1. The Relation Between Thyroid Function and Anemia: A Pooled Analysis of Individual Participant Data
- Author
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Rudi G. J. Westendorp, Anne R. Cappola, Kushang V. Patel, Jacobijn Gussekloo, Daisy M. Wopereis, Kay-Tee Khaw, Oscar H. Franco, Robert S. Du Puy, Natasja M. van Schoor, Massimo Iacoviello, Alexandra Bremner, Sabrina Molinaro, Salman Razvi, Nicolas Rodondi, Graziano Ceresini, J. Wouter Jukema, Robin P. F. Dullaart, Bert Vaes, Mark Vanderpump, Matthias Nauck, Christa M. Cobbaert, Carmen Floriani, John P. Walsh, Martin Feller, Bruce M. Psaty, Misa Imaizumi, Wendy P. J. den Elzen, Robert Luben, Stephan J. L. Bakker, Roger K. Schindhelm, Jean Degryse, Georgio Iervasi, Luigi Ferrucci, David J. Stott, Douglas C. Bauer, Diana van Heemst, Robin P. Peeters, Henry Völzke, Groningen Institute for Organ Transplantation (GIOT), Lifestyle Medicine (LM), Groningen Kidney Center (GKC), Epidemiology, Internal Medicine, Internal medicine, Epidemiology and Data Science, APH - Aging & Later Life, and APH - Personalized Medicine
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HYPERTHYROIDISM ,endocrine system diseases ,Endocrinology, Diabetes and Metabolism ,Clinical Biochemistry ,Thyroid Function Tests ,Biochemistry ,DISEASE ,0302 clinical medicine ,Endocrinology ,SUBCLINICAL HYPOTHYROIDISM ,hemic and lymphatic diseases ,Euthyroid ,OSMOTIC FRAGILITY ,030212 general & internal medicine ,Longitudinal Studies ,Subclinical infection ,RISK ,medicine.diagnostic_test ,Thyroid disease ,Thyroid ,Anemia ,ASSOCIATION ,Prognosis ,humanities ,3. Good health ,medicine.anatomical_structure ,HORMONES ,Thyroid function ,medicine.medical_specialty ,endocrine system ,education ,030209 endocrinology & metabolism ,Thyroid function tests ,03 medical and health sciences ,Hypothyroidism ,Internal medicine ,medicine ,Humans ,Clinical Research Articles ,METAANALYSIS ,business.industry ,MORTALITY ,Biochemistry (medical) ,Thyroid Studies Collaboration ,Odds ratio ,medicine.disease ,Cross-Sectional Studies ,ERYTHROPOIESIS ,business ,Follow-Up Studies - Abstract
Context Anemia and thyroid dysfunction often co-occur, and both increase with age. Human data on relationships between thyroid disease and anemia are scarce. Objective To investigate the cross-sectional and longitudinal associations between clinical thyroid status and anemia. Design Individual participant data meta-analysis. Setting Sixteen cohorts participating in the Thyroid Studies Collaboration (n = 42,162). Main Outcome Measures Primary outcome measure was anemia (hemoglobin Results Cross-sectionally, participants with abnormal thyroid status had an increased risk of having anemia compared with euthyroid participants [overt hypothyroidism, pooled OR 1.84 (95% CI 1.35 to 2.50), subclinical hypothyroidism 1.21 (1.02 to 1.43), subclinical hyperthyroidism 1.27 (1.03 to 1.57), and overt hyperthyroidism 1.69 (1.00 to 2.87)]. Hemoglobin levels were lower in all groups compared with participants with euthyroidism. In the longitudinal analyses (n = 25,466 from 14 cohorts), the pooled hazard ratio for the risk of development of anemia was 1.38 (95% CI 0.86 to 2.20) for overt hypothyroidism, 1.18 (1.00 to 1.38) for subclinical hypothyroidism, 1.15 (0.94 to 1.42) for subclinical hyperthyroidism, and 1.47 (0.91 to 2.38) for overt hyperthyroidism. Sensitivity analyses excluding thyroid medication or high levels of C-reactive protein yielded similar results. No differences in mean annual change in hemoglobin levels were observed between the thyroid hormone status groups. Conclusion Higher odds of having anemia were observed in participants with both hypothyroid function and hyperthyroid function. In addition, reduced thyroid function at baseline showed a trend of increased risk of developing anemia during follow-up. It remains to be assessed in a randomized controlled trial whether treatment is effective in reducing anemia.
- Published
- 2018
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