Serum thyrotrophin at baseline predicts the natural course of subclinical hyperthyroidism

摘要: SummaryObjective Optimal therapeutic strategies for subclinical hyperthyroidism are undecided. Overt disease develops in a minority of cases, but the risk factors progression remain unclear. We examined whether baseline thyrotrophin (TSH) predicted to overt asymptomatic individuals with hyperthyroidism. Design, patients and measurements This was retrospective study 323 seen our institution from 2003 2010 (mean age 71 years, males 26·9%, females 73·1%, mean follow-up duration 32 months, range 6–93 months). Serum TSH free thyroxine (FT4) were documented at during follow-up. After excluding nonthyroid causes low TSH, grouped according initial as: 0·10–0·39 mU/l (grade I) TSH < 0·10 II). Results Only 38 (11·8%) developed annual rates 0·6–3·7%. Most reverted normal thyroid status (31·6%) or remained subclinically hyperthyroid (56·7%). Progression frank higher grade II than I (20·3% vs 6·8%, P < 0·001, Chi square test). Kaplan–Meier curves showed faster (P < 0·001, log rank In stepwise multivariate Cox regression analysis, TSH < 0·1 associated (hazard ratio 3·4, confidence interval 1·6–7·0), whereas age, gender, FT4 aetiological diagnosis not hyperthyroidism. Conclusions Thyrotrophin predicts hyperthyroidism. Patients have progressing those mU/l.