Huang M, Yang S, Ge G, Zhi H, Wang L. Effects of thyroid dysfunction and thyroid stimulating hormone levels on the Atrial fibrillation risks: a systematic review and dose-response meta-analysis from cohort studies.
Endocr Pract 2022;
28:822-831. [PMID:
35660465 DOI:
10.1016/j.eprac.2022.05.008]
[Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 05/23/2022] [Accepted: 05/25/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE
To explore the relationship between thyroid dysfunction, thyroid stimulating hormone (TSH) levels and risks of atrial fibrillation (AF) in studies as well as to conduct a dose-response meta-analysis on the correlation between TSH levels and AF risks.
METHODS
13 studies from five databases with 649,293 subjects (mean age 65.1 years) were included. The dose-response meta-analysis was conducted by comparing the Risk Ratios (RRs) and 95% Confidence Intervals (CI) for incident AF associated with different levels of TSH (vs TSH=0 mU/L) across studies. Data were collected until Oct 25, 2021.
RESULTS
Subclinical hyperthyroidism, subclinical hypothyroidism, clinical hyperthyroidism were associated with the increased risk of AF respectively (RR=1.70, 95% CI: 1.11-2.62; RR=1.23, 95% CI:1.05-1.44; RR=2.35, 95% CI:1.07-5.16), while clinical hypothyroidism was not found associated with the significantly increased risk of AF (RR=1.20, 95% CI: 0.72-1.99). A non-linear relationship was observed in two models (crude model: Pnonlinear<0.001; adjusted model: Pnonlinear =0.0391) between the TSH concentrations and the risks of AF.
CONCLUSIONS
Our study indicated that subclinical hyperthyroidism, subclinical hypothyroidism, clinical hyperthyroidism were associated with the risk of AF, and the results for TSH levels and AF risk were mixed which showed a U-shaped relationship.
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