Impact of Hypothyroidism and Heart Failure on Hospitalization Risk

Ro, Kevin; Yuen, Alexander; Du, Lin; Ro, Clarissa C.; Seger, Christian; Yeh, Michael W.; Leung, Angela M.; Rhee, Connie M.

doi:10.1089/thy.2017.0362

Cited by 17 publications

(11 citation statements)

References 37 publications

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“…We included cross-product terms of exposure and mediator in the model given the previous findings that underlying cardiovascular status can be a modifier of the association between hypothyroidism and the long-term adverse health outcomes. 28,29 More detailed discussion and coding are described elsewhere. 26,27 As the TSH distribution differs by sex and age, 30 stratum-specific analyses were conducted to estimate the associations of TSH with mortality according to sex (men and women) and age (<60 and Ն60 years) using category-specific tertiles to define low-normal, middle-normal, and high-normal TSH in each analysis.…”

Section: Discussionmentioning

confidence: 99%

Association of Subclinical Hypothyroidism and Cardiovascular Disease With Mortality

et al. 2020

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IMPORTANCE Subclinical hypothyroidism is a common clinical entity among US adults associated in some studies with an increase in the risk of cardiovascular disease (CVD) and mortality. However, the extent to which CVD mediates the association between elevated serum thyrotropin (TSH) and mortality has not yet been well established or sufficiently quantified. OBJECTIVE To elucidate the extent to which subclinical hypothyroidism, elevated serum TSH and normal serum free thyroxine, or high-normal TSH concentrations (ie, upper normative-range TSH concentrations) are associated with mortality through CVD among US adults.

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Section: Discussionmentioning

confidence: 99%

Association of Subclinical Hypothyroidism and Cardiovascular Disease With Mortality

et al. 2020

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“…The study was conducted in accordance with the Declaration of Helsinki, and the protocol was approved by the Ethics Committee of medical ethics committee of China Medical University (Serial number: IRB[2008]34). The inclusion criteria were as follows: 1) over the age of 20 years, 2) Han nationality, 3) living in Wuhan for at least 10 years, 4) did not receive iodine-containing contrast agent or drugs such as amiodarone within the past three months, and 5) no previous thyroid disease. We excluded subjects with clinically abnormal thyroid function, missing important information as well as pregnant and lactating women.…”

Section: Study Participantsmentioning

confidence: 99%

“…Because of the occult symptoms, these two thyroid diseases are often ignored by most patients, and the detection of the disease mainly depends on screening in the general population. However, a number of studies have shown that subclinical hypothyroidism is associated with increased risk of a variety of cardiovascular diseases [3] and cognitive impairment [4], and may develop into dominant hypothyroidism, and solitary thyroid nodules also have varying degrees of risk of deterioration [5]. Therefore, it is of great signi cance for the early diagnosis and early warning of the above two diseases, especially in the susceptible population with different risk factors.…”

Section: Introductionmentioning

confidence: 99%

The Association between BMI, Smoking, Drinking and Thyroid Disease: A Cross-sectional Study in Wuhan, China

Chen

Wang

Liu

et al. 2021

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Background: There is no clear conclusion on the relationship between thyroid disease and obesity and living habits such as smoking and drinking. In this study, a cross-sectional survey of urban residents in central China was conducted to analyze the association of body mass index (BMI), smoking and drinking with subclinical hypothyroidism (SHO) and thyroid nodules (TNs), and to discuss the potential mechanism between these risk or protective factors and the two diseases.Methods: This study included 1279 participants in 2011 and 2012. Questionnaire survey, laboratory examination and ultrasonic diagnosis were conducted on these participants. Binary logistics regression analysis was used to analyze these factors.Results: Overweight (BMI ≥25kg/m2) was closely related to subclinical hypothyroidism and thyroid nodules in univariate and multivariate logistics regression analysis. Smoking had protective effect on subclinical hypothyroidism and thyroid nodules in univariate logistics regression, while drinking had protective effect on thyroid nodules in univariate logistics regression, but there was no significant difference between smoking and drinking and two kinds of thyroid diseases in multivariate logistics regression analysis. In subgroup analysis, BMI ≥ 25kg/m2 was significantly associated with subclinical hypothyroidism in people with positive thyroid antibodies (OR= 2.221, 95%CI: 1.168-4.184, P=0.015) and smokers (OR= 2.179, 95%CI: 1.041-4.561, P=0.039). Thyroid nodules were significantly associated with thyroid nodules in people over 60 years old (OR= 2.069, 95%CI: 1.149-3.724, P=0.015) and drinkers (OR=3.065, 95%CI: 1.413-6.648, P=0.005). Drinking alcohol has a protective effect on thyroid nodules in smokers (OR=0.456, 95%CI: 0.240-0.865, P=0.016) and people with BMI ≥ 25kg/m2 (OR=0.467, 95%CI: 0.236-0.925, P=0.029). No statistical association was found between smoking and the two thyroid diseases in different subgroups.Conclusion: Obesity is a risk factor for thyroid disease, especially in the elderly and people with positive thyroid autoantibodies. Obesity and metabolic syndrome may be more associated with thyroid nodules than subclinical hypothyroidism. Smoking may be a protective factor for thyroid disease, while drinking is a protective factor for thyroid nodules.

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“…Because of the occult symptoms, these two thyroid diseases are often ignored by most patients, and the detection of the disease mainly depends on screening in the general population. However, a number of studies have shown that SHO is associated with an increased risk of a variety of cardiovascular diseases [ 3 ] and cognitive impairment [ 4 ] and may develop into dominant hypothyroidism. Additionally, solitary TNs have varying degrees of the risk of progression [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

The association between BMI, smoking, drinking and thyroid disease: a cross-sectional study in Wuhan, China

et al. 2021

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Background There is no clear conclusion on the relationship between thyroid disease and obesity and lifestyle factors such as smoking and drinking. In this study, we analysed the association of body mass index (BMI), smoking and drinking with subclinical hypothyroidism (SHO) and thyroid nodules (TNs) with the results of a cross-sectional survey of urban residents in central China and discussed the potential mechanism linking these predictive factors and the two diseases. Methods This study included 1279 participants who were recruited from a Chinese community in 2011 and 2012. A questionnaire, laboratory examination and ultrasound diagnosis were conducted on these participants. Binary logistic regression analysis was used to analyse these factors. Results Overweight (BMI ≥ 25 kg/m2) was closely related to SHO and TNs in univariate and multivariate logistic regression analyses. Smoking had a protective effect on SHO and TNs, while drinking had a protective effect on TNs in univariate logistic regression and multivariate logistic regression with some covariates, but there was no significant difference between smoking and drinking and the two kinds of thyroid diseases in multivariate logistic regression analysis with all the covariates. In subgroup analysis, BMI ≥ 25 kg/m2 was significantly associated with SHO in people with positive thyroid antibodies (odds ratio (OR) = 2.221, 95 % confidence interval (CI): 1.168–4.184, P = 0.015) and smokers (OR = 2.179, 95 % CI: 1.041–4.561, P = 0.039). BMI ≥ 25 kg/m2 was significantly associated with TNs in people over 60 years old (OR = 2.069, 95 % CI: 1.149–3.724, P = 0.015) and drinkers (OR = 3.065, 95 % CI: 1.413–6.648, P = 0.005). Drinking alcohol had a protective effect on TNs in smokers (OR = 0.456, 95 % CI: 0.240–0.865, P = 0.016) and people with BMI ≥ 25 kg/m2 (OR = 0.467, 95 % CI: 0.236–0.925, P = 0.029). No significant association was found between smoking and the two thyroid diseases in different subgroups. Conclusions Obesity is a risk factor for both TNs and SHO, especially in elderly individuals and people with positive thyroid autoantibodies. Obesity and metabolic syndrome may be more associated with TNs than SHO. Smoking may have a protective effect on thyroid disease, while drinking may have a protective effect only on TNs.

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Impact of Hypothyroidism and Heart Failure on Hospitalization Risk

Abstract: Hypothyroidism is associated with higher hospitalization risk among patients with underlying cardiovascular disease. Future studies are needed to determine whether correction of thyroid status with replacement therapy ameliorates hospitalization risk in this population.

Cited by 17 publications

References 37 publications

Association of Subclinical Hypothyroidism and Cardiovascular Disease With Mortality

Association of Subclinical Hypothyroidism and Cardiovascular Disease With Mortality

The Association between BMI, Smoking, Drinking and Thyroid Disease: A Cross-sectional Study in Wuhan, China

The association between BMI, smoking, drinking and thyroid disease: a cross-sectional study in Wuhan, China

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