Alzghoul Bashar N, Amer Farah N, Barb Diana, Innabi Ayoub, Mardini Mamoun T, Bai Chen, Alzghoul Bara, Al-Hakim Tamara, Singh Noopur, Buchanan Mindy, Serchuck Leslie, Gomez Manjarres Diana, Woodmansee Whitney W, Maier Lisa A, Patel Divya C
Division of Pulmonary, Critical Care and Sleep Medicine, University of Florida, Gainesville, FL, USA.
Dept of Internal Medicine, University of Central Florida/North Florida Regional Medical Center, Gainesville, FL, USA.
ERJ Open Res. 2021 Mar 29;7(1). doi: 10.1183/23120541.00754-2020. eCollection 2021 Jan.
Little is known about the prevalence, clinical characteristics and impact of hypothyroidism in patients with sarcoidosis. We aimed to determine the prevalence and clinical features of hypothyroidism and its relation to organ involvement and other clinical manifestations in patients with sarcoidosis. We conducted a national registry-based study investigating 3835 respondents to the Sarcoidosis Advanced Registry for Cures Questionnaire between June 2014 and August 2019. This registry is based on a self-reported, web-based questionnaire that provides data related to demographics, diagnostics, sarcoidosis manifestations and treatment. We compared sarcoidosis patients with and without self-reported hypothyroidism. We used multivariable logistic regression and adjusted for potential confounders to determine the association of hypothyroidism with nonorgan-specific manifestations. 14% of the sarcoidosis patients self-reported hypothyroidism and were generally middle-aged white women. Hypothyroid patients had more comorbid conditions and were more likely to have multiorgan sarcoidosis involvement, especially with cutaneous, ocular, joints, liver and lacrimal gland involvement. Self-reported hypothyroidism was associated with depression (adjusted odds ratio (aOR) 1.3, 95% CI 1.01-1.6), antidepressant use (aOR 1.3, 95% CI 1.1-1.7), obesity (aOR 1.7, 95% CI 1.4-2.1), sleep apnoea (aOR 1.7, 95% CI 1.3-2.2), chronic fatigue syndrome (aOR 1.5, 95% CI 1.2-2) and was borderline associated with fibromyalgia (aOR 1.3, 95% CI 1-1.8). Physical impairment was more common in patients with hypothyroidism. Hypothyroidism is a frequent comorbidity in sarcoidosis patients that might be a potentially reversible contributor to fatigue, depression and physical impairment in this population. We recommend considering routine screening for hypothyroidism in sarcoidosis patients especially in those with multiorgan sarcoidosis, fatigue and depression.
结节病患者甲状腺功能减退的患病率、临床特征及影响鲜为人知。我们旨在确定结节病患者甲状腺功能减退的患病率和临床特征，及其与器官受累和其他临床表现的关系。我们进行了一项基于全国登记处的研究，调查了2014年6月至2019年8月期间对结节病高级治愈登记问卷的3835名受访者。该登记处基于一份自我报告的网络问卷，提供与人口统计学、诊断、结节病表现和治疗相关的数据。我们比较了自我报告有或无甲状腺功能减退的结节病患者。我们使用多变量逻辑回归并对潜在混杂因素进行调整，以确定甲状腺功能减退与非器官特异性表现的关联。14%的结节病患者自我报告有甲状腺功能减退，且通常为中年白人女性。甲状腺功能减退患者有更多的合并症，更有可能有多器官结节病受累，尤其是皮肤、眼睛、关节、肝脏和泪腺受累。自我报告的甲状腺功能减退与抑郁症（调整后的优势比[aOR] 1.3，95%可信区间[CI] 1.01 - 1.6）、使用抗抑郁药（aOR 1.3，95% CI 1.1 - 1.7）、肥胖（aOR 1.7，95% CI 1.4 - 2.1）、睡眠呼吸暂停（aOR 1.7，95% CI 1.3 - 2.2）、慢性疲劳综合征（aOR 1.5，95% CI 1.2 - 2）相关，与纤维肌痛呈临界相关（aOR 1.3，95% CI 1 - 1.8）。身体损伤在甲状腺功能减退患者中更常见。甲状腺功能减退是结节病患者中常见的合并症，可能是该人群疲劳、抑郁和身体损伤的潜在可逆因素。我们建议对结节病患者，尤其是那些有多器官结节病、疲劳和抑郁的患者，考虑进行甲状腺功能减退的常规筛查。
