scholarly journals Thyroid Dysfunction in Patients with Metabolic Syndrome: A Cross-Sectional, Epidemiological, Pan-India Study

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Vaishali Deshmukh ◽  
Faraz Farishta ◽  
Milind Bhole
Keyword(s):  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Subclinical Hypothyroidism ◽  
Thyroid Dysfunction ◽  
Overt Hypothyroidism ◽  
Subclinical Hyperthyroidism ◽  
Cross Sectional ◽  
Fasting Plasma ◽  
Indian Patients ◽  
Overt Hyperthyroidism

Background. This study was conducted to assess the prevalence and clinical and epidemiological factors of thyroid dysfunction (TD) in Indian patients diagnosed with metabolic syndrome (MetS). Methods. In this cross-sectional study, 432 adults with an established diagnosis of MetS were enrolled across ten centers in India. Anthropometric measurements and vital signs were noted. Blood samples were tested for hemogram, coagulogram, lipid profile, and thyroid function. Fasting plasma glucose (FPG) and fasting plasma insulin were used for the calculation of homeostasis model assessment-estimated insulin resistance (HOMA-IR). Overt hypothyroidism was defined as thyroid-stimulating hormone TSH>4.50 μIU/mL with free thyroxine FT4<0.8 ng/dL and free triiodothyronine FT3<1.4 pg/mL; subclinical hypothyroidism as TSH>4.50 μIU/mL with FT4=0.8-1.8 ng/dL and FT3=1.4-4.4 pg/mL; overt hyperthyroidism as TSH<0.45 μIU/mL with FT4>1.8 ng/dL and FT3>4.4 pg/mL; and subclinical hyperthyroidism as TSH<0.45 μIU/mL with FT4=0.8-1.8 ng/dL and FT3=1.4-4.4 pg/mL. Results. About 121 out of 432 patients (28%) were diagnosed with TD (mean age±SD: 47.9±10.96 years), with women predominance (75% versus 25%). Most patients were in the >45 years of age group (men: 63%; women: 59%). TD was associated with high waist circumference (99.17%), reduced high-density lipoprotein-C (87.60%), raised HOMA-IR (86.78%), systolic blood pressure (77.69%), diastolic blood pressure (59.50%), fasting glucose (58.68%), and triglycerides (33.06%). Overt hypothyroidism was reported in 17.59% (N=76) of patients. Subclinical hypothyroidism, overt hypothyroidism, and subclinical hyperthyroidism were reported in 8.10%, 1.60%, and 0.70% patients with newly occurred TD, respectively. No case of overt hyperthyroidism was present in these patients. Conclusion. Hypothyroidism was the most common TD in Indian patients with MetS. A large proportion of TD cases diagnosed during the study highlight the need for vigilant thyroid screening in patients with MetS in a real-life setting.

scholarly journals The Relationship Between Thyroid Function and Metabolic Syndrome and Its Components: A Cross-Sectional Study in a Chinese Population

2021 ◽  
Vol 12 ◽  
Author(s):  
Jiaji He ◽  
Yaxin Lai ◽  
Jing Yang ◽  
Yongli Yao ◽  
Yongze Li ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Waist Circumference ◽  
Thyroid Function ◽  
Subclinical Hypothyroidism ◽  
Chinese Population ◽  
Overt Hypothyroidism ◽  
Iodine Nutrition ◽  
Cross Sectional ◽  
The Relationship ◽  
Overt Hyperthyroidism

ObjectiveThe present study examined the relationship between thyroid function status and the prevalence of metabolic syndrome in a Chinese population.MethodsCross-sectional data were obtained from the Thyroid Disease, Iodine Nutrition and Diabetes Epidemiology (TIDE) Survey. A total of 62,408 subjects aged ≥18 years were enrolled. Differences in metabolic indicators and the prevalence of metabolic syndrome according to sex and thyroid function status were compared. Logistic regression was used to analyze the influence of thyroid function on metabolic syndrome and its components.ResultsThe prevalence of metabolic syndrome was generally higher in men than women. Overt hyperthyroidism and subclinical hypothyroidism had a significant effect on metabolism in men. Body mass index (BMI), waist circumference, and triglycerides (TGs) were significantly lower in men in the overt hyperthyroidism group, and BMI, waist circumference, systolic blood pressure (SBP) and TGs were higher in men in the subclinical hypothyroidism group than men in the normal group. Overt and subclinical hypothyroidism had significant impacts on metabolic components in women. BMI, waist circumference, TGs, SBP and DBP in the subclinical and overt hypothyroidism groups were significantly higher than the euthyroid group in women. The relative risk of abdominal obesity and hypertriglyceridemia was increased in women with hypothyroidism. Thyroid dysfunction had different effects on metabolic syndrome and its components before and after menopause.ConclusionThyroid function had important effects on the prevalence of metabolic syndrome. Women with hypothyroidism, especially post-menopausal women, had a higher risk of metabolic syndrome than men.

scholarly journals Thyroid dysfunction in patients of metabolic syndrome: A study from a tertiary care center in India

2021 ◽  
Vol 12 (10) ◽  
pp. 47-50
Author(s):  
Ritu Gupta ◽  
Akhil K Vijayan ◽  
Sushma Choudhary
Keyword(s):  
Metabolic Syndrome ◽  
Thyroid Dysfunction ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Thyroid Stimulating Hormone ◽  
P Value ◽  
Overt Hypothyroidism ◽  
Free T4 ◽  
Cross Sectional

Background: Metabolic syndrome is characterized by hypertension, dyslipidemia, central obesity, glucose intolerance, insulin resistance. Thyroid hormone acts as general pacemaker, accelerating metabolic process and may be associated with metabolic syndrome. There is no information available in literature regarding the prevalence and association of thyroid dysfunction in metabolic syndrome in this central region of the country. Aims and Objective: To estimate the prevalence of thyroid dysfunction in patients of metabolic syndrome. Materials and Methods: It is a duration based prospective cross sectional study including 200 patients of metabolic syndrome. A detailed history, clinical examination and relevant investigations including serum Free T4 (FT4), Free T3 (FT3), Thyroid Stimulating Hormone (TSH) were done. Range, frequencies, percentage, mean, standard deviation and P value were calculated. P value of < 0.05 was taken as significant. Results: Prevalence of thyroid dysfunction in metabolic syndrome patients was 28.5%. Prevalence of subclinical and overt hypothyroidism was 18.5% and 8.5% respectively. In patients with both metabolic syndrome and thyroid dysfunction, most common components associated are diabetes mellitus and hypertriglyceridemia. Conclusion: Thyroid dysfunction is significantly common in metabolic syndrome patients. It should be aggressively detected and treated in these patients for better outcome.

scholarly journals Prevalence of subclinical hypothyroidism in metabolic syndrome: our experience from Karnataka

2021 ◽  
Author(s):  
Praveen R. Badri ◽  
Tanveer Ahmed ◽  
Anant Arunrao Takalkar
Keyword(s):  
Metabolic Syndrome ◽  
Subclinical Hypothyroidism ◽  
General Medicine ◽  
Female Gender ◽  
Iodine Intake ◽  
Overt Hypothyroidism ◽  
Age Group ◽  
Cross Sectional ◽  
Medical College ◽  
And Gender

Background: Metabolic syndrome is a collection of factors which can increase the risk of heart disease, stroke and diabetes. Subclinical hypothyroidism is a state of mild thyroid failure. There are few factors which increase the risk for developing subclinical hypothyroidism such as female gender, advanced age and greater dietary iodine intake. Subclinical hypothyroidism as it is more common than overt hypothyroidism. Objectives were to study prevalence of subclinical hypothyroidism in patients of metabolic syndrome and its association with demographic and clinical parameters.Methods: This cross-sectional observational study was conducted on patients attending General Medicine OPD and in-patients admitted at Navodaya Medical College and Hospital, Raichur including 103 cases of metabolic syndrome. The data was analyzed using statistical package for the social sciences (SPSS) 24.0 version.Results: Prevalence of subclinical hypothyroidism in our study was 30.1%. Majority were from 41-50 years age group i.e., 9 (29%) and majority were females i.e., 17 (54.8%). We did not find any association between Subclinical hypothyroidism and gender (p>0.05). Prevalence of overweight in our study among SCH was 35.5% compared to 18.1% of normal patients. Elevated levels of TG were observed in 64 i.e., 62.1%, elevated TC 23.3%, elevated levels of LDL in 30.1% patients.Conclusions: Prevalence of subclinical hypothyroidism in our study was 30.1%. Majority were from 41-50 years age group i.e., 29% and majority were females i.e., 17 (54.8%). We did not find any association between subclinical hypothyroidism and body mass index (BMI) in our study.

scholarly journals Prevalence of Metabolic Syndrome in Patients with Subclinical and Overt Hypothyroidism Visiting Tertiary Care Centre of Western Nepal

2020 ◽  
Vol 8 (1) ◽  
pp. 33-37
Author(s):  
Amit Chandra Jha ◽  
Kedar Nath Koirala ◽  
Archana Jayan ◽  
Narayan Gautam ◽  
Raju Kumar Dubey ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Subclinical Hypothyroidism ◽  
Tertiary Care ◽  
Colorimetric Method ◽  
Hormone Deficiency ◽  
Overt Hypothyroidism ◽  
Atherosclerotic Cardiovascular Disease ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Increased Risk

INTRODUCTION: Hypothyroidism is a syndrome resulting from thyroid hormone deficiency. Metabolic syndrome (MetS) is a cluster of metabolic abnormalities is associated with increased risk for atherosclerotic cardiovascular disease (CVS) and type 2 diabetes mellitus. Thyroid hormones are major regulatory hormones that control the rate of metabolic function; thus, alteration in the levels of these hormones may be associated with MetS. The objective of our study was to find out the prevalence of MetS in subclinical and overt hypothyroidism. MATERIAL AND METHODS: A hospital-based cross sectional study was conducted at Universal College of Medical Sciences Teaching Hospital (UCMS-TH) Bhairahawa from March to September 2019. A total of 222 hypothyroid patients were enrolled in this study. MetS was diagnosed by National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III; 2005) revision criteria. The anthropometric indices were recorded. fT3, fT4  and TSH were measured by chemiluminescence immunoassay (CLIA) method and other biochemical parameters were estimated by colorimetric method. Data were analyzed by using SPSS 16.0. RESULTS: Patients were aged between 10 and 60 years, with a mean age of 38.89 years. The prevalence of MetS was 44.1% of which 80.6% were females. Furthermore, the prevalence of MetS was found to be 43.7% in subclinical hypothyroidism and 46.6% in overt hypothyroidism. CONCLUSION: The prevalence of MetS is high in both overt and subclinical hypothyroidism. Screening for MetS in patients with hypothyroidism can reduce the risk for CVD, as well as the mortality rate and mortality associated with it.

scholarly journals Metabolic Syndrome in Hypothyroid Patients

2015 ◽  
Vol 7 (2) ◽  
pp. 57-61
Author(s):  
R Haque ◽  
S Ferdousi ◽  
SS Ferdousi ◽  
W Rahman ◽  
MN Uddin ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Hdl Cholesterol ◽  
Overt Hypothyroidism ◽  
Serum Triglycerides ◽  
Fasting Plasma ◽  
Significant Difference ◽  
Hypothyroid Patients

Thyroid functions affect metabolic syndrome (MetS) parameters including blood pressure, fasting plasma glucose, serum triglycerides and HDL-Cholesterol. But the relationship between MetS and thyroid functions is yet to be identified clearly. Metabolic syndrome is a state in which most features of hypothyroidism can be seen. The aim of the present study was to investigate the frequency of MetS in hypothyroid patients. Thirty one patients with overt hypothyroidism, 32 patients with subclinical hypothyroidism (SCH) and 58 euthyroid controls were enrolled in this study. NCEP-ATP III criteria was used to diagnose metabolic syndrome. Majority of the participants were in the age group of 30-40 years. Body mass index and waist circumference, blood pressure, fasting plasma glucose and serum triglycerides were found to be higher in hypothyroid patients compared to that of euthyroid controls (p<0.001). On the other hand serum HDL-C was found to be significantly lower in hypothyroid patients compared to that of euthyroid controls (p<0.001). Prevalence of MetS was 82.5% in the hypothyroid group and 27.6% in eythyroid controls (p<0.001). No significant difference was found between SCH (81.3%) and overt hypothyroid (86.7%) groups in respect to prevalence of MetS (p<0.05). The findings of the study suggest a need to investigate the presence of hypothyroidism during the management of MetS patients. DOI: http://dx.doi.org/10.3329/bjmb.v7i2.22414 Bangladesh J Med Biochem 2014; 7(2): 57-61

scholarly journals Isfahan Thyroid Cohort Study (ITCS)

2021 ◽  
Vol 24 (11) ◽  
pp. 788-795
Author(s):  
Samaneh Shahrokh Esfahani ◽  
Aliye Tabatabaee ◽  
Ashraf Aminorroaya ◽  
Masoud Amini ◽  
Awat Feizi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Subclinical Hypothyroidism ◽  
Epidemiological Studies ◽  
Overt Hypothyroidism ◽  
Cluster Sampling ◽  
Thyroid Peroxidase ◽  
Second Phase ◽  
Thyroid Disorders ◽  
Subclinical Hyperthyroidism ◽  
Overt Hyperthyroidism

Background: The Isfahan Thyroid Cohort Study (ITCS) is one of the few population-based epidemiological studies in Iran that investigates the prevalence and incidence of thyroid disorders including hypothyroidism, hyperthyroidism, goiter, nodule, and iodine status. Methods: This cohort is located in Isfahan, Iran. The first phase was initiated in 2006 with 2523 participants (1275 males, 1248 females). The participants were selected using multi-stage cluster sampling from the general residents of Isfahan, Iran. The study had two phases (2006 and 2011) and its third stage is planned for 2020–2021. Results: The prevalence of thyroid function states was euthyroid (89.3%, 95% CI: 88%–90%), overt hypothyroidism (2.8%, 95% CI: 2%‒3%), subclinical hypothyroidism (5.8%, 95% CI: 4%–6%), overt hyperthyroidism (0.8%, 95% CI: 0.4%‒1%), and subclinical hyperthyroidism (0.99%, 95% CI: 0.6%–1%). Hypothyroidism and hyperthyroidism were significantly associated with goiter. The incidence of thyroid dysfunction was reported as follows: overt hypothyroidism (2.7, 95% CI: 1.6–3.7), subclinical hypothyroidism (20.6, 95% CI: 18–23), overt hyperthyroidism (1.9, 95% CI: 1–2.7) and subclinical hyperthyroidism (2.7, 95% CI: 1.6–3.7) per 1000 (person-year). Conclusion: We assessed the prevalence and incidence of thyroid disorders in Isfahan in the first and second phase, respectively. We are conducting the third phase of the ITCS in order to study the associations between thyroid peroxidase antibody (TPOAb) level and environmental factors such as infection.

THE ASSOCIATION BETWEEN BODY MASS INDEX AND SUBCLINICAL THYROID DYSFUNCTION IN DIFFERENT SEXES OF CHINESE

2019 ◽  
Vol 25 (11) ◽  
pp. 1166-1175
Author(s):  
Zhengzhou Pan ◽  
Chao Huang ◽  
Zhaowei Meng ◽  
Wenjuan Zhang ◽  
Yongle Li ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
Body Mass ◽  
Subclinical Hypothyroidism ◽  
Odds Ratio ◽  
Thyroid Dysfunction ◽  
Density Lipoprotein ◽  
Continuous Variable ◽  
Health Examination ◽  
Subclinical Hyperthyroidism

Objective: To study subclinical thyroid dysfunction (SCTD)—subclinical hyperthyroidism and subclinical hypothyroidism—in Chinese patients in relation to body mass index (BMI) and to determine whether a difference between sexes exists. Methods: This cross-sectional study recruited 13,503 healthy participants (8,345 male, 5,158 female) who participated in a health examination. Clinical data, including anthropometric measurements and serum parameters, were collected. The association between SCTD and the BMI of each sex was analyzed separately by stratifying the data by SCTD type and regarding BMI as a categorical or as a continuous variable in different models. The odds ratio of SCTD was calculated from binary logistic regression models. Results: The prevalence of both subclinical hyperthyroidism and subclinical hypothyroidism was significantly lower in males compared to females. For subclinical hypothyroidism, we found no significant association with BMI in females. In males, there was a significant negative relationship between BMI and subclinical hypothyroidism. For subclinical hyperthyroidism, we did not find any significant relationship with BMI in either sex after stratifying the data and treating BMI as a categorical or as a continuous variable. Conclusion: For subclinical hyperthyroidism, no significant effect was found in either sex. For subclinical hypothyroidism, high BMI was associated with lower rates of subclinical hypothyroidism in males, and no significant correlation was found in females. The mechanism of this sex-specific association between BMI and SCTD needs more verification. Abbreviations: ALT = alanine aminotransferase; AST = aspartate aminotransferase; BMI = body mass index; BUN = blood urea nitrogen; CI = confidence interval; Cr = creatinine; DBP = diastolic blood pressure; FG = fasting glucose; FT3 = free triiodothyronine; FT4 = free thyroxine; HDL = high-density lipoprotein; LDL = low-density lipoprotein; OR = odds ratio; SBP = systolic blood pressure; SCTD = subclinical thyroid dysfunction; TBIL = total bilirubin; TC = total cholesterol; TG = triglyceride; TSH = thyroid-stimulating hormone; UA = uric acid; WBC = white blood cell; WC = waist circumference

Thyroid Dysfunction States and Incident Cardiovascular Events: The Tehran Thyroid Study

2017 ◽  
Vol 50 (01) ◽  
pp. 37-43 ◽  
Author(s):  
Maryam Tohidi ◽  
Arash Derakhshan ◽  
Samaneh Akbarpour ◽  
Atieh Amouzegar ◽  
Ladan Mehran ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Subclinical Hypothyroidism ◽  
Thyroid Dysfunction ◽  
Middle Eastern ◽  
Thyroid Stimulating Hormone ◽  
Overt Hypothyroidism ◽  
Subclinical Hyperthyroidism ◽  
Significant Difference ◽  
Middle Eastern Population

AbstractThe objective of the study was to investigate the relation of different thyroid function states with the incidence of cardiovascular disease (CVD)/coronary heart disease (CHD) among a Middle-Eastern population with a high incidence of CVD/CHD. A total of 3975 participants entered the study (43.6% men). According to their thyroid stimulating hormone (TSH) and free thyroxin (FT4) levels, the participants were categorized into 5 groups: euthyroid, subclinical hypothyroidism, overt hypothyroidism, subclinical hyperthyroidism, and overt hyperthyroidism. Multivariable Cox proportional hazard models were used to assess the relation of different thyroid function states with incident CVD/CHD, with euthyroid state as reference. The mean age (SD) of the participants was 46.5 (12.0) years. At baseline, no significant difference was observed in the frequency of prevalent CVD cases (n=201) between all groups. No significant interaction was found between prevalent CVD and different thyroid function states with outcomes, hence, we did not exclude participants with prevalent CVD from data analysis. A total of 400 CVD events (358 CHD cases) during a median follow-up of 11.2 years (inter-quartile range: 1.96) occurred. During the follow-up, even in the age and sex adjusted model, no association was observed between different states of thyroid dysfunction and incidence of CVD/CHD. The multivariable hazard ratios (95% CI) of subclinical hypothyroidism, hypothyroidism, subclinical hyperthyroidism, and hyperthyroidism for CVD events were 1.21 (0.77–1.88), 0.76 (0.33–1.69), 0.81 (0.46–1.41) and 1.48 (0.70–3.16), respectively. Both at baseline and during follow-up, no relation was observed between different states of thyroid function with prevalence and incidence of CVD/CHD.

scholarly journals STUDY OF THYROID DYSFUNCTION IN PATIENTS WITH METABOLIC SYNDROME

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Sheetal Ratankumar Gatagat
Keyword(s):  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Thyroid Hormones ◽  
Subclinical Hypothyroidism ◽  
Thyroid Dysfunction ◽  
Thyroid Diseases ◽  
Endocrine Disorders ◽  
Age Group ◽  
Thyroxine Replacement ◽  
The Impact

Introduction: Metabolic syndrome (MS) is described as insulin resistance, clusters of abnormalities including abdominal obesity, hypertension, hyperglycaemia, increased triglycerides, and decreased high-density lipoprotein cholesterol (HDL-C). In maintaining thermogenesis and metabolic homeostasis Thyroxine and Triidothryronine play an important role. Thyroid is established by thyroid stimulation hormone (TSH). Thyroid hormones up-regulate metabolic pathways relevant to resting energy expenditure, hence obesity and thyroid functions are often correlated. It is still not clear whether these alterations in thyroid hormones are a cause or an effect of obesity. Hypothyroidism is well known to cause diastolic hypertension, endothelial dysfunction, hyperlipidemia and cardiovascular disease. The functions of thyroid affect the components of metabolic syndrome including triglycerides (TG), HDL–cholesterol (HDL-C), blood pressure and plasma glucose. The impact of various degree of thyroid dysfunction on components of metabolic syndrome, however, continues to be debatable. On components of metabolic syndrome, Thyroid dysfunction is also risk factor for ASCVD mediated by the effects of thyroid hormones on glucose metabolism, lipid and blood pressure. In India about onethird of the urban population in large cities has metabolic syndrome with the overall prevalence varying between 11% and 56%. Worldwide Thyroid diseases are most prevalent endocrine disorders. According to various studies it showed that about 42 million people in India suffer from thyroid diseases. Aim: The main aim of this study was to study thyroid dysfunction in metabolic syndrome. Material and Methods: In this study 150 patients with different age group from 20 years to 60 years old were included with metabolic syndrome diagnosed as per IDF criteria. From all the patients who visit hospital as OPD and IPD patients’ detailed history was recorded and also laboratory examination were done. Result: In this study total 150 patients with metabolic syndrome were included in which there were 82 were males and 68 were females.  In this study there were maximum numbers of male patients in comparing with female patients as 43.3% and 54.7% respectively with different age group from 20 years to 60 years old. Out of total patients age group of 35 to 50 years old shows maximum and the age group 50- 60 years old showed least as 37% and 23% respectively. In this study in the age group of 35-50 had abnormal TGL values, compared to the other age groups. While HDL values were low in the 50-60 age group compared to others. Conclusion: Thyroid dysfunction is common in metabolic syndrome patients. The prevalence of hypothyroidism is more common in metabolic syndrome. Therefore early detection and thyroxine replacement could reduce the significant cardiovascular risk. However, there is still a controversy whether the patients with subclinical hypothyroidism would be benefited from thyroxine replacement. Hence Subclinical hypothyroidism should be picked up and treated at the earliest. Keywords: Metabolic syndrome, Thyroid dysfunction, hypothyroidism, HDL

scholarly journals The Relation Between Thyroid Function and Anemia: A Pooled Analysis of Individual Participant Data

2018 ◽  
Vol 103 (10) ◽  
pp. 3658-3667 ◽  
Author(s):  
Daisy M Wopereis ◽  
Robert S Du Puy ◽  
Diana van Heemst ◽  
John P Walsh ◽  
Alexandra Bremner ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Subclinical Hypothyroidism ◽  
Sensitivity Analyses ◽  
Overt Hypothyroidism ◽  
Individual Participant Data ◽  
Subclinical Hyperthyroidism ◽  
Thyroid Status ◽  
Increased Risk ◽  
Individual Participant ◽  
Overt Hyperthyroidism

Abstract Context Anemia and thyroid dysfunction often co-occur, and both increase with age. Human data on relationships 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 &lt;130 g/L in men and &lt;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.

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