Respiratory manifestations of hypothyroidism: A systematic review

Jesper Roed Sorensen, Kristian Hillert Winther, Steen Joop Bonnema, Christian Godballe, Laszlo Hegedus

Publikation: Bidrag til tidsskriftReviewForskningpeer review

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Resumé

BACKGROUND: Hypothyroidism has been associated with increased pulmonary morbidity and overall mortality. We conducted a systematic review to identify the prevalence and underlying mechanisms of respiratory problems among patients with thyroid insufficiency.

METHODS: PubMed and EMBASE databases were searched for relevant literature from January 1950 through January 2015 with study eligibility criteria: English-language publications; Adult subclinical or overt hypothyroid patients; Intervention, observational or retrospective studies; and respiratory manifestations. We followed the PRISMA statement and used the Cochrane's risk of bias tool.

RESULTS: A total of 1699 papers were screened by two independent authors for relevant titles. Of 109 relevant abstracts, 28 papers underwent full text analyses, of which 22 were included in the review. We identified possible mechanisms explaining respiratory problems at multiple physiological levels such as the ventilator control system, diaphragmatic muscle function, pulmonary gas exchange, goiter caused upper airway obstruction, decreased capacity for energy transduction, and reduced glycolytic activity. Obstructive sleep apnea syndrome was found among 30% of newly diagnosed patients with overt hypothyroidism, and demonstrated reversibility following treatment. The evidence for or against a direct effect on pulmonary function was ambiguous. However, each of the above mentioned areas were only dealt with in a limited number of studies. Therefore, we refrain from giving strong conclusions on any of these themes. Moreover, most studies were hampered by considerable risk of bias due to e.g. small numbers of patients, lack of control groups, randomization and blinding, and differences in BMI, gender, and age between subjects and controls.

CONCLUSION: Mechanistic data, linking hypothyroidism and respiratory function are at best limited. This area of research is therefore open for retesting hypotheses, using appropriate study designs and methods. Systematic review registration number on PROSPERO: CRD42015016815.

OriginalsprogEngelsk
TidsskriftThyroid
Vol/bind26
Udgave nummer11
Sider (fra-til)1519-1527
ISSN1050-7256
DOI
StatusUdgivet - 2016

Fingeraftryk

Lung
Airway Obstruction
Mechanical Ventilators
Random Allocation
Diaphragm
PubMed
Publications
Language
Retrospective Studies
Databases
Control Groups
Research

Citer dette

Sorensen, Jesper Roed ; Winther, Kristian Hillert ; Bonnema, Steen Joop ; Godballe, Christian ; Hegedus, Laszlo. / Respiratory manifestations of hypothyroidism : A systematic review. I: Thyroid. 2016 ; Bind 26, Nr. 11. s. 1519-1527.
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Respiratory manifestations of hypothyroidism : A systematic review. / Sorensen, Jesper Roed; Winther, Kristian Hillert; Bonnema, Steen Joop; Godballe, Christian; Hegedus, Laszlo.

I: Thyroid, Bind 26, Nr. 11, 2016, s. 1519-1527.

Publikation: Bidrag til tidsskriftReviewForskningpeer review

TY - JOUR

T1 - Respiratory manifestations of hypothyroidism

T2 - A systematic review

AU - Sorensen, Jesper Roed

AU - Winther, Kristian Hillert

AU - Bonnema, Steen Joop

AU - Godballe, Christian

AU - Hegedus, Laszlo

PY - 2016

Y1 - 2016

N2 - BACKGROUND: Hypothyroidism has been associated with increased pulmonary morbidity and overall mortality. We conducted a systematic review to identify the prevalence and underlying mechanisms of respiratory problems among patients with thyroid insufficiency.METHODS: PubMed and EMBASE databases were searched for relevant literature from January 1950 through January 2015 with study eligibility criteria: English-language publications; Adult subclinical or overt hypothyroid patients; Intervention, observational or retrospective studies; and respiratory manifestations. We followed the PRISMA statement and used the Cochrane's risk of bias tool.RESULTS: A total of 1699 papers were screened by two independent authors for relevant titles. Of 109 relevant abstracts, 28 papers underwent full text analyses, of which 22 were included in the review. We identified possible mechanisms explaining respiratory problems at multiple physiological levels such as the ventilator control system, diaphragmatic muscle function, pulmonary gas exchange, goiter caused upper airway obstruction, decreased capacity for energy transduction, and reduced glycolytic activity. Obstructive sleep apnea syndrome was found among 30% of newly diagnosed patients with overt hypothyroidism, and demonstrated reversibility following treatment. The evidence for or against a direct effect on pulmonary function was ambiguous. However, each of the above mentioned areas were only dealt with in a limited number of studies. Therefore, we refrain from giving strong conclusions on any of these themes. Moreover, most studies were hampered by considerable risk of bias due to e.g. small numbers of patients, lack of control groups, randomization and blinding, and differences in BMI, gender, and age between subjects and controls.CONCLUSION: Mechanistic data, linking hypothyroidism and respiratory function are at best limited. This area of research is therefore open for retesting hypotheses, using appropriate study designs and methods. Systematic review registration number on PROSPERO: CRD42015016815.

AB - BACKGROUND: Hypothyroidism has been associated with increased pulmonary morbidity and overall mortality. We conducted a systematic review to identify the prevalence and underlying mechanisms of respiratory problems among patients with thyroid insufficiency.METHODS: PubMed and EMBASE databases were searched for relevant literature from January 1950 through January 2015 with study eligibility criteria: English-language publications; Adult subclinical or overt hypothyroid patients; Intervention, observational or retrospective studies; and respiratory manifestations. We followed the PRISMA statement and used the Cochrane's risk of bias tool.RESULTS: A total of 1699 papers were screened by two independent authors for relevant titles. Of 109 relevant abstracts, 28 papers underwent full text analyses, of which 22 were included in the review. We identified possible mechanisms explaining respiratory problems at multiple physiological levels such as the ventilator control system, diaphragmatic muscle function, pulmonary gas exchange, goiter caused upper airway obstruction, decreased capacity for energy transduction, and reduced glycolytic activity. Obstructive sleep apnea syndrome was found among 30% of newly diagnosed patients with overt hypothyroidism, and demonstrated reversibility following treatment. The evidence for or against a direct effect on pulmonary function was ambiguous. However, each of the above mentioned areas were only dealt with in a limited number of studies. Therefore, we refrain from giving strong conclusions on any of these themes. Moreover, most studies were hampered by considerable risk of bias due to e.g. small numbers of patients, lack of control groups, randomization and blinding, and differences in BMI, gender, and age between subjects and controls.CONCLUSION: Mechanistic data, linking hypothyroidism and respiratory function are at best limited. This area of research is therefore open for retesting hypotheses, using appropriate study designs and methods. Systematic review registration number on PROSPERO: CRD42015016815.

U2 - 10.1089/thy.2015.0642

DO - 10.1089/thy.2015.0642

M3 - Review

C2 - 27673426

VL - 26

SP - 1519

EP - 1527

JO - Thyroid

JF - Thyroid

SN - 1050-7256

IS - 11

ER -