Association between rheumatoid arthritis and thyroid dysfunction: A meta-analysis and systematic review

Liu, Yijing; Miao, Hai-bing; Lin, Shu; Chen, Zhe

doi:10.3389/fendo.2022.1015516

Cited by 25 publications

(17 citation statements)

References 59 publications

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“…reported that the different presence of hypothyroid disease between cohorts of patients with or without RA was not significant at the time of RA diagnosis in the earlier stage ( 12 ). Recently, the meta-analysis also showed that the risk of developing thyroid dysfunction particularly hypothyroidism was increased in RA patients ( 13 ). However, in many cases, the earlier diagnosed RA or hypothyroidism does not mean that it begins earlier; the relationship between hypothyroidism and RA remains elusive.…”

Section: Introductionmentioning

confidence: 99%

Hypothyroidism and rheumatoid arthritis: a two-sample Mendelian randomization study

2023

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BackgroundMeta-analysis of genome-wide association studies (GWAS) data showed that the relationship between hypothyroidism and rheumatoid arthritis (RA) risk remains under debate. This study is conducted to test the causal relationship of hypothyroidism and RA.MethodsA two-sample Mendelian randomization (TSMR) analysis was employed to estimate the causality of hypothyroidism and rheumatoid arthritis in European ancestry and Asian ancestry. Integrating the effects generated by TSMR, functional annotations and noncoding variant prediction framework were applied to analyze and interpret the functional instrument variants (IVs).ResultsThe results of the inverse variance weighted method showed a strong significant causal relationship between hypothyroidism and risk of RA in European ancestry [odds ratio (OR) = 1.96; 95% confidence interval (CI) 1.49, 2.58; p < 0.001]. The outcomes of MR-Egger, weighted median, weighted mode, and simple mode also showed that hypothyroidism was significantly associated with increased risk of RA in European ancestry. The MR-PRESSO method also showed significant results [Outlier-corrected Causal Estimate = 0.70; standard error (SE) = 0.06; p < 0.001]. An independent dataset and an Asian ancestry dataset were applied to estimate and obtain the coincident results. Furthermore, we integrated the effect of variants in TSMR analysis, functional annotations, and prediction methods to pinpoint the single-nucleotide polymorphism (SNP) rs4409785 as one of the causal variants, which suggested that this variant could impact the binding of CTCF-cohesin and play a vital role in immune cells.ConclusionIn this study, we prove that hypothyroidism is significantly causally associated with increased RA risk, which has not been shown in previous studies. Furthermore, we pinpoint the potential causal variants in RA.

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Section: Introductionmentioning

confidence: 99%

Hypothyroidism and rheumatoid arthritis: a two-sample Mendelian randomization study

2023

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“…Some studies have also discovered that (subclinical) hyperthyroidism and (subclinical) hypothyroidism are both found to be closely related to rheumatoid arthritis. [29] Autoimmune diseases often lead to endothelial cell damage and increase the incidence of VTE. Therefore, this may also factor in the increased risk of VTE in patients with thyroid dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Association between thyroid dysfunction and venous thromboembolism: A systematic review and meta-analysis

et al. 2023

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Background: Thyroid dysfunction plays an important role in the development of cardiovascular disease. However, its relationship with venous thromboembolism (VTE) remains unclear. We performed a meta-analysis of published cohort and case-control studies to investigate the association between thyroid dysfunction and VTE comprehensively. Methods: Three reviewers independently searched EMbase, PubMed, China national knowledge infrastructure, and Cochrane Library databases for relevant articles from the time of database establishment to 01 October 2022 and identified all studies on thyroid dysfunction and VTE as studies of interest. Of the 2418 publications retrieved, we identified 10 articles with 15 studies that met our selection criteria. Pooled ORs and 95% confidence intervals were calculated using fixed- or random-effect models. Results: We pooled 8 studies by a fixed-effect model, which suggested an increased risk of VTE in patients with (subclinical) hyperthyroidism (OR 1.33, 95% CI: 1.29–1.38). In the other 7 studies on patients with (subclinical) hypothyroidism, the risk was similarly increased when pooled by a random-effect model (OR 1.52, 95% CI: 1.23–1.89). After sensitivity analysis and risk of bias analysis, the risk of VTE was still increased in both (subclinical) hyperthyroidism (OR 1.322, 95% CI: 1.278–1.368) and (subclinical) hypothyroidism (OR 1.74, 95% CI: 1.41–2.16). Conclusion: Patients with thyroid dysfunction have an increased risk of VTE. Therefore, it is recommended to perform thyroid function screening routinely in patients at high risk of VTE.

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“…Autoimmune polyendocrine syndrome 3 involving autoimmune thyroid disease can also be comorbid with RA and myasthenia gravis. Liu et al [7] conducted a metaanalysis of the 29 research papers available to May 2022. They examined 35,708 cases of patients in terms of possible coexistence of RA and thyroid disorders, confirming the high incidence of AID, especially hypothyroidism, in this group of patients.…”

Section: Rheumatoid Arthritismentioning

confidence: 99%

Autoimmune polyendocrine syndromes associated with autoimmune rheumatic diseases

Jankowska,

Dudek,

Stasiek

et al. 2023

Reumatologia

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Autoimmune polyendocrine syndromes (APSs), also called autoimmune polyglandular syndromes, are a group of autoimmune diseases characterized by the co-occurrence of dysfunctions of several (at least two) endocrine glands. They develop under the influence of environmental factors in genetically predisposed people. Autoimmune polyendocrine syndromes may accompany autoimmune rheumatic diseases and worsen their course – APS-2 and APS-3 are the most common. The APS-2 includes the coexistence of, e.g. Hashimoto’s disease, celiac disease and rheumatoid arthritis (RA). In APS-3, rheumatic diseases such as RA, systemic lupus erythematosus, and Sjögren’s syndrome may coexist with Hashimoto’s disease, type 1 diabetes and hypogonadism or other endocrinopathies. Undiagnosed endocrine diseases may be the reason for the intensification of metabolic disorders observed in the course of rheumatic diseases, cause the ineffectiveness of rheumatological treatment and also increase the frequency of bone fractures due to osteoporosis, cardiovascular complications and even miscarriages when coexistent, e.g. Hashimoto’s disease with hypothyroiditis, which increases the risk of pregnancy loss. It is important to be able to conduct an extensive interview, paying attention to the symptoms of possible endocrinopathy as well as the features of other autoimmune disorders in the physical examination (e.g. vitiligo or darkening of the skin in Addison’s disease). Depending on the history and physical examination, screening for various APSs is advised.

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Association between rheumatoid arthritis and thyroid dysfunction: A meta-analysis and systematic review

Cited by 25 publications

References 59 publications

Hypothyroidism and rheumatoid arthritis: a two-sample Mendelian randomization study

Hypothyroidism and rheumatoid arthritis: a two-sample Mendelian randomization study

Association between thyroid dysfunction and venous thromboembolism: A systematic review and meta-analysis

Autoimmune polyendocrine syndromes associated with autoimmune rheumatic diseases

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