{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:17:59Z","timestamp":1747185479653,"version":"3.40.5"},"reference-count":29,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,8,30]],"date-time":"2022-08-30T00:00:00Z","timestamp":1661817600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Current guidelines recommend thyroid\u2010stimulating hormone (TSH) for initial biochemical evaluation of thyroid function, with borderline TSH abnormalities a common finding. The likelihood of a borderline TSH progressing to overt abnormality is not well characterised at the population level.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To determine risk factors and likelihood for progression of borderline TSH to overt abnormality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Population\u2010based retrospective longitudinal data\u2010linkage study for TSH tests performed in Tasmania (1996\u20132013). Kaplan\u2013Meier methodology was used to summarise conversion time for overt TSH elevation (\u226510 mU\/L) and overt suppression (\u22640.1 mU\/L) in patients whose initial TSH was borderline elevated (BeTSH; 4.0\u20139.99 mU\/L) and borderline suppressed (BsTSH; 0.10\u20130.39 mU\/L) respectively. Main outcome measures are the progression from borderline to overt TSH abnormality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1\u2009296\u2009060 TSH tests was performed on 367\u2009917 patients. Of these, 14\u2009507 (3.9%) patients had BeTSH on initial assessment; mean age 51.4 \u00b1\u200921.8\u2009years and median TSH of 5.0 mU\/L (interquartile range (IQR) 4.4, 5.2). Patients aged \u226580\u2009years were most likely to progress (hazard ratio (HR) =\u20092.09 compared with age &lt;20\u2009years reference group (95% confidence interval (CI): 1.64, 2.68)). Patients aged 20\u201339\u2009years had the second\u2010highest rate of progression (HR\u00a0=\u00a01.49 (95% CI: 1.18, 1.88)). Seven thousand, eight hundred and eighty\u2010three (2.14%) patients had BsTSH; mean age 50.7 \u00b1\u200922.1\u2009years and median TSH 0.30 mU\/L (IQR 0.22, 0.35). Patients aged 60\u201379\u2009years had the highest rate of progression to overt TSH suppression (HR\u00a0=\u00a02.47 compared with age &lt;20\u2009years reference group (95% CI: 1.88, 3.22)).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Follow\u2010up intervals for patients with borderline TSH abnormalities should take into account patient age as a progression risk factor.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.15674","type":"journal-article","created":{"date-parts":[[2021,12,25]],"date-time":"2021-12-25T05:22:55Z","timestamp":1640409775000},"page":"348-355","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Longitudinal population\u2010based study of progression rates for borderline thyroid\u2010stimulating hormone abnormalities"],"prefix":"10.1111","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6015-9051","authenticated-orcid":false,"given":"Ryan","family":"Endall","sequence":"first","affiliation":[{"name":"Department of Diabetes and Endocrinology Royal Hobart Hospital  Hobart Tasmania Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Stokes","sequence":"additional","affiliation":[{"name":"Tasmanian Data Linkage Unit University of Tasmania  Hobart Tasmania Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Petr","family":"Otahal","sequence":"additional","affiliation":[{"name":"Menzies Research Institute University of Tasmania  Hobart Tasmania Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Burgess","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology Royal Hobart Hospital  Hobart Tasmania Australia"},{"name":"School of Medicine University of Tasmania  Hobart Tasmania Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,8,30]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.276.4.285"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60276-6"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2007.02771.x"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2003-031089"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/09513590701259542"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.1994.4.319"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1210\/er.2006-0043"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.160.4.526"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.1995.tb01894.x"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/cen.13371"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2265.1997.2271040.x"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2005-0375"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.87.7.8678"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1993.00410080025004"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2010-0854"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1586\/17446651.2014.887433"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2015.0470"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2016.0229"},{"key":"e_1_2_7_20_1","first-page":"277","article-title":"A retrospective study of the natural history of endogenous subclinical hyperthyroidism","volume":"110","author":"Poola R","year":"2011","journal-title":"WMJ"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.1990.tb00223.x"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2010.03908.x"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAJ.0b013e318187e16d"},{"key":"e_1_2_7_24_1","unstructured":"Estimated resident population state\/territory. 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