hypothyroidism in the elderly	N/A	High prevalence of hypothyroidism

Instituto Israelita de Ensino e Pesquisa Albert Einstein Avenida Albert Einstein, 627/701 , 05651-901 São Paulo - SP, Tel.: (55 11) 2151 0904 - São Paulo - SP - Brazil
E-mail: revista@einstein.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Corresponding author: Glaucia Cruzes Duarte – Universidade Federal de São Paulo, Rua Sena Madureira, 1.500 – Vila Clementino – Zip code: 04021-021 – São Paulo, SP, Brazil – Phone: (55 11) 5576-4840 E-mail: endocrino.draglauciaduarte@gmail.com