In Reply: We agree with Dr Rotondi and colleagues and Dr Takamura and colleagues that the mediating factors between subclinical hypothyroidism and CHD remain to be determined, since in our study the associations between subclinical hypothyroidism and CHD remained of similar magnitude after adjustment for traditional cardiovascular risk factors. Rotondi et al hypothesized that inclusion of obese individuals might explain the lack of the significant association with CHD among adults with minimal TSH elevations. We disagree with this hypothesis for several reasons.
Rodondi N, Bauer DC, Gussekloo J. Risk of Coronary Heart Disease and Mortality for Adults With Subclinical Hypothyroidism. JAMA. 2010;304(22):2481-2482. doi:10.1001/jama.2010.1788