Hashimoto's Thyroiditis Increases the Risk of New-onset Systemic Lupus Erythematosus: a Nationwide Population-based Cohort Study

Overview

Journal Arthritis Res Ther

Publisher Biomed Central

Specialty Rheumatology

Date 2023 Feb 10

PMID 36759862

Authors

Hong-Ci Lin

Hsu-Min Chang

Yao-Min Hung

Renin Chang

Hsin-Hua Chen

James Cheng-Chung Wei

Affiliations

Soon will be listed here.

Abstract

Background: Previous studies have shown systemic lupus erythematosus (SLE) patients had a significantly higher prevalence of thyroid diseases and hypothyroidism than matched controls, and some case reports showed SLE may occur after Hashimoto's thyroiditis (HT).

Objective: This study aimed to investigate the subsequent risk of SLE in patients with HT.

Methods: In this retrospective cohort study done by the Taiwan National Health Insurance Research Database, the HT group (exposure group) and the non-HT group (comparator group) were propensity score matched at a ratio of 1:2 by demographic data, comorbidities, medications, and the index date. We used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Several sensitivity analyses were done for cross-validation of our findings.

Results: We identified 15,512 HT patients and matched 31,024 individuals. The incidence rate ratio of SLE was 3.58 (95% CI, 2.43-5.28; p < 0.01). Several sensitivity analyses show adjusted hazard ratio (aHR) (CIs) of 4.35 (3.28-5.76), 4.39 (3.31-5.82), 5.11 (3.75-6.98), and 4.70 (3.46-6.38), consistent with the results of the main model.

Conclusion: Our study showed an increased risk of SLE in the HT group after adjustment for baseline characteristics, comorbidities, and medical confounders compared with the reference group.

Citing Articles

Thyroid disorders and gastrointestinal dysmotility: an old association.

Xu G, Hu M, Li S, Ran X, Zhang H, Ding X Front Physiol. 2024; 15:1389113.

PMID: 38803365 PMC: 11129086. DOI: 10.3389/fphys.2024.1389113.

Relationship between autoimmune thyroid antibodies and anti-nuclear antibodies in general patients.

Ruan Y, Heng X, Yang L, He W, Li L, Wang Z Front Endocrinol (Lausanne). 2024; 15:1368088.

PMID: 38590826 PMC: 10999576. DOI: 10.3389/fendo.2024.1368088.

Efficacy and safety of in the treatment of Hashimoto's thyroiditis: a systematic review and meta-analysis.

Wei M, Ma W, Zhang W, Yin D, Tang Y, Jia W Front Pharmacol. 2023; 14:1272124.

PMID: 37854714 PMC: 10579621. DOI: 10.3389/fphar.2023.1272124.

References

Fava A, Petri M . Systemic lupus erythematosus: Diagnosis and clinical management. J Autoimmun. 2018; 96:1-13. PMC: 6310637. DOI: 10.1016/j.jaut.2018.11.001. View

Hannah J, DCruz D . Pulmonary Complications of Systemic Lupus Erythematosus. Semin Respir Crit Care Med. 2019; 40(2):227-234. DOI: 10.1055/s-0039-1685537. View

Li W, Deng C, Yang H, Wang G . The Regulatory T Cell in Active Systemic Lupus Erythematosus Patients: A Systemic Review and Meta-Analysis. Front Immunol. 2019; 10:159. PMC: 6387904. DOI: 10.3389/fimmu.2019.00159. View

Bijl M, Kallenberg C . Ultraviolet light and cutaneous lupus. Lupus. 2006; 15(11):724-7. DOI: 10.1177/0961203306071705. View

Wichainun R, Kasitanon N, Wangkaew S, Hongsongkiat S, Sukitawut W, Louthrenoo W . Sensitivity and specificity of ANA and anti-dsDNA in the diagnosis of systemic lupus erythematosus: a comparison using control sera obtained from healthy individuals and patients with multiple medical problems. Asian Pac J Allergy Immunol. 2014; 31(4):292-8. DOI: 10.12932/AP0272.31.4.2013. View

Scheinecker C, Bonelli M, Smolen J . Pathogenetic aspects of systemic lupus erythematosus with an emphasis on regulatory T cells. J Autoimmun. 2010; 35(3):269-75. DOI: 10.1016/j.jaut.2010.06.018. View

Miossec P, Kolls J . Targeting IL-17 and TH17 cells in chronic inflammation. Nat Rev Drug Discov. 2012; 11(10):763-76. DOI: 10.1038/nrd3794. View

Samnaliev M, Barut V, Weir S, Langham J, Langham S, Wang X . Health-care utilization and costs in adults with systemic lupus erythematosus in the United Kingdom: a real-world observational retrospective cohort analysis. Rheumatol Adv Pract. 2021; 5(3):rkab071. PMC: 8493101. DOI: 10.1093/rap/rkab071. View

Thornton Hampton L, Finch M, Martyniuk C, Venables B, Sellin Jeffries M . Developmental thyroid disruption causes long-term impacts on immune cell function and transcriptional responses to pathogen in a small fish model. Sci Rep. 2021; 11(1):14496. PMC: 8280131. DOI: 10.1038/s41598-021-93929-8. View

10.

Tu T, Yeh C, Hung Y, Chang R, Chen H, Cheng-Chung Wei J . Association Between a History of Nontyphoidal and the Risk of Systemic Lupus Erythematosus: A Population-Based, Case-Control Study. Front Immunol. 2021; 12:725996. PMC: 8650632. DOI: 10.3389/fimmu.2021.725996. View

11.

Dhir R, Ahluwalia A, Sridhar J, Mani H, Pruthi H, Shah K . Autoimmune thyroiditis perdating the presentation of systemic lupus erythematosus: two cases and a review of literature. Indian J Dermatol Venereol Leprol. 2007; 68(5):292-4. View

12.

Chung W, Kung P, Chang H, Tsai W . Demographics and medical disorders associated with smoking: a population-based study. BMC Public Health. 2020; 20(1):702. PMC: 7227312. DOI: 10.1186/s12889-020-08858-4. View

13.

Deapen D, Escalante A, Weinrib L, HORWITZ D, Bachman B, Roy-Burman P . A revised estimate of twin concordance in systemic lupus erythematosus. Arthritis Rheum. 1992; 35(3):311-8. DOI: 10.1002/art.1780350310. View

14.

Fiducia M, Lauretta R, Lunghi R, Kyanvash S, Pallotti S . [Hashimoto's thyroiditis and autoimmunity parameters: descriptive study]. Minerva Med. 2007; 98(2):95-9. View

15.

Rubingh J, van der Spek A, Fliers E, Boelen A . The Role of Thyroid Hormone in the Innate and Adaptive Immune Response during Infection. Compr Physiol. 2020; 10(4):1277-1287. DOI: 10.1002/cphy.c200003. View

16.

Yurasov S, Wardemann H, Hammersen J, Tsuiji M, Meffre E, Pascual V . Defective B cell tolerance checkpoints in systemic lupus erythematosus. J Exp Med. 2005; 201(5):703-11. PMC: 2212839. DOI: 10.1084/jem.20042251. View

17.

Robinson M, Obut T, Melnikova E, Trufakin V . Parameters of cellular and humoral immunity in experimental hyperthyroidism and its correction. Bull Exp Biol Med. 2014; 156(4):473-5. DOI: 10.1007/s10517-014-2377-4. View

18.

Gravano D, Hoyer K . Promotion and prevention of autoimmune disease by CD8+ T cells. J Autoimmun. 2013; 45:68-79. DOI: 10.1016/j.jaut.2013.06.004. View

19.

Zandman-Goddard G, Shoenfeld Y . Infections and SLE. Autoimmunity. 2005; 38(7):473-85. DOI: 10.1080/08916930500285352. View

20.

Robinson M, Obut T, Melnikova E, Trufakin V . Effects of thyroxin and mercazolyl on immunological parameters of blood lymphocytes and lymphoid organs. Bull Exp Biol Med. 2013; 156(2):236-8. DOI: 10.1007/s10517-013-2319-6. View