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Endocrine Abstracts (2012) 29 OC2.1

ICEECE2012 Oral Communications Thyroid Clinical I (6 abstracts)

Overt hyperthyroidism is associated with increased mortality: a nationwide register-based study of disease discordant Danish twins

F. Brandt 1 , D. Almind 2 , K. Christensen 1, , A. Green 3 , L. Hegedüs 1 & T. Brix 1


1Odense University Hospital, Odense, Denmark; 2University of Southern Denmark, Odense, Denmark; 3University of Southern Denmark and Center for National Clinical Databases, South, Odense University Hospital, Odense, Denmark.


Introduction: Overt hyperthyroidism (OH) is associated with potentially lethal conditions such as atrial fibrillation, pulmonary embolism, stroke and coagulopathy. OH has also been connected with an increased mortality. However, this could be the result of common genetic and environmental factors affecting both OH and mortality.

Objective: To investigate if OH is associated with an increased mortality and to what degree the relation might be explained from genetic and/or environmental confounding.

Setting: Denmark.

Design: Register-based cohort study.

Participants: Twins (n=96 064) and singletons from a 5% sample of the Danish population (n=281 549) born from 1870 until 1990.

Methods: Unpaired and intrapair Cox regression analyses were compared. From the discordant twin pair design early environmental and genetic confounding was controlled by design. All participants were followed until December 31, 2008.

Results: Out of all participants, 4850 singletons and 1492 twins were identified as cases (OH). In the unpaired analyses, there was a significant higher mortality in individuals diagnosed with OH both in singletons (HR=1.33, 95% CI 1.27–1.40) and in twins (HR=1.31, 95% CI 1.18–1.46). In the intrapair analyses stratification for zygosity yield similar results for dizygotic twins (HR=1.80, 95% CI 1.27–2.55), whereas the effect of OH attenuated in the monozygotic twins (HR=0.95, 95% CI 0.60–1.50).

Conclusion: The findings of a raised mortality in singletons and within dizygotic twins pairs, but not within monozygotic twins, support a genuine relation between OH and mortality, which to some degree is influenced by shared genetic determinants.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This work was supported, however funding details are unavailable.

Volume 29

15th International & 14th European Congress of Endocrinology

European Society of Endocrinology 

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