Abstract
Background: To help inform decision making in the clinical setting, we carried out a systematic review and meta-analysis to estimate the association of thyroid disease risks with obesity.Methods: Pubmed, Embase, Web of Science, Cochrane database and Google Scholar electronic databases were searched from inception to October 31, 2018 without language restrictions to explore the relationship between thyroid disorders and obesity. The relative risk (RR) or odds risk (OR) for thyroid disorders were pooled using the SPSS and STATA software.Results: A total of 22 studies were included in the study. (1) Meta-analysis showed that obesity was significantly associated with an increased risk of hypothyroidism (RR = 1.86, 95% CI 1.63–2.11, P < 0.001). Meta-analyses after stratification further showed that obese population had increased risks of overt hypothyroidism (RR = 3.21, 95% CI 2.12–4.86, P < 0.001) and subclinical hypothyroidism (RR = 1.70, 95% CI 1.42–2.03, P < 0.001). (2) Further meta-analysis also showed obesity was clearly associated with Hashimoto's thyroiditis (RR = 1.91, 95% CI 1.10–3.32, P = 0.022), but not with Graves' disease. (3) In the meta-analysis of antibodies, obesity was correlated with positive thyroid peroxidase antibody (TPOAb) (RR = 1.93, 95% CI 1.31–2.85, P = 0.001), but not with positive thyroglobulin antibody (TGAb).Conclusions: Obesity was significantly related to hypothyroidism, HT, and TPOAb, implying that prevention of obesity is crucial for thyroid disorders.Systematic Review Registration: PROSPERO: CRD42018096897.
Highlights
Since the rise of obesity epidemic worldwide, obesity has gained increasing attention and been regarded as a significant public health challenge globally for its wide-ranging adverse consequences on human health such as increased risks of diabetes [1], cardiovascular disease [2], and cancers [3].The incidence of thyroid disorders, which mainly include thyroid dysfunctions and autoimmune thyroid diseases (AITDs), is increasing in these years
Meta-analyses after stratification further showed that obese population had increased risks of overt hypothyroidism (RR = 3.21, 95% CI 2.12–4.86, P < 0.001) and subclinical hypothyroidism (RR = 1.70, 95% CI 1.42–2.03, P < 0.001)
(3) In the meta-analysis of antibodies, obesity was correlated with positive thyroid peroxidase antibody (TPOAb) (RR = 1.93, 95% CI 1.31–2.85, P = 0.001), but not with positive thyroglobulin antibody (TGAb)
Summary
The incidence of thyroid disorders, which mainly include thyroid dysfunctions and autoimmune thyroid diseases (AITDs), is increasing in these years. AITDs, one of the most common autoimmune diseases, are characterized by autoantibodies against thyroid antigens, such as TSH receptor antibody (TRAb), thyroid peroxidase antibody (TPOAb), and thyroglobulin antibody (TGAb). They have two principal subtypes: Graves’ disease (GD) and Hashimoto’s thyroiditis (HT), which hold different clinical manifestations though have similar immunogenetic mechanisms [5]. Patients with thyroid disorders have a high risk of other nonthyroid diseases, such as cardiovascular diseases, cancer, obesity, and adverse pregnancy outcomes [6,7,8,9]. To help inform decision making in the clinical setting, we carried out a systematic review and meta-analysis to estimate the association of thyroid disease risks with obesity
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