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Increased Risk of Thyroid Disease in Patients With Sjogren's Syndrome: A Systematic Review and Meta-Analysis

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Increased Risk of Thyroid Disease in Patients With Sjogren's Syndrome: A Systematic Review and Meta-Analysis

Xin Sun et al. PeerJ.

Abstract

Background: Sjogren's syndrome (SS) is a chronic autoimmune epithelitis characterized by disruption of epithelial cells, ensuing lymphoplasmocytic infiltration of exocrine glands, and subsequent dryness of the mouth and eyes. Individuals with SS are more likely to have the thyroid disease. However, this association remains controversial. This meta-analysis aimed to evaluate the risk of thyroid disease in patients with SS.

Methods: We performed this systematic review by searching both English and Chinese literature databases. Random- or fixed-effects models were used to summarize the association between thyroid disease and SS. The results were subjected to meta-analysis with odds ratios (ORs) and corresponding 95% confidence intervals (CIs).

Results: The eight articles in this meta-analysis included 988 SS cases and 2,884 controls. Overall, the risk of thyroid disease in patients with SS was significantly increased compared with controls (OR, 3.29; 95% CI [2.08-5.21]). The risk of autoimmune thyroid disease (AITD) and non-AITD were also higher in patients with SS than in controls (OR, 3.48; 95% CI [1.59-7.63]; and OR, 2.90; 95% CI [1.51-5.57], respectively).

Conclusions: To the best of our knowledge, this systematic review is the first to demonstrate that the risk of thyroid disease was increased in SS compared to controls, suggesting that SS patients should be screened for thyroid disease.

Keywords: Incidence; Sjogren's syndrome; Thyroid disease.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1. Flow chart showing the detailed procedure for study inclusion or exclusion.
The initial search retrieved 1006 articles from PubMed, Web of Science, Embase, and CNKI. After selection, eight articles were included.
Figure 2
Figure 2. Forest plots of the frequency of thyroid disease in patients with Sjogren’s syndrome versus controls.
Diamond, pooled odds ratio (OR), and 95% confidence interval (CI).
Figure 3
Figure 3. Forest plots of the frequency of autoimmune thyroid disease (AITD) and non-AITD in patients with Sjogren’s syndrome compared with the controls.
Diamond, pooled odds ratio (OR), and 95% confidence interval (CI).
Figure 4
Figure 4. Forest plots of the frequency of hyperthyroidism and hypothyroidism in patients with Sjogren’s syndrome versus controls.
Diamond, pooled odds ratio (OR), and 95% confidence interval (CI).
Figure 5
Figure 5. Sensitivity analysis results.
The sensitivity analysis was performed to examine the influence of any particular study. There was no significant difference in results of the sensitivity analysis and our previous estimates, indicating that our statistics were relatively credible.
Figure 6
Figure 6. Publication bias results.
Begg’s test was used to determine whether potential publication bias existed in the reviewed studies. The results suggested that there were no publication bias.

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Grant support

This research was financially supported by the National Natural Science Foundation of China (grant number 81800697). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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