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Zhang K, Luo Z, Wang X. The association of common autoimmune diseases with autoimmune thyroiditis: a two-sample Mendelian randomization study. Front Endocrinol (Lausanne) 2024; 15:1383221. [PMID: 39314521 PMCID: PMC11416997 DOI: 10.3389/fendo.2024.1383221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 07/23/2024] [Indexed: 09/25/2024] Open
Abstract
Objective Numerous observational and retrospective studies have demonstrated an association between Autoimmune Thyroiditis (AIT) and various systemic Autoimmune Diseases (AIDs). However, the causal relationship between them remains uncertain. This study aims to investigate the causal link between AIT and diverse types of AIDs utilizing the Mendelian Randomization (MR) method. Method We assessed the causal relationship between AIT and eight prevalent AIDs. Summary statistics from genome-wide association studies (GWAS) were sourced from the FinnGen biobank and IEU Open GWAS database. Two-sample MR analyses were conducted, with the primary statistical approach being the Inverse Variance Weighting (IVW) method. This was complemented by a series of sensitivity analyses, and the robustness of the findings was evaluated through the estimation of heterogeneity and pleiotropy. Results When AIT was considered as the outcome, MR evidence suggested an association between Rheumatoid arthritis (RA), Type 1 diabetes (T1D), and Systemic lupus erythematosus (SLE) with AIT. Utilizing the Inverse Variance Weighting (IVW) method, we observed an increased risk of AIT with exposure to RA (P = 0.024, OR=1.25; 95% CI = 1.03, 1.52), T1D (P < 0.001, OR=1.27 95% CI = 1.11,1.46), and SLE (P = 0.037, OR=1.14; 95% CI = 1.04,1.26). Conversely, no significant genetic causal relationship with AIT was found for Sjögren's syndrome (SS), Ankylosing Spondylitis (AS), Multiple sclerosis (MS), Crohn's disease (CD), and Ulcerative colitis (UC). Conclusion This study identified RA, T1D, and SLE as triggering factors for AIT. The incidence rate of AIT in patients with RA, T1D, and SLE may be higher than that in the general population. Therefore, individuals with these three diseases should undergo regular monitoring of thyroid-related indicators.
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MESH Headings
- Humans
- Mendelian Randomization Analysis
- Thyroiditis, Autoimmune/genetics
- Thyroiditis, Autoimmune/epidemiology
- Thyroiditis, Autoimmune/complications
- Genome-Wide Association Study
- Autoimmune Diseases/genetics
- Autoimmune Diseases/epidemiology
- Autoimmune Diseases/complications
- Diabetes Mellitus, Type 1/genetics
- Diabetes Mellitus, Type 1/complications
- Diabetes Mellitus, Type 1/epidemiology
- Arthritis, Rheumatoid/genetics
- Arthritis, Rheumatoid/complications
- Arthritis, Rheumatoid/epidemiology
- Lupus Erythematosus, Systemic/genetics
- Lupus Erythematosus, Systemic/complications
- Lupus Erythematosus, Systemic/epidemiology
- Genetic Predisposition to Disease
- Polymorphism, Single Nucleotide
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Affiliation(s)
- Kaiyuan Zhang
- Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Ziyue Luo
- Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Xinchang Wang
- Department of Rheumatology, The Second Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
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Pawar A, Joshi P, Singhai A. Study on disease activity of immunological disorders to correlate with thyroid function and other associated correlations. J Family Med Prim Care 2024; 13:896-902. [PMID: 38736834 PMCID: PMC11086795 DOI: 10.4103/jfmpc.jfmpc_1053_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 09/04/2023] [Accepted: 09/07/2023] [Indexed: 05/14/2024] Open
Abstract
Background Organ-specific immunological disorders involving organ/gland like the thyroid, liver, muscles, pancreas, etc., is a result of autoimmunity which can be with or without association with systemic immunological disorders. The thyroid gland is most commonly involved. We evaluated thyroid dysfunction and ESR among various immunological disorders and their correlation with disease activity and hemoglobin respectively. Material and Methods A cross-sectional/observational study was conducted by including 110 patients with different immunological disorders who came in as in-patients and outpatients in our institute for 18 months and various data were collected and evaluated to analyze the targeted parameters among the study group. Results We found a positive correlation between disease activity and thyroid dysfunction in different immunological disorders (only in Rheumatoid arthritis [P = 0.004) and Systemic lupus erythematosus (0.009) and not in other immunological disorders] among the study group. A positive correlation was found between ESR (Mean value - 19.63 and Standard Deviation (SD) - 09.473) and disease activity (only in Rheumatoid arthritis P = 0.0001) where a negative correlation was found between ESR and Hemoglobin (Mean value - 11.07 and SD - 01.91 (P = 0.001) in patients under study. Conclusion Our study demonstrated a positive correlation between thyroid dysfunction and ESR with disease activity, whereas demonstrated a negative correlation between ESR and Hemoglobin in patients with various immunological disorders under study.
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Affiliation(s)
- Akash Pawar
- Department of General Medicine, AIIMS, Bhopal, Madhya Pradesh, India
| | - Prakash Joshi
- Department of Medicine, Sri Aurobindo Institute of Medical Sciences and PGI, Indore, Madhya Pradesh, India
| | - Abhishek Singhai
- Department of General Medicine, AIIMS, Bhopal, Madhya Pradesh, India
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Pawar A, Joshi P, Singhai A. An Assessment of Thyroid Dysfunction and Related Parameters in Patients With Systemic Autoimmune Disorders. Cureus 2023; 15:e42783. [PMID: 37664252 PMCID: PMC10469658 DOI: 10.7759/cureus.42783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2023] [Indexed: 09/05/2023] Open
Abstract
Background and objective Systemic autoimmune disorders involve abnormal immune responses leading to tissue damage. Dysfunction of the thyroid gland due to autoimmune mechanisms is common in such disorders, which can cause either hypofunctioning or hyperfunctioning of the gland. This study aimed to investigate the prevalence of thyroid dysfunction among patients with various systemic autoimmune disorders. Material and methods This cross-sectional observational study included 110 adult patients either diagnosed with or having clinical/biological features of systemic autoimmune diseases. The patients underwent a detailed clinical history assessment, physical examination, and necessary investigations. Data were analyzed using IBM SPSS Statistics for Windows, Version 26.0. (IBM Corp., Armonk, NY). Results Among the 110 autoimmune disorder patients, 22.7% had thyroid dysfunction, specifically hypothyroidism, while 77.3% were euthyroid. Hypothyroidism was prevalent among patients with rheumatoid arthritis (RA, 20.3%), systemic sclerosis (SSc, 20%), ankylosing spondylitis (AS, 15.8%), and systemic lupus erythematosus (SLE, 54.5%). Moreover, 60% of patients were anemic, and the prevalence of anemia was higher among female patients and younger individuals. Conclusions This study showed a higher prevalence of thyroid dysfunction, particularly hypothyroidism, in patients with systemic autoimmune disorders. Female patients and younger individuals were more susceptible to autoimmune disorders, thyroid dysfunction, and anemia. These findings highlight the need for simultaneous screening and evaluation for thyroid dysfunction and anemia in systemic autoimmune disease patients, particularly in female patients and those of younger age groups.
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Affiliation(s)
- Akash Pawar
- General Medicine, All India Institute of Medical Sciences Bhopal, Bhopal, IND
| | - Prakash Joshi
- Internal Medicine, Sri Aurobindo Medical College & PG Institute, Indore, IND
| | - Abhishek Singhai
- General Medicine, All India Institute of Medical Sciences Bhopal, Bhopal, IND
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Mishra D, Harish BV, Gadde S, Patro PS. Disease Activity Assessment in Nonradiographic Axial Spondyloarthritis: Is It Time to Move Beyond the Bath Ankylosing Spondylitis Disease Activity Index or Ankylosing Spondylitis Disease Activity Score? Comment on the Article by Rusman et al. Arthritis Rheumatol 2021; 73:2351-2352. [PMID: 34180157 DOI: 10.1002/art.41905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 06/06/2021] [Indexed: 11/06/2022]
Affiliation(s)
- Debashish Mishra
- Institute of Medical Sciences and Sum Hospital, Bhubaneswar, India
| | - B V Harish
- Institute of Medical Sciences and Sum Hospital, Bhubaneswar, India
| | - Sudhish Gadde
- Institute of Medical Sciences and Sum Hospital, Bhubaneswar, India
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Ramírez J, Nieto-González JC, Curbelo Rodríguez R, Castañeda S, Carmona L. Prevalence and risk factors for osteoporosis and fractures in axial spondyloarthritis: A systematic review and meta-analysis. Semin Arthritis Rheum 2017; 48:44-52. [PMID: 29290311 DOI: 10.1016/j.semarthrit.2017.12.001] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 11/24/2017] [Accepted: 12/05/2017] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To describe the prevalence of osteoporosis, the prevalence and incidence of fractures, and the frequency of risk factors for low bone mineral density (BMD) in axial spondyloarthritis (Ax-SpA). METHODS A systematic review and meta-analysis of observational studies was conducted. Medline, Embase, and Cochrane Library databases were searched with a sensitive strategy. Large cross-sectional and longitudinal studies published in the last 10 years (January 2006-2016) with representative samples of patients with Ax-SpA estimating the frequency of osteoporosis, risk factors or fractures were selected. RESULTS After screening 3597 titles and abstracts, 46 studies were reviewed in detail, of which 35 studies had a cross-sectional design, 5 were prospective and 6 retrospective; 21 studies compared Ax-SpA patients with a control group-either healthy individuals (18 studies) or subjects with other diseases (6 studies). The prevalence of osteoporosis varied from 11.7% to 34.4% and that of fractures from 11% to 24.6%. Alcohol intake (58-61%), use of corticosteroids (11.7-66.9%), and 25-OH vitamin D deficiency (26-76%) were unexpectedly high in Ax-SpA patients. CONCLUSION The prevalence of osteoporosis and fractures in Ax-SpA varies between 11.7% and 34.4% and 11-24.6%, respectively. Alcohol intake, steroid use, and low levels of 25-OH-vitamin D should be taken into account in osteoporosis assessment in patients with Ax-SpA. Inconsistent results, lack of bone quality assessment, and high likelihood of bias of the published studies confirm the need for performing well-designed studies.
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Affiliation(s)
- Julio Ramírez
- Rheumatology Department, Arthritis Unit, Hospital Clinic and IDIBAPS, Barcelona, Spain.
| | | | | | - Santos Castañeda
- Rheumatology Department, Hospital Universitario La Princesa, IIS-Princesa, Madrid, Spain
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Hao J, Liu Y, Xu J, Wang W, Wen Y, He A, Fan Q, Guo X, Zhang F. Genome-wide DNA methylation profile analysis identifies differentially methylated loci associated with ankylosis spondylitis. Arthritis Res Ther 2017; 19:177. [PMID: 28743287 PMCID: PMC5526246 DOI: 10.1186/s13075-017-1382-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 07/06/2017] [Indexed: 01/19/2023] Open
Abstract
Background Ankylosing spondylitis (AS) is a chronic rheumatic and autoimmune disease. Little is known about the potential role of DNA methylation in the pathogenesis of AS. This study was undertaken to explore the potential role of DNA methylation in the genetic mechanism of AS. Methods In this study, we compared the genome-wide DNA methylation profiles of peripheral blood mononuclear cells (PBMCs) between five AS patients and five healthy subjects, using the Illumina Infinium HumanMethylation450 BeadChip. Quantitative real-time reverse transcription-polymerase chain reaction (qRT-PCR) was performed to validate the relevance of the identified differentially methylated genes for AS, using another independent sample of five AS patients and five healthy subjects. Results Compared with healthy controls, we detected 1915 differentially methylated CpG sites mapped to 1214 genes. The HLA-DQB1 gene achieved the most significant signal (cg14323910, adjusted P = 1.84 × 10–6, β difference = 0.5634) for AS. Additionally, the CpG site cg04777551 of HLA-DQB1 presented a suggestive association with AS (adjusted P = 1.46 × 10–3, β difference = 0.3594). qRT-PCR observed that the mRNA expression level of HLA-DQB1 in AS PBMCs was significantly lower than that in healthy control PBMCs (ratio = 0.48 ± 0.10, P < 0.001). Gene Ontology (GO) and KEGG pathway enrichment analysis of differentially methylated genes identified four GO terms and 10 pathways for AS, functionally related to antigen dynamics and function. Conclusions Our results demonstrated the altered DNA methylation profile of AS and implicated HLA-DQB1 in the development of AS. Electronic supplementary material The online version of this article (doi:10.1186/s13075-017-1382-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jiangcan Hao
- Key Laboratory of Trace Elements and Endemc Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Yang Liu
- Xi'an No.5 Hospital, Xi'an, People's Republic of China
| | - Jiawen Xu
- Department of Clinical Medicine, Health Science Center, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Wenyu Wang
- Key Laboratory of Trace Elements and Endemc Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Yan Wen
- Key Laboratory of Trace Elements and Endemc Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Awen He
- Key Laboratory of Trace Elements and Endemc Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Qianrui Fan
- Key Laboratory of Trace Elements and Endemc Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Xiong Guo
- Key Laboratory of Trace Elements and Endemc Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Feng Zhang
- Key Laboratory of Trace Elements and Endemc Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, People's Republic of China.
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The clinical importance of the thyroid nodules during anti-tumor necrosis factor therapy in patients with axial spondyloarthritis. Clin Rheumatol 2017; 36:1071-1076. [PMID: 28357602 DOI: 10.1007/s10067-017-3607-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Revised: 01/28/2017] [Accepted: 03/14/2017] [Indexed: 12/17/2022]
Abstract
The clinical importance of the thyroid nodules in patients with axial spondyloarthritis (ax-SpA) rests with the need to exclude thyroid malignancy. The aim of this study is to assess the risk of thyroid malignancy in ax-SpA patients receiving anti-TNF therapy. From September 2015 until December 2015, 70 patients diagnosed with ax-SpA were included in the research. Forty of the patients had received anti-TNF therapy, and 30 of the patients were anti-TNF naive. All cases were screened for the presence of nodules in the thyroid gland with ultrasound. Of the patients that received anti-TNF therapy, 15 (37.5%); and of the anti-TNF naive patients, 11 (36.7%) had thyroid nodule(s). Four patients from the anti-TNF group underwent fine needle aspiration biopsy of the nodules, and two of them were diagnosed with papillary thyroid carcinoma. None of the nodules in anti-TNF naive patients required biopsy. When compared to the normal population, the standardized incidence ratio (SIR) was found to be increased in both male (SIR 2.03, 95% CI 1.9 to 18) and female (SIR 2.7, 95% CI 2.6 to 24) cases. It is not yet established whether the development of cancer during the treatment process is the effect of the treatment or if it is a part of the natural course of the disease or if it is coincidental. We saw a mild increase in thyroid malignancies in ax-SpA patients who received anti-TNF therapy. Therefore, we believe that the thyroid gland should also be taken into consideration while screening for malignancy before anti-TNF therapy.
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Erdogan M, Kulaksizoglu M, Ganidagli S, Berdeli A. Fas/FasL gene polymorphism in patients with Hashimoto's thyroiditis in Turkish population. J Endocrinol Invest 2017; 40:77-82. [PMID: 27572459 DOI: 10.1007/s40618-016-0534-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 08/16/2016] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Hashimoto's disease is a polygenic disorder with complex etiopathogenesis. Apoptosis is proposed as one of its mechanisms. The Fas/Fas ligand cascade represents a major pathway initiating apoptosis. This study aims to evaluate the influence of Fas and FasL gene polymorphism in Hashimoto's thyroiditis in Turkish population. MATERIALS AND METHODS A total of 112 patients with Hashimoto's thyroiditis and 112 cases of healthy control people were included in this study. The evaluation of genotype for Fas -670 A/G and FasL 843 C/T gene polymorphism was performed by using PCR-RFLP method. RESULTS The FAS genotype and gene allele frequency distribution did differ between the control group (AA 36.6 %, AG 50.0 %, GG 13.4 %, A 61.6 %, G 38.4 %) and the Hashimoto's thyroiditis patients (AA 21.4 %, AG 50.9 %, GG 27.7 %, A 46.9 %, G 53.1 %) (p < 0.01). The evaluation of FasL genotype and gene allele frequency did not show statistically significant difference between the patient group (CC 27.7 %, CT 45.5 %, TT 26.8 %, C 50.4 %, T 49.6 %) and control group (CC 33.9 %, CT 44.6 %, TT 21,4 %, C 56.3 %, T 43.8 %) (p > 0.05). CONCLUSIONS Gene polymorphism of Fas and G allele frequency may play a role in the regulation of apoptosis in thyroid autoimmune disorders. There is a need for further studies to clarify the genetic role of apoptosis in HT.
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Affiliation(s)
- M Erdogan
- Department of Endocrinology and Metabolic Diseases, Ege University Medical School, 35100, Bornova, Izmir, Turkey.
| | - M Kulaksizoglu
- Department of Endocrinology and Metabolic Diseases, Necmettin Erbakan University Medical School, Konya, Turkey
| | - S Ganidagli
- Department of Internal Medicine, Numune Training and Research Hospital, Adana, Turkey
| | - A Berdeli
- Laboratory of Molecular Medicine, Department of Pediatrics, Ege University Medical School, Bornova, Izmir, Turkey
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