C-reactive protein and thyroid-stimulating hormone levels as risk factors for hypothyroidism in patients with subacute thyroiditis

Abstract

Objective: This study was designed to explore the relationships between the clinical characteristics and outcomes of patients with subacute thyroiditis (SAT). Design: This is a single-center retrospective study. Patients: Eighty-nine patients with SAT who were hospitalized in the Sir Run Run Shaw Hospital in Zhejiang, China, from October 2014 to September 2020 were included. Methods: The Mann–Whitney U-test, chi-square test, and Cox regression analysis were conducted to identify the relationships between clinical characteristics and outcomes. Receiver operating characteristic (ROC) analysis was performed to determine the optimal cutoff levels of C-reactive protein (CRP) and thyroid-stimulating hormone (TSH). Results: The hypothyroidism and recurrence rates were 15.7% and 16.9%, respectively. CRP (≥72.0 mg/L), TSH (<0.02 mIU/L), and free triiodothyronine (fT3) (≥4.10 pg/mL) were associated with hypothyroidism. The cutoff level was 97.80 mg/L for CRP (area under the curve (AUC), 0.717, p= 0.014; sensitivity, 57.1%; specificity, 84.0%) and 0.10 mIU/L for TSH (AUC, 0.752, p = 0.004; sensitivity, 100%; specificity, 46.0%) by ROC curve analysis for hypothyroidism. The factors under study were not associated with recurrence. Conclusion: CRP and TSH were risk factors for hypothyroidism in SAT. Thyroid functions should be monitored closely to detect hypothyroidism early, especially in patients with CRP levels of more than 97.80 mg/L and TSH levels of less than 0.10 mIU/L.

Efficacy evaluation of probiotics combined with prebiotics in patients with clinical hypothyroidism complicated with small intestinal bacterial overgrowth during the second trimester of pregnancy

“…Tang C et al. also believed that hypothyroidism was related to inflammatory factors, including IL-6, TNF-α and hs-CRP, and the concentration of inflammatory factors was relatively high in nonpregnant hypothyroidism patients ( Abbas and Sakr, 2016 ; Tang et al., 2021 ), consistent with our research results. Our previous studies on fecal 16S RNA sequencing found that increased CRP was related to Gammaproteobacteria, Pasteurellaceae and Firmicutes , and the combined effect of CRP and phosphocholine on bacteria could activate inflammatory factors.…”

“…In this study, we found that the levels of hsCRP, IL-10, IL-6 and TNF-a in pregnant women with clinical hypothyroidism during pregnancy were significantly higher than those in the control group. Tang C et al also believed that hypothyroidism was related to inflammatory factors, including IL-6, TNF-a and hs-CRP, and the concentration of inflammatory factors was relatively high in nonpregnant hypothyroidism patients (Abbas and Sakr, 2016;Tang et al, 2021), consistent with our research results. Our previous studies on fecal 16S RNA sequencing found that increased CRP was related to Gammaproteobacteria, Pasteurellaceae and Firmicutes, and the…”

The diagnostic value of blood cell-derived indexes in subacute thyroiditis patients with thyrotoxicosis: a retrospective study

“…Receiver operating characteristic (ROC) curve analysis was used to determine their capacity for differentiating SAT from GD. A recent study found that elevated levels of C-reactive protein (CRP) is a risk factor for hypothyroidism in SAT patients (17). Blood cell derived indexes, also as inflammatory markers of SAT, may be associated with the occurrence of hypothyroidism.…”

The Old and the New in Subacute Thyroiditis: An Integrative Review

“…Görges et al [143] investigated the long-term follow-up of SAT for up to 30 years, concluding that one-quarter of patients with SAT develop hypothyroidism in the long term. Recently, a Chinese study [144] reported that patients with higher CRP and lower TSH levels were at a higher risk of developing hypothyroidism. A possible role of TRAb in the development of prolonged hypothyroidism was hypothesized by Tamai et al [145], in particular regarding TSH-blocking antibodies (TSH-BAb).…”

“…SAT recurrency is thought to be uncommon, but reported prevalence ranges from 2% [9,12] up to 20% [144], usually occurring within one year after diagnosis. However, late recurrence after several years has also been described, even after more than ten years [9,65,151].…”