|
KMID : 0371020140470010036
|
|
Journal of Preventive Medicine and Public Health
2014 Volume.47 No. 1 p.36 ~ p.46
|
|
|
Levothyroxine Dose and Fracture Risk According to the Osteoporosis Status in Elderly Women
|
|
Ko Young-Jin
Kim Ji-Young
Lee Joong-Yub
Song Hong-Ji
Kim Ju-Young
Choi Nam-Kyong
Park Byung-Joo
|
|
|
Abstract
|
|
|
Objectives: To evaluate the association between fracture risk and levothyroxine use in elderly women with hypothyroidism, according to previous osteoporosis history.
Methods: We conducted a cohort study from the Korean Health Insurance Review and Assessment Service claims database from January 2005 to June 2006. The study population comprised women aged ≥65 years who had been diagnosed with hypothyroidism and prescribed levothyroxine monotherapy. We excluded patients who met any of the following criteria: previous fracture history, hyperthyroidism, thyroid cancer, or pituitary disorder; low levothyroxine adherence; or a follow-up period <90 days. We categorized the daily levothyroxine doses into 4 groups: ≤50 μg/d, 51 to 100 μg/d, 101 to 150 μg/d, and >150 μg/d. The hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated with the Cox proportional hazard model, and subgroup analyses were performed according to the osteoporosis history and osteoporosis-specific drug prescription status.
Results: Among 11 155 cohort participants, 35.6% had previous histories of osteoporosis. The adjusted HR of fracture for the >150 μg/d group, compared with the 51 to 100 μg/d group, was 1.56 (95% CI, 1.03 to 2.37) in osteoporosis subgroup. In the highly probable osteoporosis subgroup, restricted to patients who were concurrently prescribed osteoporosis-specific drugs, the adjusted HR of fracture for the >150 μg/d group, compared with the 51 to 100 μg/d group, was 1.93 (95% CI, 1.14 to 3.26).
Conclusions: While further studies are needed, physicians should be concerned about potential levothyroxine overtreatment in elderly osteoporosis patients.
|
|
|
KEYWORD
|
|
|
Thyroxine, Fractures, Cohort studies, Aged, Osteoporosis
|
|
|
FullTexts / Linksout information
|
|
|
|
|
Listed journal information
|
|
  
|
|