@article {7817, title = {The relation between thyroid function and anemia: a pooled analysis of individual participant data.}, journal = {J Clin Endocrinol Metab}, year = {2018}, month = {2018 Aug 02}, abstract = {

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.

}, issn = {1945-7197}, doi = {10.1210/jc.2018-00481}, author = {Wopereis, Daisy M and Du Puy, Robert S and van Heemst, Diana and Walsh, John P and Bremner, Alexandra and Bakker, Stephan J L and Bauer, Douglas C and Cappola, Anne R and Ceresini, Graziano and Degryse, Jean and Dullaart, Robin P F and Feller, Martin and Ferrucci, Luigi and Floriani, Carmen and Franco, Oscar H and Iacoviello, Massimo and Iervasi, Georgio and Imaizumi, Misa and Jukema, J Wouter and Khaw, Kay-Tee and Luben, Robert N and Molinaro, Sabrina and Nauck, Matthias and Patel, Kushang V and Peeters, Robin P and Psaty, Bruce M and Razvi, Salman and Schindhelm, Roger K and van Schoor, Natasja M and Stott, David J and Vaes, Bert and Vanderpump, Mark P J and V{\"o}lzke, Henry and Westendorp, Rudi G J and Rodondi, Nicolas and Cobbaert, Christa M and Gussekloo, Jacobijn and den Elzen, Wendy P J} }