The Impact of Obesity on Thyroid Autoimmunity and Dysfunction: A Systematic Review and Meta-Analysis

Rong-Hua Song, Bin Wang, Qiu-Ming Yao, Qian Li, Xi Jia, Jin-An Zhang, Rong-Hua Song, Bin Wang, Qiu-Ming Yao, Qian Li, Xi Jia, Jin-An Zhang

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.

Keywords: hypothyroidism; meta-analysis; obesity; systematic review; thyroid autoimmunity; thyroid disease; thyroid dysfunction.

Copyright © 2019 Song, Wang, Yao, Li, Jia and Zhang.

Figures

Figure 1
Figure 1
Flow chart of study selection in this meta-analysis.
Figure 2
Figure 2
Forest plot for the risk of the whole hypothyroid disorders in obesity. SCH, subclinical hypothyroidism; Overtthypo, overt hypothyroidism.
Figure 3
Figure 3
Forest plots for the risk of hypothyroid disorders in obesity. (A) Forest plot for the risk of overt hypothyroidism in obesity patients. (B) Forest plot for the risk of subclinical hypothyroidism in obesity patients. SCH, subclinical hypothyroidism; Overtthypo, overt hypothyroidism.
Figure 4
Figure 4
Meta-analysis of association between HT and obesity.
Figure 5
Figure 5
Meta-analysis of association between thyroid auto-antibodies and obesity. (A) Association between positive TGAb and obesity. (B) Association between positive TPOAb and obesity patients.

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