Hidradenitis suppurativa is associated with hypothyroidism and hyperthyroidism: a large-scale population-based study.


Journal

International journal of dermatology
ISSN: 1365-4632
Titre abrégé: Int J Dermatol
Pays: England
ID NLM: 0243704

Informations de publication

Date de publication:
Mar 2021
Historique:
received: 02 07 2020
revised: 07 09 2020
accepted: 29 10 2020
pubmed: 27 11 2020
medline: 22 6 2021
entrez: 26 11 2020
Statut: ppublish

Résumé

Hidradenitis suppurativa (HS) is a chronic inflammatory disease involving the skin bearing apocrine glands. There are numerous comorbidities and associated diseases among patients with HS. The association of HS and thyroid abnormalities is equivocal. We aimed to explore whether HS is associated with thyroid disorders. In this cross-sectional large-scale population-based study in Israel, patients with a validated diagnosis of HS were matched at a proportion of 1:5 with age- and gender-matched healthy controls without HS. A cross-checking for HS diagnosis by International Classification of Diseases, ninth revision (ICD-9) coding, and hyperthyroidism and hypothyroidism by ICD-9 coding was performed. Demographic and exposure covariates were identified. Univariate and multivariate logistic regressions were utilized to establish the association of HS with thyroid disorders. Study participants included 4,191 HS patients and 20,941 controls. The average age of patients was 39.7 years old, and 61.8% were female. 53.4% of HS patients and 13.5% of controls (P < 0.001) were smokers. Odds ratios (ORs) for hypothyroidism and hyperthyroidism in HS were 2.91 (95% confidence interval [CI] 2.48-3.40) and 2.25 (95% CI 1.55-3.28), respectively (P < 0.001 for both). While the association of HS with hypothyroidism was maintained across genders and all age groups, and remained positive after controlling for smoking status, the association with hyperthyroidism remained positive only among females, middle-aged patients, and nonsmokers. HS is independently associated with hypothyroidism. The association of HS with hyperthyroidism held significance only in limited subgroups. Smoking status is a major modifier, mainly in the association of HS with hyperthyroidism.

Sections du résumé

BACKGROUND BACKGROUND
Hidradenitis suppurativa (HS) is a chronic inflammatory disease involving the skin bearing apocrine glands. There are numerous comorbidities and associated diseases among patients with HS. The association of HS and thyroid abnormalities is equivocal. We aimed to explore whether HS is associated with thyroid disorders.
METHODS METHODS
In this cross-sectional large-scale population-based study in Israel, patients with a validated diagnosis of HS were matched at a proportion of 1:5 with age- and gender-matched healthy controls without HS. A cross-checking for HS diagnosis by International Classification of Diseases, ninth revision (ICD-9) coding, and hyperthyroidism and hypothyroidism by ICD-9 coding was performed. Demographic and exposure covariates were identified. Univariate and multivariate logistic regressions were utilized to establish the association of HS with thyroid disorders.
RESULTS RESULTS
Study participants included 4,191 HS patients and 20,941 controls. The average age of patients was 39.7 years old, and 61.8% were female. 53.4% of HS patients and 13.5% of controls (P < 0.001) were smokers. Odds ratios (ORs) for hypothyroidism and hyperthyroidism in HS were 2.91 (95% confidence interval [CI] 2.48-3.40) and 2.25 (95% CI 1.55-3.28), respectively (P < 0.001 for both). While the association of HS with hypothyroidism was maintained across genders and all age groups, and remained positive after controlling for smoking status, the association with hyperthyroidism remained positive only among females, middle-aged patients, and nonsmokers.
CONCLUSION CONCLUSIONS
HS is independently associated with hypothyroidism. The association of HS with hyperthyroidism held significance only in limited subgroups. Smoking status is a major modifier, mainly in the association of HS with hyperthyroidism.

Identifiants

pubmed: 33241580
doi: 10.1111/ijd.15319
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

321-326

Informations de copyright

© 2020 the International Society of Dermatology.

Références

Jemec GB. Clinical practice. Hidradenitis suppurativa. N Engl J Med 2012; 366: 158-164.
Goldburg SR, Strober BE, Payette MJ. Hidradenitis suppurativa: epidemiology, clinical presentation, and pathogenesis. J Am Acad Dermatol 2020; 82: 1045-1058.
Bui TL, Silva-Hirschberg C, Torres J, et al. Hidradenitis suppurativa and diabetes mellitus: a systematic review and meta-analysis. J Am Acad Dermatol 2018; 78: 395-402.
Vanderpump MP. The epidemiology of thyroid disease. Br Med Bull 2011; 99: 39-51.
McLeod DS, Cooper DS. The incidence and prevalence of thyroid autoimmunity. Endocrine 2012; 42: 252-265.
Chaker L, Bianco AC, Jonklaas J, et al. Hypothyroidism. Lancet 2017; 390: 1550-1562.
Taylor PN, Albrecht D, Scholz A, et al. Global epidemiology of hyperthyroidism and hypothyroidism. Nat Rev Endocrinol 2018; 14: 301-316.
Baldini E, Odorisio T, Tuccilli C, et al. Thyroid diseases and skin autoimmunity. Rev Endocr Metab Disord 2018; 19: 311-323.
Kridin K, Khamaisi M, Comaneshter D, et al. Autoimmune thyroid diseases and thyroid cancer in pemphigus: a big data analysis. Front Med (Lausanne) 2018; 5: 159.
Lee JH, Kwon HS, Jung HM, et al. Prevalence and comorbidities associated with hidradenitis suppurativa in Korea: a nationwide population-based study. J Eur Acad Dermatol Venereol 2018; 32: 1784-1790.
Shlyankevich J, Chen AJ, Kim GE, et al. Hidradenitis suppurativa is a systemic disease with substantial comorbidity burden: a chart-verified case-control analysis. J Am Acad Dermatol 2014; 71: 1144-1150.
Antonelli A, Ferrari SM, Corrado A, et al. Autoimmune thyroid disorders. Autoimmun Rev 2015; 14: 174-180.
Yazıcı D, Aydın SZ, Yavuz D, et al. Anti-Saccharomyces Cerevisiae antibodies (ASCA) are elevated in autoimmune thyroid disease ASCA in autoimmune thyroid disease. Endocrine 2010; 38: 194-198.
Tzur Bitan D, Berzin D, Cohen AD. Hidradenitis suppurativa and schizophrenia: a nationwide cohort study. J Eur Acad Dermatol Venereol 2020; 34: 574-579.
Tricarico PM, Boniotto M, Genovese G, et al. An integrated approach to unravel hidradenitis suppurativa etiopathogenesis. Front Immunol 2019; 10: 892.
van der Zee HH, Horvath B, Jemec GBE, Prens EP. The association between hidradenitis suppurativa and Crohn's disease: in search of the missing pathogenic link. J Invest Dermatol 2016; 136: 1747-1748.
Boelen A, Kwakkel J, Fliers E. Beyond low plasma T3: local thyroid hormone metabolism during inflammation and infection. Endocr Rev 2011; 32: 670-693.
González-López MA, Hernández JL, Vilanova I, et al. Thyroid autoimmunity in patients with hidradenitis suppurativa: a case-control study. Clin Exp Dermatol 2017; 42: 642-644.
Miller IM, Vinding G, Sørensen HA, et al. Thyroid function in hidradenitis suppurativa: a population-based cross-sectional study from Denmark. Clin Exp Dermatol 2018; 43: 899-905.
Acharya P, Mathur M. Thyroid disorders in patients with hidradenitis suppurativa: a systematic review and meta-analysis. J Am Acad Dermatol 2020; 82: 491-493.
Cannistrà C, Finocchi V, Trivisonno A, et al. New perspectives in the treatment of hidradenitis suppurativa: surgery and brewer's yeast-exclusion diet. Surgery 2013; 154: 1126-1130.
Aboud C, Zamaria N, Cannistrà C. Treatment of hidradenitis suppurativa: surgery and yeast (Saccharomyces cerevisiae)-exclusion diet. Results after 6 years. Surgery 2020; 167: 1012-1015.
Matusiak L, Bieniek A, Szepietowski JC. Increased serum tumour necrosis factor-alpha in hidradenitis suppurativa patients: is there a basis for treatment with anti-tumour necrosis factor-alpha agents? Acta Derm Venereol 2009; 89: 601-603.
Acharya P, Mathur M. Hidradenitis suppurativa and smoking: a systematic review and meta-analysis. J Am Acad Dermatol 2020; 82: 1006-1011.
Vitales-Noyola M, Ramos-Levi AM, Martínez-Hernández R, et al. Pathogenic Th17 and Th22 cells are increased in patients with autoimmune thyroid disorders. Endocrine 2017; 57: 409-417.
Melnik BC, John SM, Chen W, et al. T helper 17 cell/regulatory T-cell imbalance in hidradenitis suppurativa/acne inversa: the link to hair follicle dissection, obesity, smoking and autoimmune comorbidities. Br J Dermatol. 2018; 179: 260-272.
Klein SL, Flanagan KL. Sex differences in immune responses. Nat Rev Immunol. 2016; 16: 626-638.
Vadasz Z, Haj T, Kessel A, et al. Age-related autoimmunity. BMC Med. 2013; 11: 94.
Vestergaard P. Smoking and thyroid disorders-a meta-analysis. Eur J Endocrinol 2002; 146: 153-161.
Díez JJ, Hernanz A, Medina S, et al. Serum concentrations of tumour necrosis factor-alpha (TNF-alpha) and soluble TNF-alpha receptor p55 in patients with hypothyroidism and hyperthyroidism before and after normalization of thyroid function. Clin Endocrinol (Oxf) 2002; 57: 515-521.
Krassas GE, Wiersinga W. Smoking and autoimmune thyroid disease: the plot thickens. Eur J Endocrinol 2006; 154: 777-780.
Kim SJ, Kim MJ, Yoon SG, et al. Impact of smoking on thyroid gland: dose-related effect of urinary cotinine levels on thyroid function and thyroid autoimmunity. Sci Rep 2019; 9: 4213.

Auteurs

Shany Sherman (S)

Division of Dermatology, Rabin Medical Center (Beilinson Hospital), Petah Tikva, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Dana Tzur Bitan (D)

Department of Behavioral Sciences, Ariel University, Ariel, Israel.
Shalvata Mental Health Center, affiliated with the Sackler School of Medicine, Tel Aviv University, Hod Hasharon, Israel.

Khalaf Kridin (K)

Lubeck Institute of Experimental Dermatology, Lubeck, Germany.

Lev Pavlovsky (L)

Division of Dermatology, Rabin Medical Center (Beilinson Hospital), Petah Tikva, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Emmilia Hodak (E)

Division of Dermatology, Rabin Medical Center (Beilinson Hospital), Petah Tikva, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Arnon D Cohen (AD)

Department of Quality Measurements and Research, Chief Physician Office, Clalit Health Services, Tel Aviv, Israel.
Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH