Determinants and Clinical Implications of Thyroid Peroxidase Antibodies in Middle-Aged and Elderly Individuals: The Rotterdam Study

Khan, Samer R.; Peeters, Robin P.; Hagen, P. Martin van; Dalm, Virgil A.S.H.; Chaker, Layal

doi:10.1089/thy.2021.0403

Cited by 13 publications

(9 citation statements)

References 59 publications

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“…Both TPO Ab-positive and TPO Ab-negative groups had comparable disease activity (hyperthyroxinemia, TSH-R Ab titer, uptake at scintigraphy). Patients with positive TPO Abs were younger, which is in line with the recent observation by Khan et al where higher age was associated with lower odds of having a positive TPO Ab status ( 17 ). However, other factors could have interfered since, for example, previous episodes of hyperthyroidism were more frequent in the TPO Ab-positive group, which could have elicited immunization against thyroid antigens, including TPO.…”

Section: Discussionsupporting

confidence: 89%

TPO antibody status prior to first radioactive iodine therapy as a predictive parameter for hypothyroidism in Graves’ disease

Verdickt¹,

Nes²,

Moyson³

et al. 2022

European Thyroid Journal

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Objective We investigated if a positive thyroid peroxidase antibody (TPO Ab) status before radioactive iodine (RAI) therapy in patients with Graves’ hyperthyroidism is a predictive factor for developing hypothyroidism post RAI. Methods We performed a retrospective study of patients with Graves’ hyperthyroidism with known TPO Ab status, receiving a first administration of RAI. Patients from 4 thyroid outpatient centres in Belgium receiving a first RAI therapy between the years 2011 and 2019 were studied. Clinical, laboratory, imaging, and treatment data were recorded from medical charts. Hypothyroidism and cure (defined as combined hypo- and euthyroidism) were evaluated in period 1 (≥2 and ≤9 months, closest to 6 months post RAI) and period 2 (>9 months and ≤ 24 months post RAI, closest to 12 months post RAI). Results One hundred fifty-two patients were included of which 105 (69%) were TPO Ab positive. Compared to TPO Ab negative patients, TPO Ab positive patients were younger, had a larger thyroid gland, and had more previous episodes of hyperthyroidism. In period 1, 89% of the TPO Ab positive group developed hypothyroidism versus 72% in the TPO Ab negative group (p=0.007). In period 2, the observation was similar: 88% vs. 72% (p=0.019). In the multivariate logistic regression analysis, a positive TPO Ab status was associated with hypothyroidism in period 2 (adjusted OR 4.78 (95% CI 1.27-20.18;p=0.024). In period 1, the aOR was 4.16 (95% CI 1.0-18.83; p=0.052). Conclusion A positive TPO Ab status in patients with Graves’ hyperthyroidism receiving a first administration of RAI is associated with a higher risk of early hypothyroidism.

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Section: Discussionsupporting

confidence: 89%

TPO antibody status prior to first radioactive iodine therapy as a predictive parameter for hypothyroidism in Graves’ disease

Verdickt¹,

Nes²,

Moyson³

et al. 2022

European Thyroid Journal

View full text Add to dashboard Cite

show abstract

“…Both TPO Ab positive and TPO Ab negative groups had comparable disease activity (hyperthyroxinemia, TSH-R Ab titer, uptake at scintigraphy). Patients with positive TPO Abs were younger, which is in line with the recent observation by Khan et al where higher age was associated with lower odds of having a positive TPO Ab status 17 . However, other factors could have interfered since, for example, previous episodes of hyperthyroidism where more frequent in the TPO Ab positive group, which could have elicited immunization against thyroid antigens, including TPO.…”

Section: Discussionsupporting

confidence: 90%

TPO antibody status prior to first radioactive iodine therapy as a predictive parameter for hypothyroidism in Graves' disease

Sebastien¹,

Nes²,

Moyson³

et al. 2022

EJEA

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Objective We investigated if a positive thyroid peroxidase antibody (TPO Ab) status before radioactive iodine (RAI) therapy in patients with Graves' hyperthyroidism is a predictive factor for developing hypothyroidism post RAI. MethodsWe performed a retrospective study of patients with Graves' hyperthyroidism with known TPO Ab status, receiving a first administration of RAI. Patients from 4 thyroid outpatient centres in Belgium receiving a first RAI therapy between the years 2011 and 2019 were studied.Clinical, laboratory, imaging, and treatment data were recorded from medical charts.Hypothyroidism and cure (defined as combined hypo-and euthyroidism) were evaluated in period 1 (≥2 and ≤9 months, closest to 6 months post RAI) and period 2 (>9 months and ≤ 24 months post RAI, closest to 12 months post RAI). ResultsOne hundred fifty-two patients were included of which 105 (69%) were TPO Ab positive.Compared to TPO Ab negative patients, TPO Ab positive patients were younger, had a larger thyroid gland, and had more previous episodes of hyperthyroidism. In period 1, 89% of the TPO Ab positive group developed hypothyroidism versus 72% in the TPO Ab negative group (p=0.007). In period 2, the observation was similar: 88% vs. 72% (p=0.019). In the multivariate logistic regression analysis, a positive TPO Ab status was associated with hypothyroidism in period 2 (adjusted OR 4.78 (95% CI 1.27-20.18;p=0.024). In period 1, the aOR was 4.16 (95% CI 1.0-18.83; p=0.052). ConclusionA positive TPO Ab status in patients with Graves' hyperthyroidism receiving a first administration of RAI is associated with a higher risk of early hypothyroidism.

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“…Additionally, sensitivity analyses were also performed. First, considering the probable interrelationship between iodine status, thyroid autoantibodies, and TSH levels [ 27 , 28 ], additional adjustments for urinary iodine, TPO-Ab, and TT 4 were performed. Second, dietary factors or frailty may have an impact on the relationship of interest, the HEI or frailty was further adjusted in the multivariate model [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

TSH levels within the normal range and risk of cardiovascular and all-cause mortality among individuals with diabetes

Zhu

Lao

Chen

et al. 2022

Cardiovasc Diabetol

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Background Evidence regarding thyroid-stimulating hormone (TSH) levels within the normal range and mortality in adults with diabetes is scarce. This study aimed to identify the association between TSH levels and cardiovascular disease (CVD) and all-cause mortality among euthyroid patients with diabetes. Methods This prospective cohort study included 1830 adults with diabetes from the Third National Health and Nutrition Examination Survey III. Mortality outcomes were ascertained by linkage to National Death Index records through December 31, 2019. Participants were categorized by tertiles of TSH levels (low-normal, 0.39–1.30 mIU/L; medium-normal, 1.30–2.09 mIU/L; high-normal, 2.09–4.60 mIU/L). Multivariable Cox proportional hazards models were used to explore the association between TSH levels within the normal range and overall and CVD mortality. Furthermore, restricted cubic spline analyses were used to determine the nonlinear relationship between TSH levels and mortality. Results During a median follow-up of 17.1 years, 1324 all-cause deaths occurred, including 525 deaths from CVD. After multivariate adjustment, a U-shaped relationship was observed between TSH levels in euthyroid status and all-cause or CVD mortality among patients with diabetes (both P < 0.05 for nonlinearity). Compared with participants with medium-normal TSH levels, those with high-normal TSH levels had a significantly higher risk of all-cause (hazard ratio, 1.31; 95% confidence interval, 1.07–1.61) and CVD (1.52; 1.08–2.12) mortality. Similarly, low-normal TSH levels also increased all-cause (1.39; 1.12–1.73) and CVD (1.69; 1.17–2.44) mortality risk. In stratum-specific analyses, we found that high-normal TSH levels were associated with higher mortality risk in younger (< 60 years) patients with diabetes but not in older (≥ 60 years) participants. Conclusion Low- and high-normal serum TSH levels were associated with increased all-cause and CVD mortality in euthyroid adults with diabetes. Further studies are needed to confirm the present observation in a wider population.

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Determinants and Clinical Implications of Thyroid Peroxidase Antibodies in Middle-Aged and Elderly Individuals: The Rotterdam Study

Cited by 13 publications

References 59 publications

TPO antibody status prior to first radioactive iodine therapy as a predictive parameter for hypothyroidism in Graves’ disease

TPO antibody status prior to first radioactive iodine therapy as a predictive parameter for hypothyroidism in Graves’ disease

TPO antibody status prior to first radioactive iodine therapy as a predictive parameter for hypothyroidism in Graves' disease

TSH levels within the normal range and risk of cardiovascular and all-cause mortality among individuals with diabetes

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