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Morbidity before and after the Diagnosis of Hyperthyroidism: A Nationwide Register-Based Study
Open accessAbstract
BACKGROUND: Hyperthyroidism has been linked with different morbidities, like atrial fibrillation, stroke and diabetes mellitus. However, our knowledge regarding the extent and temporal relation between hyperthyroidism and other diseases is fragmented. Here, we aimed at evaluating various morbidities before and after the diagnosis of hyperthyroidism. METHODS: Observational cohort study. From nationwide Danish health registers 2631 hyperthyroid singletons and 375 twin pairs discordant for hyperthyroidism were identified and followed for an average of 6 years (range 0-13). Data on the occurrence of cardiovascular diseases, lung diseases, diabetes mellitus, rheumatic diseases and malignant diseases was obtained by person-to-person record linkage with the National Danish Patient Register and/or the Danish National Prescription Registry (lung diseases and diabetes mellitus). Logistic and Cox regression models were used to assess the risk of morbidity before and after the diagnosis of hyperthyroidism, respectively. All Cox regression analyses were adjusted for the degree of co-morbidity preceding the diagnosis of hyperthyroidism, using the Charlson score. RESULTS: Hyperthyroid individuals had a significantly higher risk of being diagnosed with cardiovascular diseases (odds ratio (OR) 1.65; 95% confidence interval (CI): 1.45-1.87), lung diseases (OR 1.53; 95% CI: 1.29-1.60), and diabetes mellitus (OR 1.43, 95% CI: 1.20-1.72), but not with malignant diseases (OR 1.16, 95% CI: 0.99-1.36) prior to the diagnosis of hyperthyroidism. After the diagnosis of hyperthyroidism, subjects had a significantly higher risk of being diagnosed with cardiovascular diseases (hazard ratio (HR) 1.34; 95% CI: 1.15-1.56), lung diseases (HR 1.28; 95% CI: 1.10-1.49), and diabetes mellitus (HR 1.46; 95% CI: 1.16-1.84), but not with rheumatic diseases (HR 1.39, 95% CI: 0.92-2.09) or malignant diseases (HR 1.18, 95% CI 0.97-1.42). CONCLUSIONS: We demonstrate a significantly increased burden of morbidity, both before and after the diagnosis of hyperthyroidism.
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“An elevated risk of T2DM in patients with hyperthyroidism has been documented (6, 7).”
From The progression of secondary diabetes: A review of modeling studies (2022) · cites this paper as [6]
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“A number of studies have reported the rising incidence of diabetes mellitus in patients with thyroid hormone dysregulation and vice versa (6, 7).”
From The progression of secondary diabetes: A review of modeling studies (2022) · cites this paper as [6]
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“Thus, overtreatment of hypothyroidism most likely carries a similar risk of increased morbidity (39,40) and mortality, (41) as shown for hyperthyroidism.”
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Gharib, H., Papini, E., Garber, J. R., Duick, D. S., Harrell, R. M., Hegedűs, L. D., Paschke, R., Valcavi, R., & Vitti, P. (2016) · Endocrine Practice · doi:10.4158/ep161208.gl · Cited by 1,285
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Self-citationThyroid dysfunction and diabetes mellitus: two closely associated disorders
Biondi, B., Kahaly, G. J., & Robertson, R. P. (2019) · Endocrine Reviews · doi:10.1210/er.2018-00163 · Cited by 598
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Metadata
- Authors
- Brandt, F., Thvilum, M., Almind, D., Christensen, K., Green, A., Hegedüs, L., & Brix, T. H.
- Affiliations
- Odense University Hospital (DK)
- University of Southern Denmark (DK)
- Corresponding author
- Brandt, Frans
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2013-06-20
- Volume
- 8
- Issue
- 6
- Pages
- e66711
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC3688572
- OpenAlex
- W2044489693
- Cited by
- 142
- References
- 44
- Citations by year
- 2026: 1 · 2025: 7 · 2024: 10 · 2023: 15 · 2022: 17 · 2021: 13 · 2020: 17 · 2019: 6 · 2018: 12 · 2017: 11 · 2016: 8 · 2015: 9 · 2014: 15 · 2013: 1
- FWCI
- 8.67
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion)
- Funders
- Novo Nordisk
- Syddansk Universitet
- Novo Nordisk Fonden
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Health Sciences › Medicine › Ophthalmology › Ophthalmology and Eye Disorders
- Keywords
- hyperthyroidism, comorbidities, cardiovascular disease, lung disease, diabetes mellitus, rheumatic diseases, cancer, atrial fibrillation, stroke, hyperthyroidism diagnosis, twin discordance, Charlson Comorbidity Index, Denmark, patient registry, data linkage
- MeSH terms
- Aged, Cardiovascular Diseases, Denmark, Diabetes Mellitus, Female, Humans, Hyperthyroidism, Lung Diseases, Male, Middle Aged, Morbidity, Registries, Time Factors, Cohort Studies, Logistic Models, Proportional Hazards Models
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