Key Laboratory of Environmental Medicine Engineering, Ministry of Education, Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing, China.
Department of Cardiology, ZhongDa Hospital, Southeast University, Nanjing, China.
Endocr Pract. 2022 Aug;28(8):822-831. doi: 10.1016/j.eprac.2022.05.008. Epub 2022 May 31.
To explore the relationship between thyroid dysfunction, thyroid-stimulating hormone (TSH) levels, and risks of atrial fibrillation (AF) in studies and conduct a dose-response meta-analysis on the correlation between the TSH levels and risk of AF.
Thirteen studies from 5 databases with 649 293 subjects (mean age, 65.1 years) were included. The dose-response meta-analysis was conducted by comparing the risk ratios (RRs) and 95% confidence intervals (CIs) for incident AF associated with different levels of TSH (vs TSH level of 0 mU/L) across studies. Data were collected until October 25, 2021.
Subclinical hyperthyroidism, subclinical hypothyroidism, and clinical hyperthyroidism were associated with an increased risk of AF (RR, 1.70; 95% CI, 1.11-2.62; RR, 1.23; 95% CI, 1.05-1.44; and RR, 2.35; 95% CI, 1.07-5.16, respectively), whereas clinical hypothyroidism was not associated with the significantly increased risk of AF (RR, 1.20; 95% CI, 0.72-1.99). A nonlinear relationship was observed in 2 models (crude model, P < .001; adjusted model, P = .0391) between the TSH levels and risks of AF.
Our study indicated that subclinical hyperthyroidism, subclinical hypothyroidism, clinical hyperthyroidism were associated with the risk of AF, and the results for the TSH levels and risk of AF were mixed, which showed a U-shaped relationship.
探讨甲状腺功能障碍、促甲状腺激素（TSH）水平与心房颤动（AF）风险之间的关系，并对 TSH 水平与 AF 风险之间的相关性进行剂量-反应荟萃分析。
纳入了来自 5 个数据库的 13 项研究，共 649293 名受试者（平均年龄 65.1 岁）。通过比较不同 TSH 水平（与 TSH 水平为 0 mU/L 相比）与 AF 事件相关的风险比（RR）和 95%置信区间（CI），进行了剂量-反应荟萃分析。数据收集截至 2021 年 10 月 25 日。
亚临床甲状腺功能亢进症、亚临床甲状腺功能减退症和临床甲状腺功能亢进症与 AF 风险增加相关（RR，1.70；95%CI，1.11-2.62；RR，1.23；95%CI，1.05-1.44；RR，2.35；95%CI，1.07-5.16），而临床甲状腺功能减退症与 AF 风险的显著增加无关（RR，1.20；95%CI，0.72-1.99）。在 2 个模型（未校正模型，P<0.001；校正模型，P=0.0391）中，TSH 水平与 AF 风险之间观察到非线性关系。
我们的研究表明，亚临床甲状腺功能亢进症、亚临床甲状腺功能减退症、临床甲状腺功能亢进症与 AF 风险相关，且 TSH 水平与 AF 风险的结果不一致，呈 U 型关系。
