Levothyroxine Dose and Fracture Risk According to the Osteoporosis Status in Elderly Women
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°í¿µÁø(Ko Young-Jin) - Seoul National University College of Medicine Department of Preventive Medicine
±èÁö¿µ(Kim Ji-Young) - Seoul National University College of Medicine Department of Preventive Medicine
ÀÌÁß¿±(Lee Joong-Yub) - Seoul National University Hospital Medical Research Collaborating Center
¼ÛÈ«Áö(Song Hong-Ji) - Hallym University College of Medicine Department of Family Medicine
±èÁÖ¿µ(Kim Ju-Young) - Seoul National University Bundang Hospital Department of Family Medicine
ÃÖ³²°æ(Choi Nam-Kyong) - Seoul National University Hospital Medical Research Collaborating Center
¹Úº´ÁÖ(Park Byung-Joo) - Seoul National University College of Medicine Department of Preventive Medicine
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 ¡Ã65 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: ¡Â50 ¥ìg/d, 51 to 100 ¥ìg/d, 101 to 150 ¥ìg/d, and >150 ¥ìg/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 ¥ìg/d group, compared with the 51 to 100 ¥ìg/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 ¥ìg/d group, compared with the 51 to 100 ¥ìg/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.
Å°¿öµå
Thyroxine, Fractures, Cohort studies, Aged, Osteoporosis
KMID :
0371020140470010036
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