237282 Cross-sectional association between thyroid health and general health indicators (recent hospitalizations and the number of non-thyroid prescription medications currently taken): National Health and Nutrition Survey 1999-2002

Tuesday, November 1, 2011: 3:05 PM

Yutaka Aoki, PhD, MS, MHS, ME , Department of Health Policy and Management, Morgan State University School of Community Health and Policy, Baltimore, MD
     
     
Background and Objective: Thyroid hormone abnormalities have been associated with increased risk for a variety of health conditions including cardiovascular diseases. This study examined the association between thyroid health and overall health.

Methods: Data from NHANES 1999-2002 were used to examine the association between thyroid health and two indicators of overall health: number of hospitalizations in the past year; and number of non-thyroid prescription medications being taken (total N = 20983). Treatment for hypo/hyperthyroidism was determined by prescribed thyroid medications. Hypo/hyperthyroidism was biochemically determined (subsample N = 4392). A generalized negative binomial regression was used to obtain race-adjusted rate ratios for each of four sex-age subgroups.

Results: Biochemically-determined hypo- or hyperthyroidisms did not show statistically-significant associations with hospitalizations or prescriptions. Thyroid hormone replacement therapy, compared to no treatment, was associated with 5.0 times more hospitalizations for males age < 60 (p = 0.001) and 2.1 times more hospitalizations for females age < 60 (p = 0.04). Statistically significant associations between thyroid hormone replacement and prescriptions were also observed for all four age-sex groups (1.2 <=rate ratio <=2.5). Thyroid hormone replacement therapy accompanied by biochemically-determined hypothyroidism or euthyroidism was not associated with hospitalizations but was associated with a higher number of prescriptions taken for the most of age-sex subgroups.

Conclusions: Thyroid hormone replacement therapy, not untreated biochemically-determined hypo- or hyperthyroidism, appeared to be associated with poorer overall health. Possible interpretations include: reverse causality; adverse effects of thyroid hormone replacement therapy; and associations arising from a common unidentified cause.

Learning Areas:
Basic medical science applied in public health
Biostatistics, economics
Chronic disease management and prevention
Epidemiology

Learning Objectives:
Discuss the possible association between thyroid hormone replacement therapy and overall health. Analyze count data using generalized negative binomial regression to account for under- or over-dispersion.

Keywords: Chronic Diseases, Treatment

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I designed the study, performed the analysis, and interpreted the results.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Chronic Disease Epidemiology
See more of: Epidemiology