TY - JOUR
T1 - The Relation Between Thyroid Function and Anemia
T2 - A Pooled Analysis of Individual Participant Data
AU - Wopereis, Daisy M
AU - Du Puy, Robert S
AU - van Heemst, Diana
AU - Walsh, John P
AU - Bremner, Alexandra
AU - Bakker, Stephan J L
AU - Bauer, Douglas C
AU - Cappola, Anne R
AU - Ceresini, Graziano
AU - Degryse, Jean
AU - Dullaart, Robin P F
AU - Feller, Martin
AU - Ferrucci, Luigi
AU - Floriani, Carmen
AU - Franco, Oscar H
AU - Iacoviello, Massimo
AU - Iervasi, Georgio
AU - Imaizumi, Misa
AU - Jukema, J Wouter
AU - Khaw, Kay-Tee
AU - Luben, Robert N
AU - Molinaro, Sabrina
AU - Nauck, Matthias
AU - Patel, Kushang V
AU - Peeters, Robin P
AU - Psaty, Bruce M
AU - Razvi, Salman
AU - Schindhelm, Roger K
AU - van Schoor, Natasja M
AU - Stott, David J
AU - Vaes, Bert
AU - Vanderpump, Mark P J
AU - Völzke, Henry
AU - Westendorp, Rudi G J
AU - Rodondi, Nicolas
AU - Cobbaert, Christa M
AU - Gussekloo, Jacobijn
AU - den Elzen, Wendy P J
AU - Thyroid Studies Collaboration
PY - 2018/10/1
Y1 - 2018/10/1
N2 - 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.
AB - 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.
U2 - 10.1210/jc.2018-00481
DO - 10.1210/jc.2018-00481
M3 - Journal article
C2 - 30113667
SN - 0021-972X
VL - 103
SP - 3658
EP - 3667
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 10
ER -
