Thyroid hormone resistance index and mortality in euthyroid subjects: Di@bet.es study.

Objective It has been proposed that a mild form of acquired resistance to thyroid hormone may occur in the general population. Its clinical significance remains largely unknown. The objective was to explore whether a newly described thyroid hormone resistance index is associated with the risk of mortality in a sample of community-dwelling euthyroid subjects representative of the adult population of Spain. Design Longitudinal observational study including 3750 individuals, free of thyroid disease, TPO Abs negative ( Methods We used the Thyroid Feedback Quantile-based Index (TFQI) as a marker of resistance to thyroid hormone. The study population was grouped into categories according to their TFQI values at baseline. Fatal events were ascertained from the national death registry (end of follow-up December 2016). Results 231 deaths were recorded during an average follow-up of 7.3 years. Compared with the category with the highest sensitivity to FT4 (TFQI≤p5) (reference), the Relative Risk of mortality in the categories with TFQI>p5 and ≤p25; >p25 and ≤p50; >p50 and ≤p75; >p75 and ≤p95; and >p95 were 1.01, (0.47-2.19), 1.42 (0.68-2.97), 1.54 (0.74-3.22), 1.47 (0.70-3.11) and 2.61 (1.16-5.89) respectively (p for trend 0.003). The association remained significant after multivariate adjustment of the data (p for trend 0.017). Conclusions A thyroid hormone resistance index focused on deviations of the average pituitary response to thyroid hormones may be associated to all-cause mortality independently of other conventional risk factors and comorbidities.