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Young-Jin Ko 2 Articles
Levothyroxine Dose and Fracture Risk According to the Osteoporosis Status in Elderly Women
Young-Jin Ko, Ji Young Kim, Joongyub Lee, Hong-Ji Song, Ju-Young Kim, Nam-Kyong Choi, Byung-Joo Park
J Prev Med Public Health. 2014;47(1):36-46.   Published online January 29, 2014
DOI: https://doi.org/10.3961/jpmph.2014.47.1.36
  • 11,663 View
  • 169 Download
  • 22 Citations
AbstractAbstract PDF
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 ≥65 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: ≤50 µg/d, 51 to 100 µg/d, 101 to 150 µg/d, and >150 µg/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 µg/d group, compared with the 51 to 100 µg/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 µg/d group, compared with the 51 to 100 µg/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.

Summary

Citations

Citations to this article as recorded by  
  • Evaluation and Management of Bone Health in Patients with Thyroid Diseases: A Position Statement of the Korean Thyroid Association
    A Ram Hong, Ho-Cheol Kang
    Endocrinology and Metabolism.2023; 38(2): 175.     CrossRef
  • Refractory Hypothyroidism: Unraveling the Complexities of Diagnosis and Management
    Juan Eduardo Quiroz-Aldave, Marcio José Concepción-Zavaleta, María del Carmen Durand-Vásquez, Luis Alberto Concepción-Urteaga, Elman Rolando Gamarra-Osorio, Jacsel Suárez-Rojas, Luciana del Pilar Rafael-Robles, José Paz-Ibarra, Alejandro Román-González
    Endocrine Practice.2023;[Epub]     CrossRef
  • Assessing the cardiovascular effects of levothyroxine use in an ageing United Kingdom population (ACEL-UK) protocol: a cohort and target trial emulation study
    Mia Holley, Salman Razvi, Rosie Dew, Ian Maxwell, Scott Wilkes
    Thyroid Research.2023;[Epub]     CrossRef
  • Understanding Worry About Risks Associated With Thyroid Hormone Therapy: A National Survey of Endocrinologists, Family Physicians, and Geriatricians
    Kimi Shah, David Reyes-Gastelum, Brittany L. Gay, Maria Papaleontiou
    Endocrine Practice.2022; 28(1): 25.     CrossRef
  • Evaluation and Management of Bone Health in Patients with Thyroid Diseases: a Position Statement from the Korean Thyroid Association
    A Ram Hong, Hwa Young Ahn, Bu Kyung Kim, Seong Hee Ahn, So Young Park, Min-Hee Kim, Jeongmin Lee, Sun Wook Cho, Ho-Cheol Kang
    International Journal of Thyroidology.2022; 15(1): 1.     CrossRef
  • Levothyroxine Therapy in Elderly Patients With Hypothyroidism
    Grigoris Effraimidis, Torquil Watt, Ulla Feldt-Rasmussen
    Frontiers in Endocrinology.2021;[Epub]     CrossRef
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    British Dental Journal.2021; 231(1): 33.     CrossRef
  • The Influence of Thyroid Pathology on Osteoporosis and Fracture Risk: A Review
    Dragos Apostu, Ondine Lucaciu, Daniel Oltean-Dan, Alexandru-Dorin Mureșan, Cristina Moisescu-Pop, Andrei Maxim, Horea Benea
    Diagnostics.2020; 10(3): 149.     CrossRef
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    Gherardo Mazziotti, Anna Maria Formenti, Stefano Frara, Roberto Olivetti, Giuseppe Banfi, Maurizio Memo, Roberto Maroldi, Raffaele Giubbini, Andrea Giustina
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    Current Opinion in Endocrine and Metabolic Researc.2018;[Epub]     CrossRef
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    Hwa Young Ahn
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  • RETRACTED ARTICLE: The relationship between subclinical thyroid dysfunction and the risk of fracture or low bone mineral density: a systematic review and meta-analysis of cohort studies
    Ruifei Yang, Liang Yao, Yuan Fang, Jing Sun, Tiankang Guo, Kehu Yang, Limin Tian
    Journal of Bone and Mineral Metabolism.2018; 36(2): 209.     CrossRef
  • MANAGEMENT OF ENDOCRINE DISEASE: l-Thyroxine replacement therapy in the frail elderly: a challenge in clinical practice
    R M Ruggeri, F Trimarchi, B Biondi
    European Journal of Endocrinology.2017; 177(4): R199.     CrossRef
  • THE IMPACT OF AGE IN THE MANAGEMENT OF HYPOTHYROIDISM: RESULTS OF A NATIONWIDE SURVEY
    Maria Papaleontiou, Brittany L. Gay, Nazanene H. Esfandiari, Sarah T. Hawley, Megan R. Haymart
    Endocrine Practice.2016; 22(6): 708.     CrossRef
  • TSH Suppression after Differentiated Thyroid Cancer Surgery and Osteoporosis
    Kyoung Sik Park
    Korean Journal of Endocrine Surgery.2016; 16(1): 1.     CrossRef
  • TSH Suppression after Differentiated Thyroid Cancer Surgery and Osteoporosis
    Kyoung Sik Park
    Korean Journal of Endocrine Surgery.2016; 16(1): 1.     CrossRef
  • Role of Thyroid Hormones in Skeletal Development and Bone Maintenance
    J. H. Duncan Bassett, Graham R. Williams
    Endocrine Reviews.2016; 37(2): 135.     CrossRef
Cardiovascular Health Metrics and All-cause and Cardiovascular Disease Mortality Among Middle-aged Men in Korea: The Seoul Male Cohort Study
Ji Young Kim, Young-Jin Ko, Chul Woo Rhee, Byung-Joo Park, Dong-Hyun Kim, Jong-Myon Bae, Myung-Hee Shin, Moo-Song Lee, Zhong Min Li, Yoon-Ok Ahn
J Prev Med Public Health. 2013;46(6):319-328.   Published online November 28, 2013
DOI: https://doi.org/10.3961/jpmph.2013.46.6.319
  • 14,258 View
  • 151 Download
  • 48 Citations
AbstractAbstract PDF
Objectives

This study estimated the association of cardiovascular health behaviors with the risk of all-cause and cardiovascular disease (CVD) mortality in middle-aged men in Korea.

Methods

In total, 12 538 men aged 40 to 59 years were enrolled in 1993 and followed up through 2011. Cardiovascular health metrics defined the following lifestyle behaviors proposed by the American Heart Association: smoking, physical activity, body mass index, diet habit score, total cholesterol, blood pressure, and fasting blood glucose. The cardiovascular health metrics score was calculated as a single categorical variable, by assigning 1 point to each ideal healthy behavior. A Cox proportional hazards regression model was used to estimate the hazard ratio of cardiovascular health behavior. Population attributable risks (PARs) were calculated from the significant cardiovascular health metrics.

Results

There were 1054 total and 171 CVD deaths over 230 690 person-years of follow-up. The prevalence of meeting all 7 cardiovascular health metrics was 0.67%. Current smoking, elevated blood pressure, and high fasting blood glucose were significantly associated with all-cause and CVD mortality. The adjusted PARs for the 3 significant metrics combined were 35.2% (95% confidence interval [CI], 21.7 to 47.4) and 52.8% (95% CI, 22.0 to 74.0) for all-cause and CVD mortality, respectively. The adjusted hazard ratios of the groups with a 6-7 vs. 0-2 cardiovascular health metrics score were 0.42 (95% CI, 0.31 to 0.59) for all-cause mortality and 0.10 (95% CI, 0.03 to 0.29) for CVD mortality.

Conclusions

Among cardiovascular health behaviors, not smoking, normal blood pressure, and recommended fasting blood glucose levels were associated with reduced risks of all-cause and CVD mortality. Meeting a greater number of cardiovascular health metrics was associated with a lower risk of all-cause and CVD mortality.

Summary

Citations

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JPMPH : Journal of Preventive Medicine and Public Health