title: Subclinical hypothyroidism in addition to common risk scores for prediction of cardiovascular disease: a 10-year community-based cohort study.
abstract: OBJECTIVE
  This study was carried out to determine whether serum TSH levels improve the prediction of cardiovascular risk in addition to common clinical risk scores, given the association between subclinical hypothyroidism (SCH) and cardiovascular disease (CVD).
  
  
  METHODS
  We carried out an observational study in a prospective cohort.
  
  
  METHODS
  The study included a total of 344 SCH and 2624 euthyroid participants aged over 40 years and who were without previously recorded CVDs were included in this study analysis. We measured thyroid function and traditional risk factors at baseline and estimated the 10-year cumulative incidence of CVD in a gender-stratified analysis.
  
  
  RESULTS
  During 10 years of follow-up, 251 incident cardiovascular events were recorded. The elevation of serum TSH levels significantly increased the CV risk independent of conventional risk factors in men. In the atherosclerotic CVD (ASCVD) risk score or the Reynolds risk score (RRS) model, the addition of serum TSH levels had no effect on model discrimination as measured by the area under the curve in either women or men. Adding serum TSH did not improve the net reclassification improvement in either women (3.48% (P=0.29) in the ASCVD, -0.89% (P=0.75) in the RRS, respectively) or men (-1.12% (P=0.69), 3.45% (P=0.20), respectively) and only mildly affected the integrated discrimination Improvement in the ASCVD-adjusted model (0.30% in women and 0.42% in men, both P=0.05).
  
  
  CONCLUSIONS
  In the context of common risk scoring models, the additional assessment of serum TSH levels provided little incremental benefit for the prediction of CV risk.
authors.affiliation: Department of Internal MedicineSeoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 110-744, KoreaDepartment of MedicineSamsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, KoreaDepartment of Internal MedicineSeoul National University Bundang Hospital, Seongnam, KoreaDepartment of Preventive MedicineAjou University School of Medicine, #5 Wonchon-Dong, Youngtong-Gu, Suwon 442-749, Korea.
authors.forename: Tae Hyuk
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Department of Internal MedicineSeoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 110-744, KoreaDepartment of MedicineSamsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, KoreaDepartment of Internal MedicineSeoul National University Bundang Hospital, Seongnam, KoreaDepartment of Preventive MedicineAjou University School of Medicine, #5 Wonchon-Dong, Youngtong-Gu, Suwon 442-749, Korea.
authors.forename: Hoon Sung
authors.initials: HS
authors.lastname: Choi
authors.affiliation: Department of Internal MedicineSeoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 110-744, KoreaDepartment of MedicineSamsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, KoreaDepartment of Internal MedicineSeoul National University Bundang Hospital, Seongnam, KoreaDepartment of Preventive MedicineAjou University School of Medicine, #5 Wonchon-Dong, Youngtong-Gu, Suwon 442-749, Korea.
authors.forename: Ji Cheol
authors.initials: JC
authors.lastname: Bae
authors.affiliation: Department of Internal MedicineSeoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 110-744, KoreaDepartment of MedicineSamsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, KoreaDepartment of Internal MedicineSeoul National University Bundang Hospital, Seongnam, KoreaDepartment of Preventive MedicineAjou University School of Medicine, #5 Wonchon-Dong, Youngtong-Gu, Suwon 442-749, Korea.
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Moon
authors.affiliation: Department of Internal MedicineSeoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 110-744, KoreaDepartment of MedicineSamsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, KoreaDepartment of Internal MedicineSeoul National University Bundang Hospital, Seongnam, KoreaDepartment of Preventive MedicineAjou University School of Medicine, #5 Wonchon-Dong, Youngtong-Gu, Suwon 442-749, Korea.
authors.forename: Hyung-Kwan
authors.initials: HK
authors.lastname: Kim
authors.affiliation: Department of Internal MedicineSeoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 110-744, KoreaDepartment of MedicineSamsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, KoreaDepartment of Internal MedicineSeoul National University Bundang Hospital, Seongnam, KoreaDepartment of Preventive MedicineAjou University School of Medicine, #5 Wonchon-Dong, Youngtong-Gu, Suwon 442-749, Korea.
authors.forename: Sung Hee
authors.initials: SH
authors.lastname: Choi
authors.affiliation: Department of Internal MedicineSeoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 110-744, KoreaDepartment of MedicineSamsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, KoreaDepartment of Internal MedicineSeoul National University Bundang Hospital, Seongnam, KoreaDepartment of Preventive MedicineAjou University School of Medicine, #5 Wonchon-Dong, Youngtong-Gu, Suwon 442-749, Korea.
authors.forename: Soo
authors.initials: S
authors.lastname: Lim
authors.affiliation: Department of Internal MedicineSeoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 110-744, KoreaDepartment of MedicineSamsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, KoreaDepartment of Internal MedicineSeoul National University Bundang Hospital, Seongnam, KoreaDepartment of Preventive MedicineAjou University School of Medicine, #5 Wonchon-Dong, Youngtong-Gu, Suwon 442-749, Korea.
authors.forename: Do Joon
authors.initials: DJ
authors.lastname: Park
authors.affiliation: Department of Internal MedicineSeoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 110-744, KoreaDepartment of MedicineSamsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, KoreaDepartment of Internal MedicineSeoul National University Bundang Hospital, Seongnam, KoreaDepartment of Preventive MedicineAjou University School of Medicine, #5 Wonchon-Dong, Youngtong-Gu, Suwon 442-749, Korea.
authors.forename: Kyong Soo
authors.initials: KS
authors.lastname: Park
authors.affiliation: Department of Internal MedicineSeoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 110-744, KoreaDepartment of MedicineSamsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, KoreaDepartment of Internal MedicineSeoul National University Bundang Hospital, Seongnam, KoreaDepartment of Preventive MedicineAjou University School of Medicine, #5 Wonchon-Dong, Youngtong-Gu, Suwon 442-749, Korea.
authors.forename: Hak Chul
authors.initials: HC
authors.lastname: Jang
authors.affiliation: Department of Internal MedicineSeoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 110-744, KoreaDepartment of MedicineSamsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, KoreaDepartment of Internal MedicineSeoul National University Bundang Hospital, Seongnam, KoreaDepartment of Preventive MedicineAjou University School of Medicine, #5 Wonchon-Dong, Youngtong-Gu, Suwon 442-749, Korea.
authors.forename: Moon-Kyu
authors.initials: MK
authors.lastname: Lee
authors.affiliation: Department of Internal MedicineSeoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 110-744, KoreaDepartment of MedicineSamsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, KoreaDepartment of Internal MedicineSeoul National University Bundang Hospital, Seongnam, KoreaDepartment of Preventive MedicineAjou University School of Medicine, #5 Wonchon-Dong, Youngtong-Gu, Suwon 442-749, Korea yjparkmd@snu.ac.kr chnaha@ajou.ac.kr.
authors.forename: Nam H
authors.initials: NH
authors.lastname: Cho
authors.affiliation: Department of Internal MedicineSeoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 110-744, KoreaDepartment of MedicineSamsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, KoreaDepartment of Internal MedicineSeoul National University Bundang Hospital, Seongnam, KoreaDepartment of Preventive MedicineAjou University School of Medicine, #5 Wonchon-Dong, Youngtong-Gu, Suwon 442-749, Korea yjparkmd@snu.ac.kr chnaha@ajou.ac.kr.
authors.forename: Young Joo
authors.initials: YJ
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058070:Asymptomatic Diseases / Q000453:epidemiology*; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012107:Research Design; D012111:Residence Characteristics; D012307:Risk Factors