Age-Related Changes in Thyroid Function: A Longitudinal Study of a Community-Based Cohort

Alexandra Bremner, P. Feddema, Peter Leedman, S.J. Brown, John Beilby, Ee Lim, Scott Wilson, Peter O'Leary, John Walsh

Research output: Contribution to journalArticle

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Abstract

Context: In cross-sectional studies, serum TSH concentrations increase with age. This has not been examined longitudinally, and it is uncertain whether the TSH increase reflects healthy aging or occult thyroid failure.Methods: We measured serum TSH, free T-4, thyroid peroxidase, and thyroglobulin antibodies in 1100 participants in the 1981 and 1994 Busselton Health Surveys and derived a reference group of 908 individuals without thyroid disease or thyroid antibodies. We examined changes in thyroid function longitudinally and, in 781 participants, explored associations with the CAPZB polymorphism rs10917469.Results: At 13 yr follow-up, mean serum TSH increased from 1.49 to 1.81 mU/liter, a change in mean TSH (Delta TSH) of 0.32 mU/liter [95% confidence interval (CI) 0.27, 0.38, P <0.001], whereas mean free T-4 concentration was unchanged (16.6 vs. 16.6 pmol/liter, P = 0.7). The TSH increase was most marked in the elderly, such that gender-adjusted Delta TSH increased by 0.08 mU/liter (95% CI 0.04, 0.11) for each decade of baseline age. People with higher baseline TSH values had proportionally smaller increases in TSH, with each additional 1.0 mU/liter of baseline TSH associated with a 0.13 mU/liter decrease (age and gender adjusted) in Delta TSH (95% CI 0.09, 0.16). The Delta TSH did not differ significantly by CAPZB genotype.Conclusions: Aging is associated with increased serum TSH concentrations, with no change in free T-4 concentrations. The largest TSH increase is in people with the lowest TSH at baseline. This suggests that the TSH increase arises from age-related alteration in the TSH set point or reduced TSH bioactivity rather than occult thyroid disease. (J Clin Endocrinol Metab 97: 1554-1562, 2012)
Original languageEnglish
Pages (from-to)1554-1562
JournalJournal of Clinical Endocrinology & Metabolism
Volume97
Issue number5
DOIs
Publication statusPublished - 2012

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Longitudinal Studies
Thyroid Gland
Aging of materials
Iodide Peroxidase
Antibodies
Thyroglobulin
Thyroid Diseases
Confidence Intervals
Bioactivity
Polymorphism
Serum
Health Surveys
Cross-Sectional Studies
Genotype

Cite this

@article{e1749322d4354d079d7bdba1bc419b97,
title = "Age-Related Changes in Thyroid Function: A Longitudinal Study of a Community-Based Cohort",
abstract = "Context: In cross-sectional studies, serum TSH concentrations increase with age. This has not been examined longitudinally, and it is uncertain whether the TSH increase reflects healthy aging or occult thyroid failure.Methods: We measured serum TSH, free T-4, thyroid peroxidase, and thyroglobulin antibodies in 1100 participants in the 1981 and 1994 Busselton Health Surveys and derived a reference group of 908 individuals without thyroid disease or thyroid antibodies. We examined changes in thyroid function longitudinally and, in 781 participants, explored associations with the CAPZB polymorphism rs10917469.Results: At 13 yr follow-up, mean serum TSH increased from 1.49 to 1.81 mU/liter, a change in mean TSH (Delta TSH) of 0.32 mU/liter [95{\%} confidence interval (CI) 0.27, 0.38, P <0.001], whereas mean free T-4 concentration was unchanged (16.6 vs. 16.6 pmol/liter, P = 0.7). The TSH increase was most marked in the elderly, such that gender-adjusted Delta TSH increased by 0.08 mU/liter (95{\%} CI 0.04, 0.11) for each decade of baseline age. People with higher baseline TSH values had proportionally smaller increases in TSH, with each additional 1.0 mU/liter of baseline TSH associated with a 0.13 mU/liter decrease (age and gender adjusted) in Delta TSH (95{\%} CI 0.09, 0.16). The Delta TSH did not differ significantly by CAPZB genotype.Conclusions: Aging is associated with increased serum TSH concentrations, with no change in free T-4 concentrations. The largest TSH increase is in people with the lowest TSH at baseline. This suggests that the TSH increase arises from age-related alteration in the TSH set point or reduced TSH bioactivity rather than occult thyroid disease. (J Clin Endocrinol Metab 97: 1554-1562, 2012)",
author = "Alexandra Bremner and P. Feddema and Peter Leedman and S.J. Brown and John Beilby and Ee Lim and Scott Wilson and Peter O'Leary and John Walsh",
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Age-Related Changes in Thyroid Function: A Longitudinal Study of a Community-Based Cohort. / Bremner, Alexandra; Feddema, P.; Leedman, Peter; Brown, S.J.; Beilby, John; Lim, Ee; Wilson, Scott; O'Leary, Peter; Walsh, John.

In: Journal of Clinical Endocrinology & Metabolism, Vol. 97, No. 5, 2012, p. 1554-1562.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Age-Related Changes in Thyroid Function: A Longitudinal Study of a Community-Based Cohort

AU - Bremner, Alexandra

AU - Feddema, P.

AU - Leedman, Peter

AU - Brown, S.J.

AU - Beilby, John

AU - Lim, Ee

AU - Wilson, Scott

AU - O'Leary, Peter

AU - Walsh, John

PY - 2012

Y1 - 2012

N2 - Context: In cross-sectional studies, serum TSH concentrations increase with age. This has not been examined longitudinally, and it is uncertain whether the TSH increase reflects healthy aging or occult thyroid failure.Methods: We measured serum TSH, free T-4, thyroid peroxidase, and thyroglobulin antibodies in 1100 participants in the 1981 and 1994 Busselton Health Surveys and derived a reference group of 908 individuals without thyroid disease or thyroid antibodies. We examined changes in thyroid function longitudinally and, in 781 participants, explored associations with the CAPZB polymorphism rs10917469.Results: At 13 yr follow-up, mean serum TSH increased from 1.49 to 1.81 mU/liter, a change in mean TSH (Delta TSH) of 0.32 mU/liter [95% confidence interval (CI) 0.27, 0.38, P <0.001], whereas mean free T-4 concentration was unchanged (16.6 vs. 16.6 pmol/liter, P = 0.7). The TSH increase was most marked in the elderly, such that gender-adjusted Delta TSH increased by 0.08 mU/liter (95% CI 0.04, 0.11) for each decade of baseline age. People with higher baseline TSH values had proportionally smaller increases in TSH, with each additional 1.0 mU/liter of baseline TSH associated with a 0.13 mU/liter decrease (age and gender adjusted) in Delta TSH (95% CI 0.09, 0.16). The Delta TSH did not differ significantly by CAPZB genotype.Conclusions: Aging is associated with increased serum TSH concentrations, with no change in free T-4 concentrations. The largest TSH increase is in people with the lowest TSH at baseline. This suggests that the TSH increase arises from age-related alteration in the TSH set point or reduced TSH bioactivity rather than occult thyroid disease. (J Clin Endocrinol Metab 97: 1554-1562, 2012)

AB - Context: In cross-sectional studies, serum TSH concentrations increase with age. This has not been examined longitudinally, and it is uncertain whether the TSH increase reflects healthy aging or occult thyroid failure.Methods: We measured serum TSH, free T-4, thyroid peroxidase, and thyroglobulin antibodies in 1100 participants in the 1981 and 1994 Busselton Health Surveys and derived a reference group of 908 individuals without thyroid disease or thyroid antibodies. We examined changes in thyroid function longitudinally and, in 781 participants, explored associations with the CAPZB polymorphism rs10917469.Results: At 13 yr follow-up, mean serum TSH increased from 1.49 to 1.81 mU/liter, a change in mean TSH (Delta TSH) of 0.32 mU/liter [95% confidence interval (CI) 0.27, 0.38, P <0.001], whereas mean free T-4 concentration was unchanged (16.6 vs. 16.6 pmol/liter, P = 0.7). The TSH increase was most marked in the elderly, such that gender-adjusted Delta TSH increased by 0.08 mU/liter (95% CI 0.04, 0.11) for each decade of baseline age. People with higher baseline TSH values had proportionally smaller increases in TSH, with each additional 1.0 mU/liter of baseline TSH associated with a 0.13 mU/liter decrease (age and gender adjusted) in Delta TSH (95% CI 0.09, 0.16). The Delta TSH did not differ significantly by CAPZB genotype.Conclusions: Aging is associated with increased serum TSH concentrations, with no change in free T-4 concentrations. The largest TSH increase is in people with the lowest TSH at baseline. This suggests that the TSH increase arises from age-related alteration in the TSH set point or reduced TSH bioactivity rather than occult thyroid disease. (J Clin Endocrinol Metab 97: 1554-1562, 2012)

U2 - 10.1210/jc.2011-3020

DO - 10.1210/jc.2011-3020

M3 - Article

VL - 97

SP - 1554

EP - 1562

JO - Journal of Endocrinology & Metabolism

JF - Journal of Endocrinology & Metabolism

SN - 0021-972X

IS - 5

ER -