The Association Between Thyroid Diseases and Alzheimer’s Disease in a National Health Screening Cohort in Korea

Abstract

ObjectivesThyroid dysfunction is linked to an increased risk of cognitive impairment. However, studies on the relationships between thyroid diseases and Alzheimer’s disease (AD) have reported conflicting results. We investigated the associations between several thyroid diseases and AD in a nested case-control study.MethodsA total of 1,977 participants with AD were identified by claims data from 2002-2015 among a random sample of half a million people in the Korean National Health Insurance database. We recruited 16,473 age- and sex-matched (1:4 ratio) control participants and applied conditional logistic regression to estimate the relationships between thyroid diseases and AD, with adjustments for potential confounders, such as basic demographics, lifestyle factors, and various medical conditions or comorbidities.ResultsThe prevalence rates of hypothyroidism (odds ratio [OR]=1.14, 95% confidence interval [CI]=1.00-1.30), thyroiditis (OR=1.22, 95% CI=1.05-1.40), and hyperthyroidism (OR=1.13, 95% CI=1.01-1.28) were significantly higher in participants with AD than in control participants after adjustment for confounders.ConclusionIn this large national sample, we found significant relationships between several thyroid diseases and AD. Despite of the need for further investigation, these findings could better support to appreciate the pathophysiology of AD.

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“…Additionally, two downregulated genes such as TTR and LTF in AD were predicted to be involved in thyroid hormone synthesis, amyloid fiber formation, diseases associated with visual transduction, neutrophil degranulation, and canonical retinoid cycle in rods (Twilight Vision) pathways. The downregulation of these two genes may lead to the cognitive impairment, amyloid-beta accumulation and retinal dysfunction and visual impairments due to the disruption in thyroid hormone signaling [45], [46], [47].…”

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