Clinical significance of monitoring hypothyroidism in patients with autoimmune rheumatic disease: a retrospective cohort study

Abstract We evaluated whether thyroid function test (TFT) screening is warranted for patients with autoimmune rheumatic diseases (ARD) by comparing the incidence of hypothyroidism requiring treatment (HRT) in ARD patients and healthy controls (HCs). Medical records of 2307 ARD patients and 78,251 HC...

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Autores principales:	Sho Fukui, Yukihiko Ikeda, Yuko Kataoka, Haruyuuki Yanaoka, Hiromichi Tamaki, Tokutarou Tsuda, Mitsumasa Kishimoto, Hiroshi Noto, Sachiko Ohde, Masato Okada
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/d49b4c565beb4637bb091dce2f426160
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spelling	oai:doaj.org-article:d49b4c565beb4637bb091dce2f4261602021-12-02T16:15:07ZClinical significance of monitoring hypothyroidism in patients with autoimmune rheumatic disease: a retrospective cohort study10.1038/s41598-021-93300-x2045-2322https://doaj.org/article/d49b4c565beb4637bb091dce2f4261602021-07-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-93300-xhttps://doaj.org/toc/2045-2322Abstract We evaluated whether thyroid function test (TFT) screening is warranted for patients with autoimmune rheumatic diseases (ARD) by comparing the incidence of hypothyroidism requiring treatment (HRT) in ARD patients and healthy controls (HCs). Medical records of 2307 ARD patients and 78,251 HCs for whom thyroid-stimulating hormone (TSH) levels were measured between 2004 and 2018 were retrospectively reviewed. Cumulative incidence of HRT in ARD patients and HCs was compared. HRT development was evaluated with age- and sex-adjusted Kaplan–Meier curve. Risk factors were identified with Cox proportional hazard models. HRT was significantly more common in ARD patients than in HCs (6.3% vs. 1.9%, P < 0.001). After adjusting for age, sex, and baseline TSH level, hazard ratios for HRT were significantly higher in overall ARD patients (hazard ratio [95% confidence interval] 3.99 [3.27–4.87]; P < 0.001), particularly with rheumatoid arthritis and antinuclear antibody-associated diseases in female, and antinuclear antibody-associated diseases, spondyloarthritis, and vasculitis in male patients. Baseline high TSH level, thyroid-related autoantibody positivity, high IgG, and renal impairment were significant risk factors for hypothyroidism development in ARD patients; 20% of high-risk patients developed HRT during follow-up. HRT was significantly more frequent in ARD patients. Careful TFT screening and follow-up could help detecting clinically important hypothyroidism.Sho FukuiYukihiko IkedaYuko KataokaHaruyuuki YanaokaHiromichi TamakiTokutarou TsudaMitsumasa KishimotoHiroshi NotoSachiko OhdeMasato OkadaNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Sho Fukui Yukihiko Ikeda Yuko Kataoka Haruyuuki Yanaoka Hiromichi Tamaki Tokutarou Tsuda Mitsumasa Kishimoto Hiroshi Noto Sachiko Ohde Masato Okada Clinical significance of monitoring hypothyroidism in patients with autoimmune rheumatic disease: a retrospective cohort study
description	Abstract We evaluated whether thyroid function test (TFT) screening is warranted for patients with autoimmune rheumatic diseases (ARD) by comparing the incidence of hypothyroidism requiring treatment (HRT) in ARD patients and healthy controls (HCs). Medical records of 2307 ARD patients and 78,251 HCs for whom thyroid-stimulating hormone (TSH) levels were measured between 2004 and 2018 were retrospectively reviewed. Cumulative incidence of HRT in ARD patients and HCs was compared. HRT development was evaluated with age- and sex-adjusted Kaplan–Meier curve. Risk factors were identified with Cox proportional hazard models. HRT was significantly more common in ARD patients than in HCs (6.3% vs. 1.9%, P < 0.001). After adjusting for age, sex, and baseline TSH level, hazard ratios for HRT were significantly higher in overall ARD patients (hazard ratio [95% confidence interval] 3.99 [3.27–4.87]; P < 0.001), particularly with rheumatoid arthritis and antinuclear antibody-associated diseases in female, and antinuclear antibody-associated diseases, spondyloarthritis, and vasculitis in male patients. Baseline high TSH level, thyroid-related autoantibody positivity, high IgG, and renal impairment were significant risk factors for hypothyroidism development in ARD patients; 20% of high-risk patients developed HRT during follow-up. HRT was significantly more frequent in ARD patients. Careful TFT screening and follow-up could help detecting clinically important hypothyroidism.
format	article
author	Sho Fukui Yukihiko Ikeda Yuko Kataoka Haruyuuki Yanaoka Hiromichi Tamaki Tokutarou Tsuda Mitsumasa Kishimoto Hiroshi Noto Sachiko Ohde Masato Okada
author_facet	Sho Fukui Yukihiko Ikeda Yuko Kataoka Haruyuuki Yanaoka Hiromichi Tamaki Tokutarou Tsuda Mitsumasa Kishimoto Hiroshi Noto Sachiko Ohde Masato Okada
author_sort	Sho Fukui
title	Clinical significance of monitoring hypothyroidism in patients with autoimmune rheumatic disease: a retrospective cohort study
title_short	Clinical significance of monitoring hypothyroidism in patients with autoimmune rheumatic disease: a retrospective cohort study
title_full	Clinical significance of monitoring hypothyroidism in patients with autoimmune rheumatic disease: a retrospective cohort study
title_fullStr	Clinical significance of monitoring hypothyroidism in patients with autoimmune rheumatic disease: a retrospective cohort study
title_full_unstemmed	Clinical significance of monitoring hypothyroidism in patients with autoimmune rheumatic disease: a retrospective cohort study
title_sort	clinical significance of monitoring hypothyroidism in patients with autoimmune rheumatic disease: a retrospective cohort study
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/d49b4c565beb4637bb091dce2f426160
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Clinical significance of monitoring hypothyroidism in patients with autoimmune rheumatic disease: a retrospective cohort study

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