title: Symptoms of thyrotoxicosis, bone metabolism and occult atrial fibrillation in older women with mild endogenous subclinical hyperthyroidism.
abstract: The objective of this study was to evaluate symptoms of thyrotoxicosis, bone turnover, bone mineral density (BMD) and occult atrial fibrillation (AF) in women ≥65 years with mild endogenous subclinical hyperthyroidism (SCH).
  
  
  
  Cross-sectional and case-control study.
  
  
  
  Signs and symptoms of thyrotoxicosis, serum carboxyterminal telopeptide (CTx) and procollagen type I N-terminal propeptide (PINP), BMD, resting electrocardiogram (ECG) and 72-h ECG monitoring were evaluated in 180 women ≥65 years, including 90 with mild SCH (TSH between 0·1 and 0·4 mIU/l) and 90 euthyroid controls matched for age and body mass index.
  
  
  
  Symptom Rating Scale scores did not differ between patients and controls. None of the patients with SCH scored 20 points, a score compatible with clinical thyrotoxicosis. Eighty patients with SCH (89%) obtained seven or fewer points, a score compatible with euthyroidism. No difference in serum CTx or PINP concentrations was observed between patients and controls. There was also no correlation between these markers and TSH, free T4 or total T3 levels. Finally, no difference in femoral neck or lumbar spine BMD was observed between patients with SCH and controls. Three patients with SCH (3·3%) and two euthyroid women (2·2%) had known AF or AF in the resting ECG. ECG monitoring for 72 h revealed episodes of occult AF in 1/87 patients with SCH and in 1/88 euthyroid women (1·1%).
  
  
  
  Mild endogenous SCH (TSH between 0·1 and 0·4 mIU/l) was not associated with symptoms of thyrotoxicosis, altered bone metabolism or a higher prevalence of occult AF in women ≥65 years.
authors.affiliation: Santa Casa de Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Pedro Weslley
authors.initials: PW
authors.lastname: Rosario
authors.affiliation: Santa Casa de Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Marina
authors.initials: M
authors.lastname: Carvalho
authors.affiliation: Santa Casa de Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Maria Regina
authors.initials: MR
authors.lastname: Calsolari
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000473:pathology*; D015519:Bone Density; D016723:Bone Remodeling; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D006980:Hyperthyroidism / Q000473:pathology*; D013971:Thyrotoxicosis / Q000473:pathology*