Patients with Autoimmune Thyroid Diseases Have Higher Prevalence of Positive Antiphospholipid Antibodies: A Systematic Review and Meta-Analysis

Overview

Journal Int J Endocrinol

Publisher Wiley

Specialty Endocrinology

Date 2022 Sep 6

PMID 36065221

Authors

Difei Lu

Zhibo Song

Ying Gao

Junqing Zhang

Xiaohui Guo

Affiliations

Soon will be listed here.

Abstract

Introduction: Autoimmune thyroid diseases (AITDs) and antiphospholipid syndrome (APS) are commonly seen in childbearing-age women and can lead to recurrent miscarriages. Studies with a relatively small sample size were conducted and concluded inconsistent results on the relationship between AITDs and APS or the presence of antiphospholipid (aPL) antibodies. This meta-analysis aimed to provide evidence on the possible association between AITDs and APL using primary data from all relevant studies.

Methods: Literature databases including PubMed, Embase, and Cochrane were searched from the time when the databases were established to March 2022. A total of 7 studies that met all inclusion criteria were selected in this meta-analysis, with 475 AITD patients and 764 healthy controls. After data extraction, the pooled odds ratio (OR) and the 95% confidence interval (95% CI) were calculated.

Results: The risk of positive APL in AITD patients was approximately 3 folds higher in AITD patients compared with those in healthy controls (OR 3.41, 95% CI 2.29-5.08, < 0.001). There was no significant association between the risk of Graves' disease (GD) and positive APL (OR 9.3, 95% CI 0.10-824.73, =0.33). The risk of positive APL in patients with Hashimoto's thyroiditis (HT) increased over 2 folds compared with healthy controls (OR 3.35, 95% CI 1.55-7.23, =0.002).

Conclusions: The result of this meta-analysis proved that the presence of APL was significantly increased in patients with AITD compared with healthy individuals, especially in patients with Hashimoto's thyroiditis.

Citing Articles

Subfertility as Overlapping of Nutritional, Endocrine, Immune, and Cardiometabolic Dysregulations-A Study Focused on Biochemical Endophenotypes of Subfertile Couples.

Wasilewski T, Wasilewska J, Lukaszewicz-Zajac M, Mroczko B J Clin Med. 2023; 12(18).

PMID: 37763034 PMC: 10531916. DOI: 10.3390/jcm12186094.

References

Promberger R, Walch K, Seemann R, Pils S, Ott J . A Retrospective Study on the Association between Thyroid Autoantibodies with β2-glycoprotein and Cardiolipin Antibodies in Recurrent Miscarriage. Iran J Allergy Asthma Immunol. 2017; 16(1):72-76. View

Ando T, Imaizumi M, Graves P, Unger P, Davies T . Intrathyroidal fetal microchimerism in Graves' disease. J Clin Endocrinol Metab. 2002; 87(7):3315-20. DOI: 10.1210/jcem.87.7.8656. View

Luo W, Mao P, Zhang L, Yang Z . Association between systemic lupus erythematosus and thyroid dysfunction: a meta-analysis. Lupus. 2018; 27(13):2120-2128. DOI: 10.1177/0961203318805849. View

Abaci A, Bober E, Yesilkaya E, Bideci A, Cinaz P, Buyukgebiz A . Prevalence of anticardiolipin antibodies in type 1 diabetes and autoimmune thyroiditis. Pol Arch Med Wewn. 2010; 120(3):71-5. View

Poppe K, Glinoer D, Tournaye H, Devroey P, Van Steirteghem A, Kaufman L . Assisted reproduction and thyroid autoimmunity: an unfortunate combination?. J Clin Endocrinol Metab. 2003; 88(9):4149-52. DOI: 10.1210/jc.2003-030268. View

Ganesh B, Bhattacharya P, Gopisetty A, Prabhakar B . Role of cytokines in the pathogenesis and suppression of thyroid autoimmunity. J Interferon Cytokine Res. 2011; 31(10):721-31. PMC: 3189552. DOI: 10.1089/jir.2011.0049. View

Kumar K, Kole A, Karmakar P, Ghosh A . The spectrum of thyroid disorders in systemic lupus erythematosus. Rheumatol Int. 2010; 32(1):73-8. DOI: 10.1007/s00296-010-1556-5. View

Pan X, Gu J, Shan Z . Patients with systemic lupus erythematosus have higher prevalence of thyroid autoantibodies: a systematic review and meta-analysis. PLoS One. 2015; 10(4):e0123291. PMC: 4408090. DOI: 10.1371/journal.pone.0123291. View

Matalon S, Blank M, Levy Y, Carp H, Arad A, Burek L . The pathogenic role of anti-thyroglobulin antibody on pregnancy: evidence from an active immunization model in mice. Hum Reprod. 2003; 18(5):1094-9. DOI: 10.1093/humrep/deg210. View

10.

Tektonidou M, Anapliotou M, Vlachoyiannopoulos P, Moutsopoulos H . Presence of systemic autoimmune disorders in patients with autoimmune thyroid diseases. Ann Rheum Dis. 2004; 63(9):1159-61. PMC: 1755126. DOI: 10.1136/ard.2004.022624. View

11.

van den Boogaard E, Vissenberg R, Land J, van Wely M, van der Post J, Goddijn M . Significance of (sub)clinical thyroid dysfunction and thyroid autoimmunity before conception and in early pregnancy: a systematic review. Hum Reprod Update. 2011; 17(5):605-19. DOI: 10.1093/humupd/dmr024. View

12.

Ferrari S, Elia G, Virili C, Centanni M, Antonelli A, Fallahi P . Systemic Lupus Erythematosus and Thyroid Autoimmunity. Front Endocrinol (Lausanne). 2017; 8:138. PMC: 5474463. DOI: 10.3389/fendo.2017.00138. View

13.

Mavragani C, Danielides S, Zintzaras E, Vlachoyiannopoulos P, Moutsopoulos H . Antithyroid antibodies in antiphospholipid syndrome: prevalence and clinical associations. Lupus. 2009; 18(12):1096-9. DOI: 10.1177/0961203309106763. View

14.

Roberts J, Jenkins C, Wilson R, Pearson C, Franklin I, MacLean M . Recurrent miscarriage is associated with increased numbers of CD5/20 positive lymphocytes and an increased incidence of thyroid antibodies. Eur J Endocrinol. 1996; 134(1):84-6. DOI: 10.1530/eje.0.1340084. View

15.

Mecacci F, Parretti E, Cioni R, Lucchetti R, Magrini A, LA TORRE P . Thyroid autoimmunity and its association with non-organ-specific antibodies and subclinical alterations of thyroid function in women with a history of pregnancy loss or preeclampsia. J Reprod Immunol. 2000; 46(1):39-50. DOI: 10.1016/s0165-0378(99)00055-8. View

16.

Kim N, Cho H, Kim H, Yang K, Ahn H, Thornton S . Thyroid autoimmunity and its association with cellular and humoral immunity in women with reproductive failures. Am J Reprod Immunol. 2010; 65(1):78-87. DOI: 10.1111/j.1600-0897.2010.00911.x. View

17.

Marongiu F, Conti M, Murtas M, Sorano G, Mameli G, Salis G . Anticardiolipin antibodies in Grave's disease: relationship with thrombin activity in vivo. Thromb Res. 1991; 64(6):745-9. DOI: 10.1016/0049-3848(91)90074-7. View

18.

Lee C, Chen S, Yang Y, Hsu C, Shen Y . Association between Graves' disease and risk of incident systemic lupus erythematosus: A nationwide population-based cohort study. Int J Rheum Dis. 2020; 24(2):240-245. DOI: 10.1111/1756-185X.14027. View

19.

Kawashima A, Tanigawa K, Akama T, Yoshihara A, Ishii N, Suzuki K . Innate immune activation and thyroid autoimmunity. J Clin Endocrinol Metab. 2011; 96(12):3661-71. DOI: 10.1210/jc.2011-1568. View

20.

Antonelli A, Fallahi P, Mosca M, Ferrari S, Ruffilli I, Corti A . Prevalence of thyroid dysfunctions in systemic lupus erythematosus. Metabolism. 2009; 59(6):896-900. DOI: 10.1016/j.metabol.2009.10.010. View