title: Relationship Between Circulating Thyroid-Stimulating Hormone, Free Thyroxine, and Free Triiodothyronine Concentrations and 9-Year Mortality in Euthyroid Elderly Adults.
abstract: OBJECTIVE
  To determine the association between plasma thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4) levels and all-cause mortality in older adults who had levels of all three hormones in the normal range.
  
  
  METHODS
  Longitudinal.
  
  
  METHODS
  Community-based.
  
  
  METHODS
  Euthyroid Invecchiare in Chianti study participants aged 65 and older (N = 815).
  
  
  METHODS
  Plasma TSH, FT3, and FT4 levels were predictors, and 9-year all-cause mortality was the outcome. Cox proportional hazards models adjusted for confounders were used to examine the relationship between TSH, FT3, and FT4 quartiles and all-cause mortality over 9 years of follow-up.
  
  
  RESULTS
  During follow-up (mean person-years 8,643.7, range 35.4-16,985.0), 181 deaths occurred (22.2%). Participants with TSH in the lowest quartile had higher mortality than the rest of the population. After adjusting for multiple confounders, participants with TSH in the lowest quartile (hazard ratio = 2.22, 95% confidence interval = 1.19-4.22) had significantly higher all-cause mortality than those with TSH in the highest quartile. Neither FT3 nor FT4 was associated with mortality.
  
  
  CONCLUSIONS
  In elderly euthyroid subjects, normal-low TSH is an independent risk factor for all-cause mortality.
authors.affiliation: Endocrinology of Aging Unit, Department of Clinical and Experimental Medicine, University Hospital of Parma, Parma, Italy.
authors.forename: Graziano
authors.initials: G
authors.lastname: Ceresini
authors.affiliation: Endocrinology of Aging Unit, Department of Clinical and Experimental Medicine, University Hospital of Parma, Parma, Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Marina
authors.affiliation: Geriatric Unit, University Hospital of Parma, Parma, Italy.
authors.forename: Fulvio
authors.initials: F
authors.lastname: Lauretani
authors.affiliation: Endocrinology of Aging Unit, Department of Clinical and Experimental Medicine, University Hospital of Parma, Parma, Italy.
authors.forename: Marcello
authors.initials: M
authors.lastname: Maggio
authors.affiliation: Geriatric Unit, Azienda Sanitaria di Firenze Toscana, Firenze, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Bandinelli
authors.affiliation: Endocrinology of Aging Unit, Department of Clinical and Experimental Medicine, University Hospital of Parma, Parma, Italy.
authors.forename: Gian P
authors.initials: GP
authors.lastname: Ceda
authors.affiliation: National Institute on Aging, Baltimore, Maryland.
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferrucci
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D005067:Euthyroid Sick Syndromes / Q000097:blood* / Q000401:mortality*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D016016:Proportional Hazards Models; D012016:Reference Values; D012307:Risk Factors; D013960:Thyroid Function Tests; D013972:Thyrotropin / Q000097:blood*; D013974:Thyroxine / Q000097:blood*; D014284:Triiodothyronine / Q000097:blood*
chemical_list: D014284:Triiodothyronine; D013972:Thyrotropin; D013974:Thyroxine
keywords: elderly; euthyroid; mortality