Abstract
We investigated the association between autoimmune thyroid disease and systemic lupus erythematosus (SLE) using nationwide insurance claims data for the entire Korean population. Claims data for the period 2009–2013 were retrieved from the National Health Insurance System database. SLE and thyroid disease were identified using the International Classification of Diseases codes and medication information. Logistic regression analyses were used to evaluate the association between SLE and thyroid disease. The study used records from 17,495 patients with SLE and 52,485 age- and sex-matched control subjects. A greater prevalence of Graves’ disease (0.94% vs. 0.46%, P < 0.001), Hashimoto’s thyroiditis (2.68% vs. 0.80%, P < 0.001), and thyroid cancer (1.81% vs. 1.30%, P < 0.001) was observed in SLE patients than in control subjects. Multivariate regression analyses demonstrated that SLE was significantly associated with an increased risk of both autoimmune thyroid disease and thyroid cancer (Graves’ disease: odds ratio [OR] 2.07, 95% confidence interval [CI] 1.70–2.53; Hashimoto’s thyroiditis: OR 3.42, 95% CI 3.00–3.91; thyroid cancer: OR 1.40, 95% CI 1.22–1.60). Age- and sex- stratified analyses revealed that the risk of autoimmune thyroid disease in SLE patients was increased for all age groups and the female group. An association between thyroid cancer and SLE was identified only in the 20- to 59-year-old age group and in the female group. Using a large population-based study, we demonstrated that patients with SLE are at a greater risk of developing thyroid disease than matched control individuals.
Highlights
After adjusting for age and sex, patients with Systemic lupus erythematosus (SLE) exhibited a greater risk for Graves’ disease and Hashimoto’s thyroiditis than control subjects
The present study demonstrates that SLE patients have a higher risk of developing Autoimmune thyroid disease (AITD) and thyroid cancer; this association was especially pronounced in women and in the
As we assessed the relationship between AITD and SLE using the national Korean population database, the total numbers of patients with SLE and with each thyroid disease were much greater than values reported in previous studies, and we show that the risk of both Graves’ disease and Hashimoto’s thyroiditis was significantly higher in SLE patients than in the control subjects
Summary
Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by disturbances in the immune response and autoantibody production that lead to multi-system organ damage. Systemic lupus erythematosus and throid disease and dysfunction [1]. Autoimmune thyroid disease (AITD) is a well-known, organ-specific autoimmune disorder that is associated with many non-specific autoimmune diseases such as rheumatoid arthritis, Sjogren’s syndrome, and SLE [6]. AITD occurs as a result of a T-cell-mediated autoimmune response characterized by diffuse lymphocytic infiltration of the thyroid gland. The possibility that a significant association exists between SLE and thyroid disease has been consistently suggested since the first case of SLE and Hashimoto’s thyroiditis was described 50 years ago [7]; whether SLE is associated with a greater incidence of thyroid disease is still unclear
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