TABLE 6-2 Endocrine Diseases

Study

Study Design

Population

Outcomes

Results

Adjustments

Comments

CDC 1988b

Retrospective cohort, prevalence, population-based, telephone interview with screening medical examination at followup

2490 Vietnam-theater veterans, 1972 Vietnam-era veterans randomly selected

Screening medical examination, standard hematologic assays, serum chemistry assays

Diabetes OR 1.1, 95% CI includes 1.0; out of TSH reference range OR 2.0, 95% CI 0.9-4.3; out of reference range for free-T3 index OR 1.2, 95% CI 0.9-1.5

Age at enlistment, race, year of enlistment, enlistment status (volunteer vs draftee), score on general technical test, primary military occupational specialty

Low participation rate in control group

VES

Eisen et al. 2005

Cross-sectional, prevalence, population-based

1061 GW-deployed veterans, 1128 nondeployed veterans

Diabetes, hypothyroidism, hyperthyroidism

Diabetes OR 1.52, 95% CI 0.81-2.85; hypothyroidism OR 1.70, 95% CI 0.75-3.87; hyperthyroidism OR 4.86, 95% CI 0.68-34.58; all NS

Age, sex, race, cigarette-smoking, duty type, service branch, education, rank (hyperthy roidism not adjusted for service branch or rank)

Low participation rates, deployed (53%), nondeployed (39%)

NHSGWEVTF

(Derived from Kang et al. 2000b)

Gray et al. 1996

Retrospective cohort, hospitalization

547,076 active-duty GW veterans, 618,335 non-GW veterans

Hospital-discharge diagnoses for endocrine-nutritional-metabolic disease

OR about 0.9 (exact value not given), 95% CI < 1.0 for all 3 years

Prewar hospitalization, sex, age, race, branch of service, marital status, rank, length of service, salary, occupation

ORs are statistically significantly below 1, but no values given; no separation of specific illnesses

Gray et al. 2000

Retrospective cohort, hospitalization

652,979 GW-deployed veterans, 652,922 randomly selected nondeployed veterans

Hospital-discharge diagnoses for endocrine, nutritional, and metabolic disease in three hospital systems: DoD, VA, COSHPD

DoD PMR 0.99, 95% CI 0.93-1.06); VA PMR 1.08, 95% CI 0.92-1.24 ; COSHPD PMR 0.81, 95% CI 0.48-1.14

Age, sex, race

Able to assess only illnesses that resulted in hospitalization; possible undetected confounders

NOTE: CI = confidence interval, COSHPD= California Office of Statewide Health Planning and Development, DoD = Department of Defense, GW = Gulf War, NHSGWEVTF =National Health Survey of Gulf War Era Veterans and Their Families, NS = not significant, OR = odds ratio, PMR = proportional morbidity ratio, PTSD = posttraumatic stress disorder, T3 = triiodothyronine, TSH = thyroid-stimulating hormone, VA = Department of Veterans Affairs, VES = Vietnam Experience Study.



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