The association between thyroid disorders and incident gout: population-based case control study
This section collects any data citations, data availability statements, or supplementary materials included in this article. This study has been approved by the Independent Scientific Advisory Committee for the Medicines and Healthcare Products Regulatory Agency database research (protocol number 15_079R). The committee did not require written informed consent be obtained from the participants, as this was a retrospective study, and all data was anonymized. YX retrieved literature, extracted data, developed quality evaluation standard, and wrote articles. Seek medical care immediately if you have a fever and a joint is hot and inflamed, which can be a sign of infection. It’s characterized by sudden, severe attacks of pain, swelling, redness and tenderness in one or more joints, most often in the big toe.
Sensitivity analyses
A possible explanation for these potential associations is the ability of thyroid hormone to influence serum urate levels through regulation of glomerular filtration rate 20. In contrast, only several older case series reported an association between gout and hypothyroidism 21–23 and the association between hyperthyroidism and gout has not been reported. In our study, the association between hypothyroid function and hyperuricaemia seems to be week.
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The results of this analysis showed that hyperuricemia was more prevalent in subclinical thyroid dysfunction than in normal thyroid function subjects. The serum UA levels of patients with SCH were significantly higher than that of patients with SCHyper and were higher than that of normal thyroid function subjects, with the difference being statistically significant. For the primary analysis, we used the number of subjects as the denominator. Cases of hyperuricaemia and gout were identified according to the aforementioned criteria.
A similar rise in TSH levels synthroid discontinued was observed in both groups (0.4 and 0.5 µUI/mL for febuxostat and allopurinol, respectively); at 12-mo, 7/88 (7.9 %) of patients on febuxostat and 4/87 (3.4 %) of patients on allopurinol showed TSH levels over 0.5 µUI/mL. Doses prescribed (corrected for estimated glomerular filtration rate in the case if patients on allopurinol) and baseline TSH levels were determinants of TSH levels at 12-month follow-up. Febuxostat, but also allopurinol, increased TSH levels in a dose-dependent way, thus suggesting rather a class effect than a drug effect, but with no apparent impact on either clinical or fT4 levels. Thyroid diseases include both hypo and hyperthyroidism with types of overt and subclinical 30.The relationship between overt thyroid dysfunction (hyperthyroidism and hypothyroidism) and UA has received considerable attention. Giordano et al. reported the prevalence of hyperuricemia was significantly higher among patients with hyperthyroidism and hypothyroidism compared with the general population 31.
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- Mean ± SD was extracted when the level of UA was used as a continuous variable, and the corresponding proportion was extracted when the level of UA was used as a binary variable.
- Additionally, medications such as febuxostat (Uloric) and allopurinol (Zyloprim) may be prescribed to lower uric acid levels in the body and prevent the formation of urate crystals that cause gout.
- Inclusion and exclusion criteria for included studies are given in Table S2 in Supplementary Materials.
- We used a 2-sample MR Study to reveal the causal relationship between autoimmune hypothyroidism and autoimmune hyperthyroidism on gout, which is helpful for further research.
The case group had a higher incidence of disease than the control group. Although its prevalence in South Korea is lower than that in other countries, the incidence increased by 25% between 2009 and 2015, according to a study using the national health insurance claim database. Dietary factors, increasing age, and comorbid conditions were environmental influences on gout incidence2,3.
We did not have full information on medications therefore this cannot be accounted for by our model. The strengths of this study include its use of carefully standardized methods and the large size of the study cohort. In addition, we used a cohort from a health screening, which is more representative of the general population than most previous hospital-based studies. Using 2-sample MR Analysis, we investigated the relationship between autoimmune hypothyroidism, autoimmune hyperthyroidism, thyroid nodules, thyroid cancer, and gout. We found a causal relationship between autoimmune hypothyroidism, autoimmune hyperthyroidism, and gout, all of which increase the risk of gout. There is no causal relationship between thyroid cancer, thyroid nodules and gout.
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Data from included studies were extracted and summarized independently using a prestandardized data extraction form. The excerpts included basic characteristics (year of publication, study area, number of participants, diagnostic criteria, the determination method of UA and thyroid hormones, and inclusion and exclusion criteria). Mean ± SD was extracted when the level of UA was used as a continuous variable, and the corresponding proportion was extracted when the level of UA was used as a binary variable. The cutoff value for the diagnosis of hyperuricemia and subclinical thyroid dysfunction was extracted. Nevertheless, a previous study provided evidence for the good reliability and sensitivity of self-reported and physician-diagnosed gout 25. In addition, we relied on a single measurement of SUA and TSH levels; therefore, we were unable to give a definite diagnosis of hyperthyroidism or hypothyroidism and cannot take into account any variation that may have occurred over time.
Association between allopurinol use and increased TSH
There is no causal relationship between gout and autoimmune hypothyroidism, autoimmune hyperthyroidism, thyroid nodules, and thyroid cancer. In future studies, we need a larger sample size to verify the causal relationship and clarify the mechanism from multiple disciplines and perspectives. We used a 2-sample MR Study to reveal the causal relationship between autoimmune hypothyroidism and autoimmune hyperthyroidism on gout, which is helpful for further research. First, to date, this is the first study using MR Methods to investigate the causal relationship between autoimmune hypothyroidism, autoimmune hyperthyroidism, thyroid nodules, and thyroid cancer and gout. Secondly, we used a rigorous IVs selection, multiple MR Methods and pleiotropic testing to ensure the reliability of the results. Finally, all included populations were European, which reduced confounding bias.
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Purine-rich seafood includes anchovies, sardines, mussels, scallops, trout and tuna. Alcoholic beverages, especially beer, and drinks sweetened with fruit sugar (fructose) promote higher levels of uric acid. Gout occurs when urate crystals accumulate in your joint, causing the inflammation and intense pain of a gout attack.
In general, 15% of the patients with gouty arthritis had hypothyroidism, with higher rates in women than men. The mean TSH of the gouty patients was also significantly greater (TSH of around 5.2) compared to the control patients (TSH of about 1.8). The study also suggested that screening for hypothyroidism should be considered in all patients presenting with gout or a history of recurrent gouty flares. This observational study showed associations, but it was unable to determine causality. Traditional medical record reviews provide detailed clinical information, whereas the database of the CDM deidentifies personal information to protect patient privacy.
