Thyroid Disease: Monthly Essentials January 2017

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The 3 essential studies on Thyroid Diseases this month, selected from 174 peer-reviewed studies

1. Many nondigestive diseases have been linked to CD. Whether thyroid disease is more common in patients with CD has been controversial. See our essential synopsis of the article from PLoS One below.

2. 5000 patients in the first prospective population-based study reporting this link. See our essential synopsis of the article from Eur J Endocrinol below.

3. Iodine deficiency during pregnancy can lead to congenital hypothyroidism in infants and intellectual impairment. Most obstetricians and midwives fail to recommend iodine supplements, says survey. See our essential synopsis of the article from Thyroid below.

 

See December's Monthly Essentials on Thyroid Diseases»
See yesterday's Monthly Essentials on Heart Failure»

 
1

Meta-analysis finds higher prevalence of thyroid disease in celiac patients

Source: PLoS One

Takeaway
 
  • Meta-analysis found thyroid disease more prevalent in patients with celiac disease (CD) compared with people without the digestive disorder.
  • Authors recommend that patients with CD be screened for thyroid disease.

Key results

  • Prevalence of thyroid disease significantly higher in patients with CD compared with control patients (P<.001).
  • Prevalence of hypothyroidism was higher than in control groups, and euthyroidism autoimmune thyroid disease was 4-fold higher than in control patients.
  • No significant association between CD and prevalence of hyperthyroidism.
  • Gluten-free diet did not appear to be associated with thyroid disease.

Study design

  • Meta-analysis including 13 case-control and retrospective cohort studies assessing the prevalence of thyroid disease in people with CD. 
  • Articles from PubMed, Web of Science, Embase, and Chinese WanFang databases through May 2016.
  • 15,629 patients with CD and 79,342 control patients included.
  • Funding: None.

Why this matters

  • Many nondigestive diseases have been linked to CD.
  • Whether thyroid disease is more common in patients with CD has been controversial.
  • Most previous studies linking CD to thyroid disease were small cross-sectional surveys and lacked control groups.

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2

Hyperactive thyroid may increase risk for decline in kidney function

 

Source: Eur J Endocrinol

Takeaway

  • Hyperactive thyroid function was associated with greater risk for kidney function decline in a prospective study.
  • Hypothyroidism was associated with decreased risk for chronic kidney disease (CKD). 
Key results
  • Higher thyroid-stimulating hormone levels were associated with lower estimated glomerular filtration rate (eGFR) and less annual eGFR decline.
  • Patients with subclinical hyperthyroidism had increased risk for CKD compared with patients with euthyroidism.
  • Patients with hypothyroidism were at decreased risk for CKD.

Study design

  • Prospective longitudinal cohort study.
  • 5103 patients aged ≥45 y from the Rotterdam Study for whom thyroid and kidney function were assessed.
  • Mean follow-up, 8.1 y.

Why this matters

  • Thyroid dysfunction has been associated with kidney function decline in cross-sectional studies.
  • First prospective population-based study reporting a link between high thyroid function and kidney function decline.

View Abstract

 
3

Do US women get proper counseling with regard to iodine intake?

 

Source: Thyroid

Takeaway

  • 75% of US obstetricians and midwives do not recommend prenatal vitamins containing iodine during preconception, pregnancy, and lactation, or recommended an inadequate amount.
  • The Endocrine Society, the American Thyroid Association, the Teratology Society, and the American Academy of Pediatrics recommend prenatal vitamins containing 150 μg iodine during preconception, pregnancy, and lactation.

Key results

  • 199 midwives and 277 obstetricians took the survey.
  • 34.8% of obstetricians thought iodine status of US pregnant women was low, whereas 43.4% of midwives did.
  • Most respondents reported rarely or never recommending supplements containing iodine for women during preconception.
  • Of those who did recommend iodine supplementations, 45% said they prescribed the recomm...