Kanker en hartfalen door hoge vrij T4?

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ineke
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Lid geworden op: 08 nov 2014, 17:53

Kanker en hartfalen door hoge vrij T4?

Bericht door ineke »

Volledig artikel (met tabellen en 1 figuur) via Endocrine Society.


Thyroid Function and Cancer Risk: The Rotterdam Study
J Clin Endocrinol Metab
Received: May 13, 2016
Accepted: September 14, 2016


Abstract:
Samer R. Khan1,2*, Layal Chaker1,2,3*, Rikje Ruiter2, Joachim G.J.V. Aerts4,
Albert Hofman2,5, Abbas Dehghan2, Oscar H. Franco2, Bruno H.C. Stricker2,
Robin P. Peeters1,2,3

1Rotterdam Thyroid Center, 2Department of Epidemiology, 3Department of Internal Medicine and
4Department of Pulmonology, Erasmus University Medical Center, Rotterdam, the Netherlands.;
5Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Mass, USA.


Context:
In vitro and in vivo experiments have assigned both oncosuppressive and oncogenic
properties to thyroid hormones. Population-based studies found inconclusive results.

Objective:
We aimed to prospectively assess the relation between thyroid function and incident
cancer in a population based setting.

Design, Setting and Participants:
The current study is a prospective population-based cohort study including 10,318 participants
for whom baseline measurements of free thyroxine (FT4) and/or thyrotropin (TSH) were available.

Main outcome measures:
Cox proportional hazards models were used to assess hazard ratios (HRs) of any solid non-skin cancer,
as well as lung, breast, prostate and gastrointestinal cancer specifically.

Results:
Higher FT4 levels were associated with a higher risk of any solid cancer (HR: 1.42; 95% confidence
interval (CI): 1.12–1.79), lung cancer (HR: 2.33; 95% CI: 1.39–3.92) and breast (HR: 1.77;
95% CI: 1.10–2.84) cancer.

The risk estimates were similar after exclusion of thyroid-altering medication, but the association
lost significance for breast cancer.
Compared to the lowest FT4 tertile, the highest tertile was associated with a 1.13 fold increased
risk of any solid, 1.79 fold increased risk of lung and 1.14 fold increased risk of breast cancer
(p for trend 0.05 for all).

For TSH levels we found no associations with cancer risk. There was no differential effect of sex or
age on the association between thyroid function and cancer risk.

Conclusions:
Higher FT4 levels are significantly associated with an increased risk of any solid, lung and breast cancer.
Further research should elucidate the underlying pathophysiological mechanisms.


Volledig artikel:
http://press.endocrine.org/doi/pdf/10.1210/jc.2016-2104



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laura
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Lid geworden op: 11 sep 2013, 22:42
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Re: Schildklierfuncties en risico op kanker: de Rotterdam studie

Bericht door laura »

hallo Ineke,

Er is ook een nieuw onderzoek naar een hoge fT4 en invloed op het hart binnen die Rotterdam Study.
Ik hoop dat ik het volledige verhaal binnenkort krijg.

Dit is de samenvatting: http://circ.ahajournals.org/content/134/10/713
Blijkbaar gaat het over 45-plussers.
laura

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laura
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Re: Schildklierfuncties en risico op kanker: de Rotterdam studie

Bericht door laura »

Het gaat dus over gemiddelden bij 55-plussers: http://www.endocrinologyadvisor.com/thy ... le/523964/

Wat heb ik daar als individuele hormoonslikker aan? Niets.
laura

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ineke
Berichten: 484
Lid geworden op: 08 nov 2014, 17:53

Re: Schildklierfuncties en risico op kanker: de Rotterdam studie

Bericht door ineke »

Laura,
Er is ook een nieuw onderzoek naar een hoge fT4 en invloed op het hart binnen die Rotterdam Study.
Ik hoop dat ik het volledige verhaal binnenkort krijg.
Hier wat uitgebreider nieuws over dat nieuwe onderzoek alsmede een interview met Dr. Chaker


Uitgebreider nieuws
Higher thyroid hormone levels linked to sudden cardiac death

American Heart Association Rapid Access Journal Report
September 06, 2016 | Categories: Heart News

Study Highlights
•The risk of sudden cardiac death was significantly greater in patients with thyroid hormone levels at the higher end of normal, compared to patients with levels at the low end.
•These findings suggest that thyroid hormone levels could help identify patients at risk for sudden cardiac death, although further research is needed.
•Researchers suggest healthcare providers be cautious when treating low thyroid hormone so that thyroid levels are not over treated.


DALLAS, Sept. 6, 2016 —
Risk of death from a sudden loss of heart function was significantly greater in patients with thyroid hormone levels at the higher end of normal range, compared to patients with levels at the lower end, according to new research in the American Heart Association’s journal Circulation.

Sudden cardiac death, occurs when the heart’s normal electrical rhythm malfunctions, causing the heart to stop beating. According to a 2012 Circulation study, more than half of all cardiovascular deaths stem from sudden cardiac death, and in many instances no previous symptoms of heart disease were apparent.

“Currently, we do not have a good way to predict sudden cardiac death in the general population,” said Layal Chaker, M.D., M.Sc., study lead author and doctoral candidate and research fellow in endocrinology and epidemiology at Erasmus University Medical Center Rotterdam in the Netherlands. “Thus identifying additional risk factors is crucial. Our results indicate that thyroid hormone levels may be useful for assessing risk to prevent sudden cardiac death.”

Thyroid hormone is made in the thyroid gland and circulates in the blood to help regulate nearly all of the body’s organs, including the heart. Although the link between abnormal levels of thyroid hormone and cardiovascular disease is well established, the hormone’s relationship with sudden cardiac death is unclear.

Researchers analyzed 10,318 patients in the Rotterdam Study, which is a long-term investigation of heart and other chronic disease among the middle-aged and elderly in the Netherlands. Participants’ average age was 65, more than half were women, and nearly all were Caucasian.

Researchers linked the association of thyroid-stimulating hormone and free thyroxine thyroid hormone levels in blood samples with sudden cardiac deaths listed on medical records and death certificates. During an average follow-up of nine years they found:
•Participants with free thyroxine hormone levels at the high end of the normal range were 2.5 times more likely to die of sudden cardiac death, compared to patients with levels at the lower end.
•The ten-year risk of sudden cardiac death was four times greater among patients with higher free thyroxine levels compared to those with lower levels — 4 percent versus 1 percent.
•The increased risk persisted even after controlling for other risk factors, such as high cholesterol and high blood pressure.
•261 cases of sudden cardiac death occurred.



“We know that a considerable proportion of patients on thyroid hormone replacement therapy are over-treated and so have high blood levels of thyroid hormone,” Chaker said. “Our study suggests more caution is warranted in the treatment of thyroid hormone replacement. Replacement therapy is often aimed at the high normal range which carries a risk of overtreatment.”

Researchers suggest further research is warranted because factors other than thyroid hormone levels could have contributed to the sudden cardiac deaths. The study also relied on a one-time test, and thyroid hormone levels could have changed throughout the course of the study. And, since most participants were Caucasian, the findings also may not apply to people of other races.

Co-authors are Marten E. van den Berg, M.D., M.Sc.; Maartje N. Niemeijer, M.D., Ph.D.; Oscar H. Franco, M.D., Ph.D.; Abbas Dehghan, M.D., Ph.D.; Albert Hofman, M.D., Ph.D.; Peter R. Rijnbeek, Ph.D.; Jaap W. Deckers, M.D., Ph.D.; Mark Eijgelsheim, M.D., Ph.D.; Bruno H.C. Stricker, M.D., Ph.D.; and Robin P. Peeters, M.D., Ph.D.

http://newsroom.heart.org/news/higher-t ... diac-death



Interview Dr. Chaker met Medpage Today
As FT4 Levels Rise, so Does Sudden Cardiac Death
—Similar results found in euthyroid participants

Thyroid dysfunction, particularly high levels of FT4, was associated with an increased risk for sudden cardiac death (SCD), according to a new study.

After an average follow-up period of about 9 years, high levels of FT4 were linked with both a higher relative and absolute risk of SCD (HR 1.77 per 1 ng/dL increase of FT4; 95% CI, 1.09-2.86), reported Layal Chaker, MD, of Erasmus University Medical Center in Rotterdam, The Netherlands, and colleagues in Circulation.

higher risk of SCD was also identified even in participants considered euthyroid, whose FT4 levels were at the high end of normal (HR 2.26 per 1 ng/dL FT4; 95% CI, 1.30-3.94). Euthyroidism was defined by a TSH level of 0.4-4.0 mIU/L.

Overall, participants whose FT4 levels at the top of the normal range had approximately a 2.5 times greater mortality rate due to SCD, compared to those at the low end of the normal range.

"Our study findings suggest that persons with higher thyroid hormone levels, even within what we consider the normal range of thyroid function, have a four-fold increased risk of sudden cardiac death compared to persons with lower thyroid hormone levels," said Chaker in an interview with MedPage Today.

Our hypothesis was that thyroid hormone levels could increase the risk of sudden cardiac death by changing levels of cardiovascular risk factors such as blood pressure. We were surprised to see that when we control our analyses for these cardiovascular risk factors, the association remained similar, suggesting that other pathways could play a role."

The study of 10,318 individuals from the Rotterdam Study assessed serum TSH and FT4 levels against occurrences of SCD.

Previous research recognized a established link between thyroid dysfunction and cardiovascular disease. Because there is little data available on abnormal thyroid hormone levels and sudden cardiac death, the authors aimed to explore this relationship.

"Currently, we do not have a good way to predict sudden cardiac death in the general population," Chaker said in a press release. "Thus identifying additional risk factors is crucial. Our results indicate that thyroid hormone levels may be useful for assessing risk to prevent sudden cardiac death."

Eligible participants included individuals who had baseline measurements for serum thyroid-stimulating hormone (TSH) or free thyroxine (FT4). Chaker and colleagues divided the population-based cohort, average age of 65, into three independent cohorts from the Rotterdam Study, labeled as RSI, RSII, and RSIII. The RSI group was further divided into participants with baseline serum measurements (RSI-1) and participants whose levels were measured at their third visit (RSI-3). Baseline TSH and FT4 levels were measured through blood samples.

Data on sudden cardiac deaths, which were each reviewed by senior cardiologist, were gathered from death certificates and medical records of participants. The researchers officially defined SCD according to the Myerburg definition, "a natural death due to cardiac causes, heralded by abrupt loss of consciousness within one hour from onset of acute symptoms." Overall, there were 261 total SCD events during the study.

Additionally, the researchers gathered data on clinical baseline characteristics which included hypertension, pulse rate, use of antihypertensive medications at baseline, heart rate variability, total cholesterol, diabetes status, BMI, cardiac dysfunction, and smoking status.

But while FT4 levels appeared predictive of sudden cardiac death, higher TSH levels in the study were not significantly associated with increased SCD risk. Also, there were insignificant differential risks of SCD among various age groups.

It's important to consider use of thyroid hormone replacement therapy in regards to SCD risk, Chaker said, particularly for individuals with thyroid function levels at the top range for normal levels.

"We know that a substantial proportion of these patients is overtreated, where thyroid hormone levels are high-normal to high," she told MedPage Today via email. "In these individuals, the thyroid hormone levels are modifiable by decreasing the dose of therapy and thereby perhaps decreasing sudden cardiac death risk."

Limits of the study included a small sample size with abnormal FT4 levels. Also, due to the demographics of the population-based cohort, there are limits to the generalizability of the results.

While the effects of thyroid medications on SCD risk were not studied in the current trial, the authors noted that future research should investigate. Furthermore, future studies are necessary to identify "which pathway could be responsible for the increased risk of sudden cardiac death with higher thyroid hormone levels," according to the researchers.

This could lead to better risk stratification and identifying possible prevention targets," Chaker said. "Low thyroid function is also associated with several cardiovascular disease and it is therefore important to find where the optimum levels of thyroid function for cardiovascular health exactly are."

http://www.medpagetoday.com/endocrinology/thyroid/60064


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laura
Berichten: 3600
Lid geworden op: 11 sep 2013, 22:42
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Re: Schildklierfuncties en risico op hartfalen: de Rotterdam studie

Bericht door laura »

hallo Ineke,

Ik heb even enkele belangrijke punten geciteerd. Het gaat om ruim 10.000 mensen van 45 tot 106 jaar.
Study Highlights
•The risk of sudden cardiac death was significantly greater in patients with thyroid hormone levels at the higher end of normal, compared to patients with levels at the low end.
•These findings suggest that thyroid hormone levels could help identify patients at risk for sudden cardiac death, although further research is needed.
•Researchers suggest healthcare providers be cautious when treating low thyroid hormone so that thyroid levels are not over treated.
Researchers linked the association of thyroid-stimulating hormone and free thyroxine thyroid hormone levels in blood samples with sudden cardiac deaths listed on medical records and death certificates. During an average follow-up of nine years they found:

•Participants with free thyroxine hormone levels at the high end of the normal range were 2.5 times more likely to die of sudden cardiac death, compared to patients with levels at the lower end.

•The ten-year risk of sudden cardiac death was four times greater among patients with higher free thyroxine levels compared to those with lower levels — 4 percent versus 1 percent.

•The increased risk persisted even after controlling for other risk factors, such as high cholesterol and high blood pressure.

261 cases of sudden cardiac death occurred.


Dat gaat dus over 26 doden per jaar.
laura

Kijk voor meer informatie ook eens op Schildkliertje.

Raadpleeg altijd een arts als je twijfelt over je gezondheid.
Het Schildklierforum kan niet worden beschouwd als vervanging van een consult of een behandeling.
ineke
Berichten: 484
Lid geworden op: 08 nov 2014, 17:53

Re: Kanker en hartfalen door hoge vrij T4?

Bericht door ineke »

Dat gaat dus over 26 doden per jaar.
Laura,
is dat een typefout :?:


Ik zie in de originele tekst toch 261 staan :roll:

261 cases of sudden cardiac death occurred


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laura
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Re: Schildklierfuncties en risico op hartfalen: de Rotterdam studie

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laura schreef:During an average follow-up of nine years they found 261 cases of sudden cardiac death occurred.
laura

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Raadpleeg altijd een arts als je twijfelt over je gezondheid.
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laura
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Re: Kanker en hartfalen door hoge vrij T4?

Bericht door laura »

Op facebook zorgde dit artikel over risico op hartfalen wel voor onrust.
laura

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Raadpleeg altijd een arts als je twijfelt over je gezondheid.
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laura
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Re: Kanker, hartfalen en diabetes ...

Bericht door laura »

Het kan niet op ... diabetes ontbrak nog in het rijtje: http://bmcmedicine.biomedcentral.com/ar ... 016-0693-4
laura

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Raadpleeg altijd een arts als je twijfelt over je gezondheid.
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laura
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Re: Kanker en hartfalen door hoge vrij T4?

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laura

Kijk voor meer informatie ook eens op Schildkliertje.

Raadpleeg altijd een arts als je twijfelt over je gezondheid.
Het Schildklierforum kan niet worden beschouwd als vervanging van een consult of een behandeling.
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