The relation between thyroid function and anemia: a pooled analysis of individual participant data.

Wopereis, Daisy M; Du Puy, Robert S; van Heemst, Diana; Walsh, John P; Bremner, Alexandra; Bakker, Stephan J L; Bauer, Douglas C; Cappola, Anne R; Ceresini, Graziano; Degryse, Jean; Dullaart, Robin P F; Feller, Martin; Ferrucci, Luigi; Floriani, Carmen; Franco, Oscar H; Iacoviello, Massimo; Iervasi, Georgio; Imaizumi, Misa; Jukema, J Wouter; Khaw, Kay-Tee; ... (2018). The relation between thyroid function and anemia: a pooled analysis of individual participant data. Journal of clinical endocrinology and metabolism, 103(10), pp. 3658-3667. Endocrine Society 10.1210/jc.2018-00481

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Context Anemia and thyroid dysfunction often co-occur and both increase with age. Human data on the relationship 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 odds ratio 1.84 [95% CI: 1.35-2.50], subclinical hypothyroidism 1.21 [1.02-1.43], subclinical hyperthyroidism 1.27 [1.03-1.57], overt hyperthyroidism 1.69 [1.00-2.87]). Hemoglobin levels were lower in all groups compared to 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: 0.86-2.20] for overt hypothyroidism, 1.18 [1.00-1.38] for subclinical hypothyroidism, 1.15 [0.94-1.42] for subclinical hyperthyroidism and 1.47 [0.91-2.38] 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 both participants with 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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine
04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine

UniBE Contributor:

Feller, Martin; Floriani, Carmen and Rodondi, Nicolas

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0021-972X

Publisher:

Endocrine Society

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

18 Sep 2018 11:14

Last Modified:

24 Oct 2019 07:14

Publisher DOI:

10.1210/jc.2018-00481

PubMed ID:

30113667

BORIS DOI:

10.7892/boris.119991

URI:

https://boris.unibe.ch/id/eprint/119991

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