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Di J, Ge Z, Xie Q, Kong D, Liu S, Wang P, Li J, Ning N, Qu W, Guo R, Chang D, Zhang J, Zheng XH. Helicobacter pylori infection increases the risk of thyroid nodules in adults of Northwest China. Front Cell Infect Microbiol 2023; 13:1134520. [PMID: 37065186 PMCID: PMC10102366 DOI: 10.3389/fcimb.2023.1134520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 03/13/2023] [Indexed: 04/03/2023] Open
Abstract
Background Thyroid nodules (TNs) are very common in the adults of Northwest China. The role of Helicobacter pylori (H. pylori) infection in TNs is poorly investigated and even with controversial conclusions. Our study aimed at highlighting the relationship between H. pylori infection and the risk of TNs. Methods 9,042 individuals were enrolled with thyroid ultrasonography and 14C-urea breath test (14C-UBT). Baseline characteristics and relevant covariates were obtained, including basic and laboratory indicators. After applying the exclusion criteria, 8,839 patients were included and divided into 2 groups: a cross-sectional study of single follow-up (n=8,711) and a retrospective cohort study of multiple follow-ups for 5 years (n=139). Results The prevalence of H. pylori infection and TNs was 39.58% and 47.94% in the adults of Northwest China, respectively. The prevalence of TNs was significantly higher among H. pylori-positive individuals than those without infection (52.55% vs. 44.92%, p<0.01). The result of binary logistic regression revealed that the crude odds ratio (OR) was 1.624 (95% CI 1.242~2.123) in Model 1 without adjustment compared to H. pylori-negative group, and was also positive in Model 2, 3, and 4 (Model 2: OR=1.731, 95% CI 1.294~2.316; Model 3: OR=2.287, 95% CI 1.633~3.205; Model 4: OR=2.016, 95% CI 1.390~2.922) after the adjustment. The data of 5-year follow-up showed that the annual incidence of TNs was significantly higher in individuals with persistent H. pylori infection than non-infected counterparts (all p<0.05). Conclusions H. pylori is an independent risk factor for TNs in the adults of Northwest China.
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Affiliation(s)
- Jia Di
- Department of Nuclear Medicine, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Zhuang Ge
- Department of Nuclear Medicine, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Qingwei Xie
- Department of Nuclear Medicine, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Danfeng Kong
- Department of Nuclear Medicine, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Sha Liu
- Department of Nuclear Medicine, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Pengwei Wang
- Department of Nuclear Medicine, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Jie Li
- Outpatient Department, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Ning Ning
- Department of Nuclear Medicine, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Wei Qu
- Department of Nuclear Medicine, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Rong Guo
- Department of Nuclear Medicine, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Danyan Chang
- Department of Gastroenterology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Jun Zhang
- Department of Gastroenterology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Xiang-hong Zheng
- Department of Nuclear Medicine, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
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Huang Y, Li Z, Yang K, Zhang L, Wei C, Yang P, Xu W. The association of uric acid with the development of thyroid nodules: a retrospective cohort study. BMC Endocr Disord 2022; 22:197. [PMID: 35941598 PMCID: PMC9358884 DOI: 10.1186/s12902-022-01119-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 07/28/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Uric acid was found to have a positive correlation with thyroid nodules in the cross-sectional studies recently. We aimed to conduct a retrospective cohort study to investigate whether uric acid is a risk factor for the development of thyroid nodules. METHODS We reviewed the data of individuals who attended the medical check-ups in our hospital from 2010 to 2019. A total of 6587 adults without thyroid nodules at baseline were enrolled in this study. Logistic regression with or without restricted cubic spline function was used to investigate the non-linear or linear association between uric acid and thyroid nodules, respectively. RESULTS Baseline characteristics showed that subjects mainly consisted of the healthy, young population. After fully adjusting for the potential confounders, such as age, sex, metabolic and inflammatory indicators, hepatic and renal function, a logistic restricted cubic spline regression model suggested that uric acid had a significant association (P = 0.028) with the development of thyroid nodules, but the association was not non-linear (P = 0.516). The results indicate that the association between them is linear, which was demonstrated by a logistic regression model, in which the odds ratio of uric acid per 100 mmol/L was 1.137 (P = 0.004). Age, sex, diastolic blood pressure, fasting blood sugar, and blood monocyte were found to be risk factors for thyroid nodules as well. CONCLUSION Uric acid is an independent risk factor for the formation of thyroid nodules. This finding warrants attention to this risk factor in apparently healthy adults.
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Affiliation(s)
- Yingshi Huang
- Health Care Center, the First Affiliated Hospital of Shantou University Medical College, No. 57, Changping Road, Shantou, 515041 China
| | - Zexin Li
- Health Care Center, the First Affiliated Hospital of Shantou University Medical College, No. 57, Changping Road, Shantou, 515041 China
| | - Kaiji Yang
- Department of Radiology, the First Affiliated Hospital of Shantou University Medical College, No. 57, Changping Road, Shantou, 515041 China
| | - Lili Zhang
- Health Care Center, the First Affiliated Hospital of Shantou University Medical College, No. 57, Changping Road, Shantou, 515041 China
| | - Chiju Wei
- Multidisciplinary Research Center, Shantou University, No. 243, Daxue Road, Shantou, 515063 China
| | - Peixuan Yang
- Health Care Center, the First Affiliated Hospital of Shantou University Medical College, No. 57, Changping Road, Shantou, 515041 China
| | - Wencan Xu
- Department of Endocrinology, the First Affiliated Hospital of Shantou University Medical College, No. 57, Changping Road, Shantou, 515041 China
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Wu Y, Zeng H, Zhang M, Li C, Tang Y, Li X, Yuan S, Wei Q, Wang J, Ning X, Zhang X. Sex-Specific Risk Factors Associated with Helicobacter pylori Infection Among Individuals Undergoing Health Examinations in China. Int J Gen Med 2022; 15:5861-5868. [PMID: 35791315 PMCID: PMC9250778 DOI: 10.2147/ijgm.s367142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 05/27/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Helicobacter pylori is one of the most common causes of peptic ulcers, gastritis, and gastric cancers. This study investigated sex-specific differences in the prevalence of H. pylori infection and its associated factors among individuals undergoing hospital-based health examinations in southern China. Methods This study enrolled consecutive healthy individuals who underwent regular health examinations at a hospital physical examination center between September 2020 and September 2021. Anthropometric characteristics and biochemical profiles were measured. All individuals underwent carbon-13 urea breath tests. Univariate and multivariate analyses were used to evaluate the factors associated with H. pylori infection. Results A total of 5035 individuals (men, 59.1%; women, 40.9%) were included in the analyses. The total rate of H. pylori infection was 35.0% (men, 35.5%; women, 34.3%). In the multivariate analysis, the risk factors identified for H. pylori infections were high fasting blood glucose levels and blood pressure ≥160 mmHg in men and older age, high body mass index, and low albumin levels in women. Conclusion These findings suggest that physicians must be aware of the metabolic factors associated with H. pylori infections in the Chinese population. Early detection of these factors and timely intervention are expected to reduce H. pylori infections and provide a theoretical basis for the primary prevention of several gastrointestinal diseases.
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Affiliation(s)
- Yumei Wu
- Department of Gastroenterology, the Third People's Hospital of Shenzhen, Shenzhen, Guangdong Province, People's Republic of China
| | - Hui Zeng
- Department of Health Management, the Third People's Hospital of Shenzhen, Shenzhen, Guangdong Province, People's Republic of China
| | - Meiping Zhang
- Department of Gastroenterology, the Third People's Hospital of Shenzhen, Shenzhen, Guangdong Province, People's Republic of China
| | - Chunyan Li
- Department of Health Management, the Third People's Hospital of Shenzhen, Shenzhen, Guangdong Province, People's Republic of China
| | - Yuanlin Tang
- Department of Health Management, the Third People's Hospital of Shenzhen, Shenzhen, Guangdong Province, People's Republic of China
| | - Xiufen Li
- Department of Gastroenterology, the Third People's Hospital of Shenzhen, Shenzhen, Guangdong Province, People's Republic of China
| | - Shanyou Yuan
- Department of Orthopedics, the Third People's Hospital of Shenzhen, Shenzhen, Guangdong Province, People's Republic of China
| | - Qifeng Wei
- Department of Orthopedics, the Third People's Hospital of Shenzhen, Shenzhen, Guangdong Province, People's Republic of China
| | - Jinghua Wang
- Centre of Clinical Epidemiology, the Third People's Hospital of Shenzhen, Shenzhen, Guangdong Province, People's Republic of China
| | - Xianjia Ning
- Centre of Clinical Epidemiology, the Third People's Hospital of Shenzhen, Shenzhen, Guangdong Province, People's Republic of China
| | - Xiaoyin Zhang
- Department of Gastroenterology, the Third People's Hospital of Shenzhen, Shenzhen, Guangdong Province, People's Republic of China
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Association of Helicobacter pylori Infection with Papillary Thyroid Carcinoma: A Case-control Study. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2022. [DOI: 10.5812/ijcm-118031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: The thyroid nodules incidence has risen worldwide. Although factors such as increasing the use of imaging techniques and more rapid detection of small thyroid nodules have been implicated in the recent rise in thyroid cancer incidence, some environmental parameters such as infectious agents may be involved. Helicobacter pylori infection is an environmental risk factor, which may mimic the antigenic properties of membranes of thyrocytes. Objectives: This study aimed at evaluating the association of H. pylori infection with benign and malignant thyroid nodules in comparison with the control group. Methods: Patients with benign thyroid nodules, papillary thyroid cancer (PTC), and euthyroid healthy controls without thyroid nodules that had just been diagnosed were included in the study. All participants underwent clinical examination. Various biochemical parameters such as serum H. pylori Ab (IgG) and thyroid function tests were measured. Comparisons were made between groups. Results: Finally, 370 patients with benign thyroid nodules, 364 patients with PTC, and 360 healthy subjects without nodules participated as a control group. In the patients with PTC, the prevalence of H. pylori infection was 89.6%, while in the group of patients with benign thyroid nodules and the control group was 81.1% and 75%, respectively (P < 0.001). Helicobacter pylori antibody (Ab) titer was not significantly associated with any of the anthropometric and biochemical variables. Conclusions: Helicobacter pylori infection was significantly higher in patients with benign thyroid nodules and PTC than in the control group. Also, the rate of infection was significantly higher in the malignant nodule group than in the benign thyroid nodules group.
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Jamil MZZ, Salman S, Akhtar M, Iqbal S, Bhalli A, Farooq H. Determining the Association Between Helicobacter pylori Infection and Treatment-Refractory Hypothyroidism. Cureus 2022; 14:e21316. [PMID: 35186575 PMCID: PMC8848460 DOI: 10.7759/cureus.21316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction Refractory hypothyroidism, despite weight-based thyroxine dosing, is a common endocrinology consultation in outpatients. Chronic Helicobacter (H.) pylori infection has been reported to be responsible for the poor absorption of thyroxine from the small gut leading to suboptimal response with contradictory evidence. This study was carried out to determine the association of chronic Helicobacter pylori infection with refractory hypothyroidism in outpatients presenting to a tertiary care hospital. Methods One hundred thirty patients with the diagnosis of hypothyroidism, visiting Jinnah Allama Iqbal Institute of Diabetes and Endocrinology (JAIDE) Jinnah Hospital Lahore, Pakistan, from January 2020 to February 2021, were included in the study after informed consent following the non-probability consecutive sampling technique. All of these patients were 15-70 years of age, non-pregnant, and receiving thyroxine treatment for at least six weeks. Patients with a history of gastric surgery, malabsorption syndrome, or poor compliance were excluded from the study. Patients’ age, sex, and body mass index (BMI) were recorded in a structured proforma. Patients were categorized into two groups, i.e. controls (biochemically euthyroid on thyroxine treatment with TSH < 4.5mU/L) and cases (refractory hypothyroidism despite 1.6 mcg/kg thyroxine treatment with TSH > 4.5 mU/L). The presence of chronic H. pylori infection was checked with serum immunoglobulin G (IgG) testing by enzyme-linked immunoassay (ELISA) from the hospital laboratory and data analysis was done by SPSS version 21.0 (IBM Corp., Armonk, NY). Results One hundred thirty patients were included in this study, with an age range from 15 to 70 years. Of these, 65/130 (50%) were euthyroid on treatment and 65/130 (50%) had treatment-refractory hypothyroidism. The mean age of patients in our study was 45.81 ± 11 years, with 118 (90.8%) female patients. The prevalence of positive H. pylori IgG antibody was 47/130 (36.2%) overall, with 23 patients (35.4%) in the control (euthyroid) group and 24 patients (36.9%) in the cases (refractory hypothyroidism) group. The difference between the two groups was not statistically significant with an odds ratio of 1.069 (CI 0.523 - 2.187) and a p-value of 0.855. Moreover, age, gender, and BMI had no effect on chronic H. pylori association with refractory hypothyroidism. Conclusion This study does not suggest any significant association between chronic H. pylori infection and treatment-refractory hypothyroidism. Other factors like poor compliance, drug-drug interactions, and malabsorption disorders should be preferably sought in case of refractory hypothyroidism.
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Wang XS, Xu XH, Jiang G, Ling YH, Ye TT, Zhao YW, Li K, Lei YT, Hu HQ, Chen MW, Wang H. Lack of Association Between Helicobacter pylori Infection and the Risk of Thyroid Nodule Types: A Multicenter Case-Control Studyin China. Front Cell Infect Microbiol 2022; 11:766427. [PMID: 34970506 PMCID: PMC8713074 DOI: 10.3389/fcimb.2021.766427] [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: 08/29/2021] [Accepted: 11/22/2021] [Indexed: 11/13/2022] Open
Abstract
The prevalence of Helicobacter pylori infection is high worldwide, while numerous research has focused on unraveling the relationship between H. pylori infection and extragastric diseases. Although H. pylori infection has been associated with thyroid diseases, including thyroid nodule (TN), the relationship has mainly focused on potential physiological mechanisms and has not been validated by large population epidemiological investigations. Therefore, we thus designed a case-control study comprising participants who received regular health examination between 2017 and 2019. The cases and controls were diagnosed via ultrasound, while TN types were classified according to the guidelines of the American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS). Moreover, H. pylori infection was determined by C14 urea breath test, while its relationship with TN type risk and severity was analyzed using binary and ordinal logistic regression analyses. A total of 43,411 participants, including 13,036 TN patients and 30,375 controls, were finally recruited in the study. The crude odds ratio (OR) was 1.07 in Model 1 (95% CI = 1.03-1.14) without adjustment compared to the H. pylori non-infection group. However, it was negative in Model 2 (OR = 1.02, 95% CI = 0.97-1.06) after being adjusted for gender, age, body mass index (BMI), and blood pressure and in Model 3 (OR = 1.01, 95% CI = 0.97-1.06) after being adjusted for total cholesterol, triglyceride, low-density lipoprotein, and high-density lipoprotein on the basis of Model 2. Control variables, including gender, age, BMI, and diastolic pressure, were significantly correlated with the risk of TN types. Additionally, ordinal logistic regression results revealed that H. pylori infection was positively correlated with malignant differentiation of TN (Model 1: OR = 1.06, 95% CI = 1.02-1.11), while Model 2 and Model 3 showed negative results (Model 2: OR = 1.01, 95% CI = 0.96-1.06; Model 3: OR = 1.01, 95% CI = 0.96-1.05). In conclusion, H. pylori infection was not significantly associated with both TN type risk and severity of its malignant differentiation. These findings provide relevant insights for correcting possible misconceptions regarding TN type pathogenesis and will help guide optimization of therapeutic strategies for thyroid diseases.
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Affiliation(s)
- Xiao-Song Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China.,The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xi-Hai Xu
- The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Health Management Center, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Gang Jiang
- Department of Social Medicine and Health Management, School of Health Management, Anhui Medical University, Hefei, China
| | - Yu-Huan Ling
- Department of Social Medicine and Health Management, School of Health Management, Anhui Medical University, Hefei, China
| | - Tian-Tian Ye
- Department of Social Medicine and Health Management, School of Health Management, Anhui Medical University, Hefei, China
| | - Yun-Wu Zhao
- The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Kun Li
- Health Management Center, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yu-Ting Lei
- Health Management Center, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Hua-Qing Hu
- The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ming-Wei Chen
- The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Heng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China.,The First Affiliated Hospital of Anhui Medical University, Hefei, China
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Sun B, Wang X, McLarnon MED, Ding Y, Liu M, Dai W, Wang G. Higher Prevalence of Non-thyroidal-Illness Syndrome in Elderly Male Patients With Active Helicobacter pylori Infection. Front Med (Lausanne) 2021; 8:682116. [PMID: 34307412 PMCID: PMC8295606 DOI: 10.3389/fmed.2021.682116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 06/11/2021] [Indexed: 12/23/2022] Open
Abstract
Objective: It is currently unclear whether the Helicobacter pylori (H. pylori) infection leads to associated alterations in thyroid functions and thyroidal illnesses. This study aims to analyse this relationship in an elderly male cohort over a five-year period. Design: A case retrospective study. Methods: A longitudinal study was designed to collect subjects (≥65 years old) receiving both a thyroid examination and H. pylori infection status determined by 13C-urea breath test in 2013 at our unit. Subjects were followed every 1 to 2 years until December 2017 for laboratory results, visits to outpatient clinics/emergency departments etc. Blood tests and thyroid ultrasonography were performed to determine thyroid function and morphology. Results: 356 male subjects with mean age 78.5 ± 9.8 years were included. Active H. pylori infection was positive in 88 subjects (24.7%). Thyroid function tests and ultrasonography showed similar patterns between H. pylori positive and negative groups. Non-thyroidal-illness syndrome (NTIS) was diagnosed in 30/210 (14%) patients who experienced acute illnesses and hospitalization over five-year follow-up. Notably, NTIS demonstrated significantly higher prevalence in the H. pylori positive group compared to the negative group (17.1 vs. 5.6%, P = 0.001). Multivariate analysis showed that when age, APACHE II score and hemoglobin levels were adjusted, H. pylori status still has significant interrelationship with NTIS (OR = 3.497, P = 0.003). Conclusions: There is a positive association between chronic active H. pylori infection and NTIS prevalence in this elderly male cohort. Further studies are needed to elucidate the role of H. pylori infection on NTIS in elderly male patients.
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Affiliation(s)
- Banruo Sun
- Department of Endocrinology, Second Medical Center, Chinese People's Liberation Army General Hospital, National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Xuanping Wang
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
| | | | - Yu Ding
- Department of Gastroenterology, Second Medical Center, Chinese People's Liberation Army General Hospital, National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Miao Liu
- Department of Statistics and Epidemiology, Graduate School of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Wei Dai
- Office of Information Management, Second Medical Center, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Gangshi Wang
- Department of Gastroenterology, Second Medical Center, Chinese People's Liberation Army General Hospital, National Clinical Research Center for Geriatric Diseases, Beijing, China
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Li Z, Huang Y, Chen X, Wei C, Yang P, Xu W. The Effect of Inflammation on the Formation of Thyroid Nodules. Int J Endocrinol 2020; 2020:9827349. [PMID: 32695162 PMCID: PMC7368952 DOI: 10.1155/2020/9827349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 06/18/2020] [Accepted: 06/20/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Some studies have demonstrated that inflammation is highly associated with the prevalence of thyroid nodules (TNs). However, more confounders, such as metabolic diseases, should be adjusted. METHODS A clinical study collecting 2722 subjects was conducted to confirm the association between inflammation and TNs. The underlying mechanism was investigated in combination with bioinformatics analysis. RESULTS In the clinical study, propensity score matching was used to match metabolic parameters and other confounders, and it is observed that subjects with high inflammation had a higher prevalence of TNs and thyroid-stimulating hormone (TSH) than those with low inflammation. After further matching TNs, it is found that inflammation was positively associated with TSH, which was also demonstrated in a population without TNs. In bioinformatics study, inflammation did not promote TNs formation directly. Instead, it inhibited the synthesis of thyroid hormone, which might be the cause of the elevated TSH coexisting with inflammation. CONCLUSION Inflammation promotes the development of TNs disease, probably due to its indirect effect through inhibiting the synthesis of thyroid hormone, which results in the elevation of TSH.
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Affiliation(s)
- Zexin Li
- Health Care Center, The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, China
| | - Yiteng Huang
- Health Care Center, The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, China
| | - Xiang Chen
- Health Care Center, The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, China
| | - Chiju Wei
- Multidisciplinary Research Center, Shantou University, Shantou 515041, China
| | - Peixuan Yang
- Health Care Center, The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, China
| | - Wencan Xu
- Department of Endocrinology, The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, China
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Li Z, Zhang L, Huang Y, Yang P, Xu W. A Mechanism Exploration of Metabolic Syndrome Causing Nodular Thyroid Disease. Int J Endocrinol 2019; 2019:9376768. [PMID: 31885566 PMCID: PMC6899280 DOI: 10.1155/2019/9376768] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 08/10/2019] [Accepted: 09/17/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Metabolic syndrome (MS) and its components have been demonstrated to facilitate the prevalence of thyroid nodules (TNs). The underlying pathogenesis needs to be elucidated. METHODS A total of 2722 subjects, who underwent health checkup in our institute from December 2014 to November 2018, were retrospectively and randomly collected. After exclusion, 2068 subjects were chosen, and their anthropic and clinical data were collected. RESULTS After matching age, gender, uric acid (UA), and creatinine (Cr) by propensity score matching (PSM), subjects with MS had higher prevalence of TNs than those without MS, as well as higher thyroid-stimulating hormone (TSH) and inflammatory levels, indicated by the higher white blood cell (WBC), lymphocyte (LY), and monocyte/high-density lipoprotein (Mo/HDL). After matching age, gender, UA, Cr, TSH, free triiodothyronine (FT3), thyroxine (FT4), WBC, NE, LY, Mo, NE/LY, LY/Mo, and Mo/HDL by PSM, no significant difference of the prevalence of TNs was found between MS and non-MS groups. Step logistic regression suggested glucose intolerance (GI), among all the components of MS, was an independent impact factor of TNs and was considered to contribute most to the formation of TNs. The prevalence of TNs was higher in the GI group after matching age, gender, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood sugar (FBS), UA, Cr, triglyceride (TG), cholesterol (CHOL), HDL, and low-density lipoprotein (LDL). CONCLUSIONS Patients with MS have a higher prevalence of TNs, probably due to the elevated TSH and inflammatory levels in vivo. Among the components of MS, glucose intolerance contributes most to the development of TNs.
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Affiliation(s)
- Zexin Li
- Health Care Center, The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, China
| | - Lili Zhang
- Health Care Center, The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, China
| | - Yingshi Huang
- Health Care Center, The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, China
| | - Peixuan Yang
- Health Care Center, The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, China
| | - Wencan Xu
- Department of Endocrinology, The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, China
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10
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Hou Y, Sun W, Zhang C, Wang T, Guo X, Wu L, Qin L, Liu T. Meta-analysis of the correlation between Helicobacter pylori infection and autoimmune thyroid diseases. Oncotarget 2017; 8:115691-115700. [PMID: 29383192 PMCID: PMC5777804 DOI: 10.18632/oncotarget.22929] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 11/14/2017] [Indexed: 01/26/2023] Open
Abstract
Objective This study presents a systematic meta-analysis of the correlation between Helicobacter pylori (H. pylori) infection and autoimmune thyroid diseases (AITD). Materials and Methods Fifteen articles including 3,046 cases were selected (1,716 observational and 1,330 control cases). These data were analyzed using Stata12.0 meta-analysis software. Results H. pylori infection was positively correlated with the occurrence of AITD (OR = 2.25, 95% CI: 1.72–2.93). Infection with H. pylori strains positive for the cytotoxin-associated gene A (CagA) were positively correlated with AITD (OR = 1.99, 95% CI: 1.07–3.70). There was no significant difference between infections detected using enzyme-linked immunosorbent assay (ELISA) and other methods (χ2 = 2.151, p = 0.143). Patients with Grave’s disease (GD) and Hashimoto’s thyroiditis (HT) were more susceptible to H. pylori infection (GD: OR = 2.78, 95% CI: 1.68–4.61; HT: OR = 2.16, 95% CI: 1.44–3.23), while the rate of H. pylori infection did not differ between GD and HT (χ2 = 3.113, p = 0.078). Conclusions H. pylori infection correlated with GD and HT, and the eradication of H. pylori infection could reduce thyroid autoantibodies.
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Affiliation(s)
- Yi Hou
- Key Laboratory of Health Cultivation of the Ministry of Education, Beijing University of Chinese Medicine, Beijing, 100029, People's Republic of China.,Dongfang Hospital of Beijing University of Chinese Medicine, Beijing, 100078, People's Republic of China
| | - Wen Sun
- Key Laboratory of Health Cultivation of the Ministry of Education, Beijing University of Chinese Medicine, Beijing, 100029, People's Republic of China
| | - Chengfei Zhang
- Key Laboratory of Health Cultivation of the Ministry of Education, Beijing University of Chinese Medicine, Beijing, 100029, People's Republic of China.,Dongfang Hospital of Beijing University of Chinese Medicine, Beijing, 100078, People's Republic of China
| | - Tieshan Wang
- Beijing Institute of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, People's Republic of China
| | - Xuan Guo
- Key Laboratory of Health Cultivation of the Ministry of Education, Beijing University of Chinese Medicine, Beijing, 100029, People's Republic of China.,Dongfang Hospital of Beijing University of Chinese Medicine, Beijing, 100078, People's Republic of China
| | - Lili Wu
- Beijing Institute of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, People's Republic of China
| | - Lingling Qin
- Department of Science and Technology, Beijing University of Chinese Medicine, Beijing, 100029, People's Republic of China
| | - Tonghua Liu
- Key Laboratory of Health Cultivation of the Ministry of Education, Beijing University of Chinese Medicine, Beijing, 100029, People's Republic of China
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Shen Z, Munker S, Luo F, Ma H, Yu C, Li Y. Effect of Non-Alcoholic Fatty Liver Disease on Estimated Glomerular Filtration Rate Could Be Dependent on Age. PLoS One 2015; 10:e0130614. [PMID: 26087253 PMCID: PMC4472701 DOI: 10.1371/journal.pone.0130614] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 05/21/2015] [Indexed: 01/14/2023] Open
Abstract
There is a gap between the association of non-alcoholic fatty liver disease (NAFLD) and renal function in an apparently healthy population. This study aims to assess whether NAFLD is associated with estimated glomerular filtration rate (eGFR) levels and to understand early changes of eGFR in NAFLD. A cross-sectional study was performed among apparently healthy persons who underwent general health screening including laboratory assessments and hepatic ultrasonography from January 2013 to December 2013 at the First Affiliated Hospital of Zhejiang University, College of Medicine, China. This study included 1,193 subjects with a mean age of 48 years. Prevalence of NAFLD was 31.3%. Mean eGFR was significantly lower in NAFLD than in controls (107 ± 19 mL/min/1.73 m(2) vs. 113 ± 23 mL/min/1.73 m(2), P<0.001). Correlation analysis between eGFR and NAFLD related risk factors revealed an inverse correlation between eGFR levels and some NAFLD risk factors (all P<0.01). All subjects were classified into five phases according to age. Average eGFR levels of NAFLD were lower than controls in three phases for subjects with ≤ 50 years of age (all P<0.05), while there were no significant differences on average eGFR levels between NAFLD and controls in two phases for subjects with >50 years of age (Both P>0.05). The eGFR level is significantly associated with NAFLD and its risk factors in an apparently healthy population. Effects of NAFLD on eGFR could be dependent on age.
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Affiliation(s)
- Zhe Shen
- Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, 310003, Hangzhou, China
| | - Stefan Munker
- Molecular Hepatology-Alcohol Associated Diseases, II. Medical Clinic Faculty of Medicine at Mannheim, University of Heidelberg, 68167, Mannheim, Germany
| | - Fugang Luo
- College of Medicine, Zhejiang University, 310058, Hangzhou, China
| | - Han Ma
- Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, 310003, Hangzhou, China
| | - Chaohui Yu
- Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, 310003, Hangzhou, China
| | - Youming Li
- Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, 310003, Hangzhou, China
- * E-mail:
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Xu C, Yan M, Sun Y, Joo J, Wan X, Yu C, Wang Q, Shen C, Chen P, Li Y, Coleman WG. Prevalence of Helicobacter pylori infection and its relation with body mass index in a Chinese population. Helicobacter 2014; 19:437-42. [PMID: 25256639 DOI: 10.1111/hel.12153] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Helicobacter pylori infection is highly prevalent worldwide. The association between obesity and H. pylori infection is controversial in the literature. This study aims to investigate the prevalence of H. pylori infection and its relation with body mass index (BMI) in a Chinese population. MATERIALS AND METHODS A cross-sectional study was performed among adults who underwent health checkups at the First Affiliated Hospital, College of Medicine, Zhejiang University in 2013. The prevalence of H. pylori infection was examined by (13)C urea breath tests, and the association between prevalence of H. pylori infection and BMI was analyzed. RESULTS Of the 8820 participants enrolled, 3859 (43.8%) were positive for H. pylori infection. H. pylori-positive participants had a more unfavorable metabolic profile than H. pylori-negative participants. Overweight/obese participants showed a higher prevalence of H. pylori infection than that of lean participants, and a positive linear correlation between BMI and prevalence of H. pylori infection was observed. Both unadjusted and adjusted analysis revealed that BMI was significantly associated with risk factors of H. pylori infection. CONCLUSIONS Our results showed that BMI was significantly and positively associated with H. pylori infection, and a high BMI was associated with an increased risk of the infection.
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Affiliation(s)
- Chengfu Xu
- Department of Gastroenterology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China; Cancer Cluster, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA; Laboratory of Biochemistry and Genetics, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
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Testerman TL, Morris J. Beyond the stomach: An updated view of Helicobacter pylori pathogenesis, diagnosis, and treatment. World J Gastroenterol 2014; 20:12781-12808. [PMID: 25278678 PMCID: PMC4177463 DOI: 10.3748/wjg.v20.i36.12781] [Citation(s) in RCA: 195] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Revised: 04/17/2014] [Accepted: 06/23/2014] [Indexed: 02/06/2023] Open
Abstract
Helicobacter pylori (H. pylori) is an extremely common, yet underappreciated, pathogen that is able to alter host physiology and subvert the host immune response, allowing it to persist for the life of the host. H. pylori is the primary cause of peptic ulcers and gastric cancer. In the United States, the annual cost associated with peptic ulcer disease is estimated to be $6 billion and gastric cancer kills over 700000 people per year globally. The prevalence of H. pylori infection remains high (> 50%) in much of the world, although the infection rates are dropping in some developed nations. The drop in H. pylori prevalence could be a double-edged sword, reducing the incidence of gastric diseases while increasing the risk of allergies and esophageal diseases. The list of diseases potentially caused by H. pylori continues to grow; however, mechanistic explanations of how H. pylori could contribute to extragastric diseases lag far behind clinical studies. A number of host factors and H. pylori virulence factors act in concert to determine which individuals are at the highest risk of disease. These include bacterial cytotoxins and polymorphisms in host genes responsible for directing the immune response. This review discusses the latest advances in H. pylori pathogenesis, diagnosis, and treatment. Up-to-date information on correlations between H. pylori and extragastric diseases is also provided.
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