The association between thyroid dysfunction, autoimmune thyroid disease, and rheumatoid arthritis disease severity

Yazdanifar, Mohammad Amin; Bagherzadeh-Fard, Mahsa; Habibi, Mohammad Amin; Vahedian, Mostafa; Bagherzadeh, Mohammad; Masoumi, Maryam

doi:10.1186/s12902-023-01473-5

Cited by 2 publications

(1 citation statement)

References 22 publications

(23 reference statements)

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“…A cross-sectional study of 350 RA patients, looking at thyroid dysfunction as well as AITD assessed by the presence of ATA, found that thyroid dysfunction, TPOAb positivity, and AITD were significantly more common in RA patients with more severe disease activity measured using the DAS28-ESR. Positive TPOAb was more prevalent (OR 2.93) among patients with severe disease activity compared to those in remission [ 69 ].…”

Section: Effect Of Aitd On Ra Disease Activitymentioning

confidence: 99%

Autoimmune thyroid disease and rheumatoid arthritis: where the twain meet

Lichtiger,

Fadaei,

Tagoe

2024

Clin Rheumatol

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Autoimmune thyroid disease (AITD) is the most prevalent autoimmune disease. It shares multiple genetic, clinical, and serologic characteristics with rheumatoid arthritis (RA). Although frequently described as a classic form of single-organ autoimmunity, the AITD disease burden in a subset of patients extends well beyond the thyroid gland. This review explores the complex interaction between the two diseases and the clinical consequences when they overlap. Beyond the well-known effects of AITD on thyroid function in RA, there is mounting evidence of the association of both conditions impacting the presentation and outcomes of diabetes, metabolic syndrome, and cardiovascular disease. An increasing number of studies suggest that there are negative effects of AITD on RA disease activity both in the presence and in the absence of thyroid dysfunction. Recent evidence suggests that AITD may not only worsen the cumulative damage of RA through higher disease activity but may also worsen secondary osteoarthritis changes. Less well-known is the significant association between AITD and chronic widespread pain syndromes including fibromyalgia. Importantly, the presence of fibromyalgia, which is increased in RA patients, appears to be further increased when it overlaps with AITD. Lastly, we probe the possible influence of AITD interacting with RA on fertility and clinical depression. Key Points• Autoimmune thyroid disease is the most common autoimmune disease and is frequently associated with rheumatoid arthritis.• Autoimmune thyroid disease can present with osteoarthritis, inflammatory arthritis, and chronic widespread pain syndromes.• The co-occurrence of autoimmune thyroid disease and rheumatoid arthritis may worsen disease activity and exacerbate other disease manifestations including cardiovascular disease, fertility, and depression.• The overlap of rheumatoid arthritis with autoimmune thyroid disease needs further research and should be sought in general clinical practice.

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Section: Effect Of Aitd On Ra Disease Activitymentioning

confidence: 99%

Autoimmune thyroid disease and rheumatoid arthritis: where the twain meet

Lichtiger,

Fadaei,

Tagoe

2024

Clin Rheumatol

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Investigating the Bidirectional Association of Rheumatoid Arthritis and Thyroid Function: A Methodologic Assessment of Mendelian Randomization

Tan,

Yao,

Lin

et al. 2024

Arthritis Care & Research

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ObjectivesRheumatoid arthritis (RA) and thyroid dysfunction are frequently observed in the same patient. However, whether they co‐occur or exhibit a causal relationship remains uncertain. We aimed to systematically investigate the causal relationship between RA and thyroid function using a large sample and advanced methods.MethodsBi‐directional two‐sample Mendelian randomization (MR) analysis was performed based on RA and six thyroid function traits datasets in the European population. The robustness of the results was demonstrated using multiple MR methods and a series of sensitivity analyses. Multivariable MR using Bayesian model averaging (MR‐BMA) was performed to adjust for possible competing risk factors. A sensitivity dataset, which included patients with seropositive RA and controls, was used to repeat the analyses. Furthermore, enrichment analysis was employed to discover the underlying mechanism between RA and thyroid functions.ResultsA significantly positive causal effect was identified for RA on autoimmune thyroid disease (AITD), as well as for AITD on RA (P < 0.001). Further sensitivity analyses showed consistent causal estimates from a variety of MR methods. After removing the outliers, MR‐MBA results showed that RA and AITD were independent risk factors in their bi‐directional causality, even in the presence of other competing risk factors (Padj < 0.05). Enrichment analysis showed immune cell activation and immune response play crucial roles in them.ConclusionOur results illustrate the significant bi‐directional causal effect of RA and AITD, which holds even in multiple competing risk factors. Clinical screening for thyroid dysfunction in RA patients deserves further attention, and vice versa.

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The association between thyroid dysfunction, autoimmune thyroid disease, and rheumatoid arthritis disease severity

Cited by 2 publications

References 22 publications

Autoimmune thyroid disease and rheumatoid arthritis: where the twain meet

Autoimmune thyroid disease and rheumatoid arthritis: where the twain meet

Investigating the Bidirectional Association of Rheumatoid Arthritis and Thyroid Function: A Methodologic Assessment of Mendelian Randomization

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