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The Relation Between Thyroid Function and Anemia: A Pooled Analysis of Individual Participant Data

Authors :
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
APH - Personalized Medicine
Source :
Journal of Clinical Endocrinology & Metabolism, 103(10), 3658-3667. ENDOCRINE SOC, Wopereis, D M, Du Puy, R S, Van Heemst, D, Walsh, J P, Bremner, A, Bakker, S J L, Bauer, D C, Cappola, A R, Ceresini, G, Degryse, J, Dullaart, R P F, Feller, M, Ferrucci, L, Floriani, C, Franco, O H, Iacoviello, M, Iervasi, G, Imaizumi, M, Wouter Jukema, J, Khaw, K T, Luben, R N, Molinaro, S, Nauck, M, Patel, K V, Peeters, R P, Psaty, B M, Razvi, S, Schindhelm, R K, Van Schoor, N M, Stott, D J, Vaes, B, Vanderpump, M P J, Völzke, H, Westendorp, R G J, Rodondi, N, Cobbaert, C M, Gussekloo, J & Den Elzen, W P J 2018, ' The relation between thyroid function and anemia : A pooled analysis of individual participant data ', Journal of Clinical Endocrinology and Metabolism, vol. 103, no. 10, pp. 3658-3667 . https://doi.org/10.1210/jc.2018-00481, Journal of Clinical Endocrinology and Metabolism, 103(10), 3658-3667, Journal of Clinical Endocrinology and Metabolism, 103(10), 3658-3667. Endocrine Society, Journal of Clinical Endocrinology and Metabolism, 103(10), 3658-3667. The Endocrine Society, Journal of Clinical Endocrinology and Metabolism, The Journal of Clinical Endocrinology & Metabolism
Publication Year :
2018

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.

Details

ISSN :
0021972X
Volume :
103
Issue :
10
Database :
OpenAIRE
Journal :
Journal of Clinical Endocrinology and Metabolism
Accession number :
edsair.doi.dedup.....8e1239bad9ca14960c215f8ec46c0697
Full Text :
https://doi.org/10.1210/jc.2018-00481