The Relation Between Thyroid Function and Anemia: A Pooled Analysis of Individual Participant Data.
- Wopereis DM Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands.
- Du Puy RS Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands.
- van Heemst D Department of Internal Medicine, Gerontology and Geriatrics Section, Leiden University Medical Center, Leiden, Netherlands.
- Walsh JP Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Perth, Western Australia.
- Bremner A School of Population Health, The University of Western Australia, Crawley, Perth, Western Australia.
- Bakker SJL Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
- Bauer DC Department of Medicine, University of California San Francisco, San Francisco, California.
- Cappola AR Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.
- Ceresini G Department of Clinical and Experimental Medicine, Geriatric Endocrine Unit, University Hospital of Parma, Parma, Italy.
- Degryse J Institute of Health and Society, Université catholique de Louvain, Brussels, Belgium.
- Dullaart RPF Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
- Feller M Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
- Ferrucci L National Institute on Aging, Baltimore, Maryland.
- Floriani C Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
- Franco OH Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands.
- Iacoviello M University Cardiology Unit, Cardiothoracic Department, University Policlinic Hospital, Bari, Italy.
- Iervasi G National Council Research Institute of Clinical Physiology/Tuscany Region G. Monasterio Foundation, Pisa, Italy.
- Imaizumi M Department of Clinical Studies, Radiation Effects Research Foundation, Nagasaki, Japan.
- Jukema JW Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands.
- Khaw KT Department of Public Health and Primary Care, University of Cambridge, Cambridge, England.
- Luben RN Department of Public Health and Primary Care, University of Cambridge, Cambridge, England.
- Molinaro S National Council Research Institute of Clinical Physiology, Pisa, Italy.
- Nauck M Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany.
- Patel KV Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington.
- Peeters RP Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands.
- Psaty BM Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology, and Health Services, University of Washington, Seattle, Washington.
- Razvi S Department of Endocrinology, Gateshead Health Foundation NHS Trust, Gateshead, Tyne and Wear, England.
- Schindhelm RK Department of Clinical Chemistry, Haematology and Immunology, Northwest Clinics, Alkmaar, Netherlands.
- van Schoor NM Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, Amsterdam, Netherlands.
- Stott DJ Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom.
- Vaes B Institute of Health and Society, Université catholique de Louvain, Brussels, Belgium.
- Vanderpump MPJ The Physicians' Clinic, London, England.
- Völzke H Institute for Community Medicine, Study of Health in Pomerania/Clinical-Epidemiological Research and German Centre of Cardiovascular Research, University of Greifswald, Greifswald, Germany.
- Westendorp RGJ Department of Public Health and Center of Healthy Aging, University of Copenhagen, Copenhagen, Denmark.
- Rodondi N Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
- Cobbaert CM Department of Clinical Chemistry and Laboratory Medicine, Leiden University Medical Center, Leiden, Netherlands.
- Gussekloo J Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands.
- den Elzen WPJ Department of Clinical Chemistry and Laboratory Medicine, Leiden University Medical Center, Leiden, Netherlands.
- 2018-08-17
Published in:
- The Journal of clinical endocrinology and metabolism. - 2018
Anemia
Cross-Sectional Studies
Follow-Up Studies
Humans
Hyperthyroidism
Hypothyroidism
Longitudinal Studies
Prognosis
Thyroid Function Tests
English
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 <130 g/L in men and <120 g/L in women).
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.
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 <130 g/L in men and <120 g/L in women).
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.
- Language
-
- English
- Open access status
- green
- Identifiers
-
- DOI 10.1210/jc.2018-00481
- PMID 30113667
- Persistent URL
- https://sonar.ch/global/documents/398
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