The Relation Between Thyroid Function and Anemia: A Pooled Analysis of Individual Participant Data.
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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, Luben Robert N, Molinaro Sabrina, Nauck Matthias, Patel Kushang V, Peeters Robin P, Psaty Bruce M, Razvi Salman, Schindhelm Roger K, van Schoor Natasja M, Stott David J, Vaes Bert, Vanderpump Mark P J, Völzke Henry, Westendorp Rudi G J, Rodondi Nicolas, Cobbaert Christa M, Gussekloo Jacobijn, den Elzen Wendy P J, Thyroid Studies Collaboration
Аннотация
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 OR 1.84 (95% CI 1.35 to 2.50), subclinical hypothyroidism 1.21 (1.02 to 1.43), subclinical hyperthyroidism 1.27 (1.03 to 1.57), and overt hyperthyroidism 1.69 (1.00 to 2.87)]. Hemoglobin levels were lower in all groups compared with 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 to 2.20) for overt hypothyroidism, 1.18 (1.00 to 1.38) for subclinical hypothyroidism, 1.15 (0.94 to 1.42) for subclinical hyperthyroidism, and 1.47 (0.91 to 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 participants with both 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.