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

TitleThe relation between thyroid function and anemia: a pooled analysis of individual participant data.
Publication TypeJournal Article
Year of Publication2018
AuthorsWopereis, DM, Puy, RSDu, van Heemst, D, Walsh, JP, Bremner, A, Bakker, SJL, Bauer, DC, Cappola, AR, Ceresini, G, Degryse, J, Dullaart, RPF, Feller, M, Ferrucci, L, Floriani, C, Franco, OH, Iacoviello, M, Iervasi, G, Imaizumi, M, J Jukema, W, Khaw, K-T, Luben, RN, Molinaro, S, Nauck, M, Patel, KV, Peeters, RP, Psaty, BM, Razvi, S, Schindhelm, RK, van Schoor, NM, Stott, DJ, Vaes, B, Vanderpump, MPJ, Völzke, H, Westendorp, RGJ, Rodondi, N, Cobbaert, CM, Gussekloo, J, Elzen, WPJ den
Corporate/Institutional AuthorsThyroid Studies Collaboration,
JournalJ Clin Endocrinol Metab
Date Published2018 Aug 02
ISSN1945-7197
Abstract<p><b>Context: </b>Anemia and thyroid dysfunction often co-occur and both increase with age. Human data on the relationship between thyroid disease and anemia are scarce.</p><p><b>Objective: </b>To investigate the cross-sectional and longitudinal associations between clinical thyroid status and anemia.</p><p><b>Design: </b>Individual participant data meta-analysis.</p><p><b>Setting: </b>Sixteen cohorts participating in the Thyroid Studies Collaboration (n=42 162).</p><p><b>Main outcome measures: </b>Primary outcome measure was anemia (hemoglobin <130 g/L in men and <120 g/L in women).</p><p><b>Results: </b>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.</p><p><b>Conclusion: </b>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.</p>
DOI10.1210/jc.2018-00481
Alternate JournalJ. Clin. Endocrinol. Metab.
PubMed ID30113667
ePub date: 
18/08