Thyroid Diseases and Chronic Rhinosinusitis: A Nested Case–Control Study Using a National Health Screening Cohort
Abstract
:1. Introduction
2. Materials and Methods
2.1. Ethics
2.2. Study Population and Participant Selection
2.3. Exposure (Thyroid Diseases)
- (1)
- Hypothyroidism was defined by the presence of the ICD-10 diagnostic codes E02 (subclinical iodine-deficiency hypothyroidism) or E03 (other hypothyroidism). We chose participants from among eligible hypothyroid patients who had been treated for hypothyroidism ≥ 2 times.
- (2)
- Hyperthyroidism was defined according to the presence of the ICD-10 diagnostic code E05 (hyperthyroidism (thyrotoxicosis)). Among eligible patients with hyperthyroidism, we selected participants who had been treated for hyperthyroidism ≥ 2 times.
- (3)
- Thyroiditis was defined according to the presence of the ICD-10 diagnostic code E06 (thyroiditis). Among eligible patients with thyroiditis, we selected participants who had been treated for thyroiditis ≥ 2 times.
- (4)
- Autoimmune thyroiditis was defined according to the presence of the ICD-10 diagnostic code E063 (autoimmune thyroiditis). Among eligible patients with autoimmune thyroiditis, we selected participants who had been treated for autoimmune thyroiditis ≥ 2 times.
- (5)
- Graves’ disease was defined according to the presence of the ICD-10 diagnostic code E050 (thyrotoxicosis with diffuse goiter). Among eligible patients with Graves’ disease, we selected participants who had been treated with anti-thyroid drugs for ≥3 months.
2.4. Outcome (CRS)
2.5. Covariates
2.6. Statistical Analyses
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristics | Total Participants | ||
---|---|---|---|
Total CRS | Control | ** Standardized Difference | |
Age (years old, n, %) | 0.00 | ||
40–44 | 229 (3.8) | 916 (3.8) | |
45–49 | 954 (15.8) | 3816 (15.8) | |
50–54 | 1294 (21.5) | 5176 (21.5) | |
55–59 | 1273 (21.1) | 5092 (21.1) | |
60–64 | 973 (16.2) | 3892 (16.2) | |
65–69 | 694 (11.5) | 2776 (11.5) | |
70–74 | 379 (6.3) | 1516 (6.3) | |
75–79 | 167 (2.8) | 668 (2.8) | |
80–84 | 50 (0.8) | 200 (0.8) | |
85+ | 11 (0.2) | 44 (0.2) | |
Sex (n, %) | 0.00 | ||
Males | 3747 (62.2) | 14,988 (62.2) | |
Females | 2277 (37.8) | 9108 (37.8) | |
Income (n, %) | 0.00 | ||
1 (lowest) | 741 (12.3) | 2964 (12.3) | |
2 | 711 (11.8) | 2844 (11.8) | |
3 | 918 (15.2) | 3672 (15.2) | |
4 | 1317 (21.9) | 5268 (21.9) | |
5 (highest) | 2337 (38.8) | 9348 (38.8) | |
Region of residence (n, %) | 0.00 | ||
Urban | 2791 (46.3) | 11,164 (46.3) | |
Rural | 3233 (53.7) | 12,932 (53.7) | |
Total cholesterol (mg/dL, mean, SD) | 197.3 (37.3) | 199.1 (37.6) | 0.05 |
SBP (mmHg, mean, SD) | 125.5 (16.1) | 126.5 (16.6) | 0.06 |
DBP (mmHg, mean, SD) | 78.4 (10.6) | 78.9 (10.9) | 0.05 |
Fasting blood glucose (mg/dL, mean, SD) | 99.6 (32.0) | 100.6 (30.4) | 0.03 |
Levothyroxine medication dates (days, mean, SD) | 70.3 (464.7) | 42.3 (349.0) | 0.07 |
Obesity (n, %) * | 0.07 | ||
Underweight | 103 (1.7) | 541 (2.3) | |
Normal | 1947 (32.3) | 8386 (34.8) | |
Overweight | 1786 (29.7) | 6728 (27.9) | |
Obese I | 2018 (33.5) | 7785 (32.3) | |
Obese II | 170 (2.8) | 656 (2.7) | |
Smoking status (n, %) | 0.07 | ||
Nonsmoker | 3931 (65.3) | 15,506 (64.4) | |
Past smoker | 896 (14.9) | 3188 (13.2) | |
Current smoker | 1197 (19.9) | 5402 (22.4) | |
Alcohol consumption (n, %) | 0.01 | ||
<1 time a week | 3923 (65.1) | 15,537 (64.5) | |
≥1 time a week | 2101 (34.9) | 8559 (35.5) | |
CCI score (score, n, %) | 0.16 | ||
0 | 3967 (65.9) | 17,590 (73.0) | |
1 | 1002 (16.6) | 3077 (12.8) | |
≥2 | 1055 (17.5) | 3429 (14.2) | |
Thyroid diseases (n, %) | |||
Hypothyroidism | 166 (2.8) | 432 (1.8) | 0.06 |
Hyperthyroidism | 121 (2.0) | 353 (1.5) | 0.04 |
Thyroiditis | 64 (1.1) | 182 (0.8) | 0.03 |
Autoimmune thyroiditis | 23 (0.4) | 77 (0.3) | 0.01 |
Graves’ disease | 16 (0.3) | 43 (0.2) | 0.02 |
Characteristics | CRS | Control | Odds Ratios for CRS | |||||||
---|---|---|---|---|---|---|---|---|---|---|
(Exposure/Total, %) | (Exposure/Total, %) | Crude † | p-Value | Model 1 †,‡ | p-Value | Model 2 †,§ | p-Value | Model 3 †,‖ | p-Value | |
Hypo- thyroidism | 166/6024 (2.8) | 432/24,096 (1.8) | 1.56 (1.30–1.88) | <0.001 * | 1.31 (1.05–1.63) | 0.018 * | 1.25 (1.00–1.57) | 0.050 * | 1.31 (1.05–1.64) | 0.017 * |
Hyper- thyroidism | 121/6024 (2.0) | 353/24,096 (1.5) | 1.38 (1.12–1.70) | 0.003 * | 1.28 (1.03–1.58) | 0.024 * | 1.22 (0.99–1.52) | 0.068 | N/A | |
Thyroiditis | 64/6024 (1.1) | 182/24,096 (0.8) | 1.42 (1.06–1.89) | 0.018 * | 1.23 (0.92–1.66) | 0.167 | 1.14 (0.84–1.54) | 0.405 | N/A | |
Autoimmune thyroiditis | 23/6024 (0.4) | 77/24,096 (0.3) | 1.20 (0.75–1.91) | 0.452 | 0.98 (0.61–1.58) | 0.928 | N/A | 0.89 (0.55–1.45) | 0.641 | |
Graves’ disease | 16/6024 (0.3) | 43/24,096 (0.2) | 1.49 (0.84–2.65) | 0.174 | 1.42 (0.80–2.53) | 0.234 | N/A | 1.41 (0.79–2.52) | 0.245 |
Characteristics | CRS with Nasal Polyp | Control | Odds Ratios for CRS with Nasal Polyp | |||||||
---|---|---|---|---|---|---|---|---|---|---|
(Exposure/Total, %) | (Exposure/Total, %) | Crude † | p-Value | Model 1 †,‡ | p-Value | Model 2 †,§ | p-Value | Model 3 †,‖ | p-Value | |
Hypo- thyroidism | 61/2901 (2.1) | 173/11,604 (1.5) | 1.43 (1.06–1.92) | 0.019 * | 1.25 (0.87–1.78) | 0.223 | 1.25 (0.87–1.79) | 0.228 | 1.29 (0.90–1.84) | 0.167 |
Hyper- thyroidism | 44/2901 (1.5) | 149/11,604 (1.3) | 1.19 (0.84–1.66) | 0.328 | 1.13 (0.80–1.59) | 0.489 | 1.12 (0.79–1.60) | 0.514 | N/A | |
Thyroiditis | 17/2901 (0.6) | 70/11,604 (0.6) | 0.97 (0.57–1.66) | 0.914 | 0.88 (0.51–1.51) | 0.637 | 0.82 (0.47–1.43) | 0.477 | N/A | |
Autoimmune thyroiditis | 5/2901 (0.2) | 37/11,604 (0.3) | 0.54 (0.21–1.37) | 0.195 | 0.44 (0.17–1.14) | 0.091 | N/A | 0.38 (0.15–1.00) | 0.051 | |
Graves’ disease | 8/2901 (0.3) | 19/11,604 (0.2) | 1.69 (0.74–3.85) | 0.216 | 1.66 (0.73–3.81) | 0.230 | N/A | 1.86 (0.80–4.33) | 0.153 |
Characteristics | CRS without Nasal Polyp | Control | Odds Ratios for CRS without Nasal Polyp | |||||||
---|---|---|---|---|---|---|---|---|---|---|
(Exposure/Total, %) | (Exposure/Total, %) | Crude † | p-Value | Model 1 †,‡ | p-Value | Model 2 †,§ | p-Value | Model 3 †,‖ | p-Value | |
Hypo- thyroidism | 105/3123 (3.4) | 259/12,492 (2.1) | 1.66 (1.31–2.09) | <0.001 * | 1.32 (1.00–1.75) | 0.054 | 1.23 (0.92–1.64) | 0.156 | 1.29 (0.97–1.71) | 0.083 |
Hyper- thyroidism | 77/3123 (2.5) | 204/12,492 (1.6) | 1.53 (1.17–1.99) | 0.002 * | 1.38 (1.05–1.81) | 0.021 * | 1.31 (0.99–1.72) | 0.060 | N/A | |
Thyroiditis | 47/3123 (1.5) | 112/12,492 (0.9) | 1.70 (1.20–2.40) | 0.003 * | 1.45 (1.02–2.07) | 0.041 * | 1.34 (0.93–1.93) | 0.114 | N/A | |
Autoimmune thyroiditis | 18/3123 (0.6) | 40/12,492 (0.3) | 1.81 (1.03–3.16) | 0.038 * | 1.51 (0.85–2.67) | 0.161 | N/A | 1.39 (0.78–2.49) | 0.262 | |
Graves’ disease | 8/3123 (0.3) | 24/12,492 (0.2) | 1.33 (0.60–2.97) | 0.481 | 1.22 (0.54–2.74) | 0.630 | N/A | 1.22 (0.54–2.73) | 0.636 |
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Choi, H.G.; Kim, T.J.; Hong, S.K.; Min, C.; Yoo, D.M.; Kim, H.; Lee, J.S. Thyroid Diseases and Chronic Rhinosinusitis: A Nested Case–Control Study Using a National Health Screening Cohort. Int. J. Environ. Res. Public Health 2022, 19, 8372. https://doi.org/10.3390/ijerph19148372
Choi HG, Kim TJ, Hong SK, Min C, Yoo DM, Kim H, Lee JS. Thyroid Diseases and Chronic Rhinosinusitis: A Nested Case–Control Study Using a National Health Screening Cohort. International Journal of Environmental Research and Public Health. 2022; 19(14):8372. https://doi.org/10.3390/ijerph19148372
Chicago/Turabian StyleChoi, Hyo Geun, Tae Jun Kim, Sung Kwang Hong, Chanyang Min, Dae Myoung Yoo, Heejin Kim, and Joong Seob Lee. 2022. "Thyroid Diseases and Chronic Rhinosinusitis: A Nested Case–Control Study Using a National Health Screening Cohort" International Journal of Environmental Research and Public Health 19, no. 14: 8372. https://doi.org/10.3390/ijerph19148372